Thorax:遗传引起的血清胆红素水平升高与肺癌发病率

2020-09-24 xiangting MedSci原创

遗传引起的血清胆红素升高在人群中普遍存在,可以保护暴露于高水平烟雾氧化剂的人群免受肺癌的侵害。

有研究表明,血清胆红素水平升高与肺癌发病率下降有关,尤其是在吸烟者中。这种关联是否与胆红素的抗氧化特性或残留混杂有关目前尚不清楚。

这项研究使用孟德尔随机抽样(MR)和英国生物银行分析了血清总胆红素与肺癌发病率之间的潜在因果关系。

研究人员使用两种变体(rs887829和rs4149056)检测血清总胆红素水平,这两种变体占人群水平变异性40%,并与轻度遗传性高胆红素血症相关。从国家癌症登记中确定入组后发生的肺癌事件。

MR分析包括377294名参与者(中位胆红素8.1μmol/L(IQR 6.4-10.4))和2002个肺癌事件。观察到胆红素水平每升高5μmol/L,肺癌发病率就会降低1.2/10000 PY(95%CI 0.7-1.8)。相应的MR估计值为降低0.8/10000PY(95%CI为0.1-1.4)。在当前吸烟者中这种关联最强,胆红素水平每升高5μmol/L与肺癌发病率下降10.2/10000 PY相关(95%CI 5.5-15.0),MR估计值为6.4/10000 PY(95%CI 1.4-11.5)。对于重度吸烟者(≥20/天),MR估计为发病率降低23.1/10000 PY(95%CI 7.3-38.9)。不吸烟者中没有这种关联,也没有呼吸功能的调节。

由此可见,遗传引起的血清胆红素升高在人群中普遍存在,可以保护暴露于高水平烟雾氧化剂的人群免受肺癌的侵害。

原始出处:

Laura Jane Horsfall. Genetically raised serum bilirubin levels and lung cancer: a cohort study and Mendelian randomisation using UK Biobank. Thorax. August 2020.

 

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