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  • 1
    Keywords: cohort study ; EPIDEMIOLOGY ; HEPATOCELLULAR-CARCINOMA ; hepatocellular carcinoma ; UNITED-STATES ; DIABETES-MELLITUS ; ALCOHOL-CONSUMPTION ; INCIDENCE RATES ; VIRUS-INFECTION ; metabolic syndrome ; US ADULTS ; REGRESSION DILUTION ; INTERNATIONAL TRENDS ; intrahepatic cholangiocarcinoma ; TOTAL SERUM-CHOLESTEROL
    Abstract: Initial studies have indicated diabetes and obesity to be risk factors for hepatocellular carcinoma; but the association between other metabolic risk factors and primary liver cancer (PLC) has not been investigated. The metabolic syndrome and cancer project (Me-Can) includes cohorts from Norway, Austria and Sweden with data on 578,700 subjects. We used Cox proportional hazard models to calculate relative risks (RRs) of PLC by body mass index (BMI), blood pressure and plasma levels of glucose, cholesterol and triglycerides as continuous standardized variables (z-score with mean = 0 and standard deviation (SD) = 1) and their standardized sum of metabolic syndrome (MetS) z-score. RRs were corrected for random error in measurements. During an average follow-up of 12.0 years (SD = 7.8), 266 PLCs were diagnosed among cohort members. RR of liver cancer per unit increment of z-score adjusted for age, smoking status and BMI and stratified by birth year, sex and sub-cohorts, was for BMI 1.39 (95% confidence interval (CI) 1.24-1.58), mid blood pressure 2.08 (0.95-4.73), blood glucose 2.13 (1.55-2.94) cholesterol 0.62 (0.51-0.76) and serum triglycerides 0.85 (0.65-1.10). The RR per one unit increment of the MetS z-score was 1.35 (1.12-1.61). BMI, glucose and a composite MetS score were positively and cholesterol negatively associated with risk of liver cancer.
    Type of Publication: Journal article published
    PubMed ID: 21805476
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  • 2
    Keywords: FOLLOW-UP ; COHORT ; MORTALITY ; BLOOD-PRESSURE ; DIABETES-MELLITUS ; METAANALYSIS ; BODY-MASS INDEX ; CUTANEOUS MALIGNANT-MELANOMA ; BASAL-CELL CARCINOMA ; REGRESSION DILUTION
    Abstract: Background Little is known about the associations of metabolic aberrations with malignant melanoma (MM) and nonmelanoma skin cancer (NMSC). Objectives To assess the associations between metabolic factors (both individually and combined) and the risk of skin cancer in the large prospective Metabolic Syndrome and Cancer Project (Me-Can). Methods During a mean follow-up of 12 years of the Me-Can cohort, 1728 (41% women) incident MM, 230 (23% women) fatal MM and 1145 (33% women) NMSC were identified. Most NMSC cases (76%) were squamous cell carcinoma (SCC) (873, 33% women). Hazard ratios (HRs) were estimated by Cox proportional hazards regression for quintiles and standardized z-scores (with a mean of 0 and SD of 1) of body mass index (BMI), blood pressure, glucose, cholesterol, triglycerides and for a combined metabolic syndrome score. Risk estimates were corrected for random error in the measurements. Results Blood pressure per unit increase of z-score was associated with an increased risk of incident MM cases in men and women [HR 1.17, 95% confidence interval (CI) 1.04-1.31 and HR 1.18, 95% CI 1.03-1.36, respectively] and fatal MM cases among women (HR 2.39, 95% CI 1.58-3.64). In men, all quintiles for BMI above the reference were associated with a higher risk of incident MM. In women, SCC NMSC risk increased across quintiles for glucose levels (P-trend 0.02) and there was a trend with triglyceride concentration (P-trend 0.09). Conclusion These findings suggest that mechanisms linked to blood pressure may be involved in the pathogenesis of MM. SCC NMSC in women could be related to glucose and lipid metabolism.
    Type of Publication: Journal article published
    PubMed ID: 22530854
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