前瞻性肝硬化队列中的血镁水平与肝细胞癌风险。

IF 3.7 3区 医学 Q2 ONCOLOGY Cancer Epidemiology Biomarkers & Prevention Pub Date : 2024-10-02 DOI:10.1158/1055-9965.EPI-24-0327
Xinyuan Zhang, Longgang Zhao, Qi Dai, Tao Hou, Christopher J Danford, Michelle Lai, Xuehong Zhang
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引用次数: 0

摘要

背景:较高的镁摄入量与较低的肝细胞癌(HCC)风险有关。然而,血镁水平与 HCC 之间的关系尚未完全定性,尤其是在 HCC 风险较高的肝硬化患者中:在麻省总医院布里格姆生物库中,我们使用有效的国际疾病分类代码建立了一个新的前瞻性队列,其中包括 1460 名无肝癌病史的肝硬化患者。我们使用 Cox 比例危险模型得出了发生 HCC 的危险比(HRs)及 95% 置信区间(CIs),并使用广义估计方程比较了肝脏生物标志物随基线血镁变化的情况,同时调整了年龄、性别、种族、生活方式、体重指数、2 型糖尿病、终末期肝病评分模型和肝炎感染等因素:在中位 4.26 年的随访期间,109 人罹患 HCC。镁缺乏血镁水平较低与较高的 HCC 风险和不利的肝脏生物标志物变化有关:如果得到证实,我们的研究结果可能有助于更好地识别HCC高风险患者,并为肝硬化的更好管理策略提供依据。
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Blood Magnesium Level and Risk of Hepatocellular Carcinoma in a Prospective Liver Cirrhosis Cohort.

Background: Higher magnesium intake was linked to a lower risk of hepatocellular carcinoma (HCC). However, the relationship between blood magnesium level and HCC has not been fully characterized, especially among patients with liver cirrhosis who are at a higher risk for HCC.

Methods: In the Mass General Brigham Biobank, we developed a new prospective cohort of 1,430 patients with liver cirrhosis without liver cancer history using the validated International Classification of Diseases codes. We used Cox proportional hazards models to generate hazard ratios (HRs) with 95% confidence intervals (CI) for incident HCC and used generalized estimating equations to compare changes in liver biomarkers according to baseline blood magnesium, adjusting for age, sex, race, lifestyles, body mass index, type 2 diabetes, model for end-stage liver disease score, and hepatitis infection.

Results: During a median follow-up period of 4.26 years, 109 patients developed HCC. Magnesium deficiency (<1.70 mg/dL; N = 158) was associated with a higher risk of HCC (HR = 1.93; 95% CI, 1.12-3.30) compared with magnesium sufficiency (≥1.70 mg/dL; N = 1282). This association remained robust in the 1-year lag analysis (HR = 2.18; 95% CI, 1.11-4.28) and in sensitivity analysis excluding patients with alcoholic liver disease (HR = 2.41; 95% CI, 1.23-4.74). Magnesium in the lowest quartile was associated with a faster increase in alanine transaminase (β = 4.35; 95% CI, 1.06-7.63), aspartate aminotransferase (β = 6.46; 95% CI, 0.28-12.6), direct bilirubin (β = 0.18; 95% CI, 0.01-0.35), and total bilirubin (β = 0.21; 95% CI, 0.03-0.39), compared with the highest quartile.

Conclusions: Lower blood magnesium level is associated with higher HCC risk and unfavorable liver biomarker changes.

Impact: If confirmed, our findings may potentially enable better identification of high-risk patients for HCC and inform better management strategies for liver cirrhosis.

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来源期刊
Cancer Epidemiology Biomarkers & Prevention
Cancer Epidemiology Biomarkers & Prevention 医学-公共卫生、环境卫生与职业卫生
CiteScore
6.50
自引率
2.60%
发文量
538
审稿时长
1.6 months
期刊介绍: Cancer Epidemiology, Biomarkers & Prevention publishes original peer-reviewed, population-based research on cancer etiology, prevention, surveillance, and survivorship. The following topics are of special interest: descriptive, analytical, and molecular epidemiology; biomarkers including assay development, validation, and application; chemoprevention and other types of prevention research in the context of descriptive and observational studies; the role of behavioral factors in cancer etiology and prevention; survivorship studies; risk factors; implementation science and cancer care delivery; and the science of cancer health disparities. Besides welcoming manuscripts that address individual subjects in any of the relevant disciplines, CEBP editors encourage the submission of manuscripts with a transdisciplinary approach.
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