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Total cholesterol, alanine aminotransferase and the risk of primary liver cancer: A population-based prospective study.
Sun, M, Wang, W, Liu, X, Wang, Y, Cui, H, Liu, S, Cao, L
Medicine. 2021;(18):e25746
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Abstract
Previous studies have shown that serum total cholesterol (TC) and serum alanine aminotransferase (ALT) are associated with liver cancer risk. However, the common contribution of TC and normal-high ALT to primary liver cancer (PLC) has not been reported. We aim to assess the separate and joint effect of low TC level and normal-high ALT level on the risk of PLC, a large prospective cohort was conducted in our study.The participants were divided into 4 groups via the cross-matching method according to TC [low level (-)/non-low level (+)] and ALT [normal level (-)/normal-high level(+)] status, and using the lower quartile value of TC and the upper quartile value of ALT as a threshold, respectively. Incident PLC was confirmed by review of medical records. Cox proportional hazards regression models and interactive additive models were used to evaluate whether the joint effect of low TC level and normal-high ALT level is associated with the risk of PLC.During 1,248,895 person-years follow-up, 298 participants were diagnosed with PLC among 114,972 subjects. In male population, TC < 4.24 mmol/L was group "TC (-)"; TC ≥ 4.24 mmol/L was group "TC (+)"; ALT < 23 U/L was group "ALT (-)": 33 U/L ≥ ALT ≥ 23 U/L was group "ALT (+)". Compared with the group "TC (+)", group "ALT (-)", respectively, the adjusted hazard ratio (HR) and 95% confidence interval (95%CI) for PLC risk was 1.74 (1.36-2.25) in group "TC (-)" and 1.49 (1.15-1.94) in group "ALT (+)". In combinatorial analysis, compared with group "TC (+) and ALT (-)", the significant increased risk of PLC were observed in group "TC (+) and ALT (+)" (HR = 1.41; 95% confidence intervals [CI]: 1.02-1.95), group "TC (-) and ALT (-)" (HR = 1.67; 95%CI: 1.24-2.27) and group "TC (-) and ALT (+)" (HR = 2.72; 95%CI: 1.81-4.09), respectively. However, no statistical significance was found among female.The separate and joint effect of low TC level and normal-high ALT level was observed for PLC risk in males. When combined, individuals with coexistence of low TC level and normal-high ALT level significantly increase the risk of PLC.
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[The changing trend of serum total cholesterol in Beijing population aged 25 - 64 years during 1984 - 1999].
Sun, JY, Zhao, D, Wang, W, Liu, J, Li, Y, Liu, S, Jia, YN, Wu, ZS
Zhonghua nei ke za zhi. 2006;(12):980-4
Abstract
OBJECTIVE To describe the changing trend of serum total cholesterol (TC) in Beijing population aged 25 - 64 years old from 1984 to 1999 and to explore the distributions of hypercholesterolemia in different subgroups. METHODS From 1984 to 1999, five independent cardiovascular diseases (CVD) risk factors surveys with the same protocol were conducted in Beijing population aged 25 - 64 years. Stratified-random sampling was used. RESULTS (1) In the period from 1984 to 1999, the mean level of TC increased 1.058 mmol/L (25.1%) in Beijing population aged 25 - 64. The mean level of TC showed increase trends in different genders and age groups, with the greatest increase of 0.998 mmol/L (25.9%) being in the 25 - 34 age group. The mean level of TC was higher in urban subjects than in rural subjects, whereas the increment of TC level was higher in the rural subjects (32.8%) than in urban subjects (26.3%). (2) The prevalence of hypercholesterolemia increased from 6.1% in 1984 to 29.9% in 1999, with 23.8% of the increase during the 15 years. Among different subgroups, both the lowest prevalence of hypercholesterolemia and the greatest increase of hypercholesterolemia prevalence were shown in men aged 25 - 34 years old, with a 16.4 fold increase in 15 years. CONCLUSION The increase trends of mean TC level and hypercholesterolemia prevalence were observed in Beijing population during 1984 - 1999, especially in rural subjects and men aged 25 - 34 years old.