| 张佳奕,全晓薇,朱滕滕,等.老年人群代谢综合征及其组分的组合模式和理想指标与肺癌发病风险的关联研究[J].肿瘤学杂志,2025,31(12):1056-1063. |
| 老年人群代谢综合征及其组分的组合模式和理想指标与肺癌发病风险的关联研究 |
| Association of Combination Patterns and Ideal Metrics with the Risk of Lung Cancer Based on Metabolic Syndrome in Older Adults |
| 投稿时间：2025-01-14 |
| DOI：10.11735/j.issn.1671-170X.2025.12.B008 |
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| 中文关键词: 代谢综合征 肺肿瘤 血糖 血脂 理想指标 老年人 队列研究 |
| 英文关键词:metabolic syndrome lung neoplasms blood glucose lipids ideal metrics elderly cohort study |
| 基金项目:国家自然科学基金青年科学基金项目（82304234）；上海市科委“科技创新行动计划”启明星培育（扬帆专项）（22YF1421200） |
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| 中文摘要: |
| 摘 要：［目的］ 探讨老年人群中代谢综合征（metabolic syndrome，MS）及其组分的组合模式与肺癌发病风险的关联，探索控制代谢指标至理想范围对其关联的影响。［方法］ 基于英国生物银行数据库（UK Biobank，UKB）构建年龄≥60岁的前瞻性老年人队列，采用血压、甘油三酯、高密度脂蛋白胆固醇（high density lipoprotein cholesterol，HDL-C）、空腹血糖和中心性肥胖定义MS。采用Yule’s Q距离和分层聚类探索代谢综合征组分的不同组合模式。依据UKB药物编码及MS诊断标准定义理想代谢指标。使用Cox比例风险回归模型分析老年人群MS、MS组分、MS组分的组合模式及理想代谢指标与肺癌发病风险的关联，并计算风险比（hazard ratio，HR）及其95%置信区间（confidence interval，CI）。［结果］ 在老年人群中，MS会增加肺癌发病风险（HR=1.29，95%CI：1.16~1.43），低HDL-C、中心性肥胖和高血糖是肺癌发病的独立危险因素（HR=1.23，95%CI：1.11~1.35；HR=1.35，95%CI：1.19~1.52；HR=1.21，95%CI：1.07~1.38）；血压和甘油三酯升高是老年人群MS组分组合模式的核心，两病、三病（结合腰围升高）和四病（结合腰围升高和HDL-C降低）组合的HR分别为1.30（95%CI：1.17~1.46）、1.35（95%CI：1.18~1.56）和1.50（95%CI：1.27~1.76）。此外，与糖尿病组合的MS患者增加36%的肺癌发病风险，控制理想的血糖可以降低16%的肺癌发病风险；与低HDL-C组合的MS患者增加35%的肺癌发病风险，控制理想的HDL-C可以降低19%的肺癌发病风险。［结论］ 在老年人群中，MS与肺癌发病风险增加有关，理想的血糖和血脂相关代谢指标可以降低肺癌发病风险。 |
| 英文摘要: |
| Abstract： ［Objective］ To investigate the association of metabolic syndrome (MS) and the combinatorial patterns of its components with the risk of lung cancer in older adults and to explore the impact of ideal metabolic metrics on the lung cancer risk. ［Methods］ A prospective cohort of older adults aged ≥60 years old was constructed using the UK Biobank (UKB) database， and MS was defined according to blood pressure， triglycerides， high-density lipoprotein cholesterol (HDL-C)， fasting blood glucose levels and central obesity. Yule’s Q distance and hierarchical clustering were used to explore different combinatorial patterns of MS components. Ideal metabolic metrics were defined based on UKB drug codes and MS diagnostic criteria. Cox proportional risk regression was adopted to analysis the associations of MS， MS components， MS combination patterns and ideal metrics of MS with the risk of lung cancer in older adults， and the hazard ratio (HR) and its 95% confidence interval (CI) were calculated. ［Results］ MS in older adults increased the risk of lung cancer (HR=1.29， 95%CI： 1.16~1.43)， and reduced HDL-C， central obesity， and elevated blood glucose were independent risk factors for lung cancer development (HR=1.23， 95%CI： 1.11~1.35； HR=1.35， 95%CI： 1.19~1.52； HR=1.21， 95%CI： 1.07~1.38)； elevated blood pressure and triglycerides were central to the patterns of the combinations of MS components in older adults， with HRs (95%CI) of 1.30 (1.17~1.46)， 1.35 (1.18~1.56) and 1.50 (1.27~1.76) for two-， three- (combined with elevated waist circumference)， and four-disease(combined with elevated waist circumference + reduced HDL-C) combinations， respectively. In addition， combination with elevated blood glucose in elderly MS patients increased the risk of lung cancer by 36%， and ideal blood glucose control reduced the risk of lung cancer by 16%； combination with reduced HDL-C in older MS patients increased the risk of lung cancer by 35%， and ideal HDL-C control reduced the risk of lung cancer by 19%. ［Conclusion］ MS in older adults is associated with an increased risk of lung cancer， ideal blood glucose and lipid-related metabolic metrics can reduce the risk of lung cancer. |
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