Serum lipid levels and the risk of biliary tract cancers and biliary stones: A population-based study in China
Corresponding Author
Gabriella Andreotti
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, Bethesda, MD
Fax: +301-402-1819
Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd., EPS 8011, MSC 7240, Bethesda, MD 20892, USASearch for more papers by this authorJinbo Chen
Department of Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA
Search for more papers by this authorYu-Tang Gao
Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China
Search for more papers by this authorAsif Rashid
Department of Pathology, M.D. Anderson Cancer Center, Houston, TX
Search for more papers by this authorShih-Chen Chang
Department of Discovery Medicine and Epidemiology, AstraZeneca, Wilmington, DE
Search for more papers by this authorMing-Chang Shen
Shanghai Tumor Hospital, Fudan University, Shanghai, China
Search for more papers by this authorBing-Sheng Wang
Zhongshan Hospital, Fudan University, Shanghai, China
Search for more papers by this authorTian-Quan Han
Department of Surgery, Ruijin Hospital, Second Medical University, Shanghai, China
Search for more papers by this authorBai-He Zhang
Institute of Oriental Hepatobiliary Surgery, Second Military University, Shanghai, China
Search for more papers by this authorKim N. Danforth
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, Bethesda, MD
Search for more papers by this authorMichelle D. Althuis
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, Bethesda, MD
Search for more papers by this authorAnn W. Hsing
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, Bethesda, MD
Search for more papers by this authorCorresponding Author
Gabriella Andreotti
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, Bethesda, MD
Fax: +301-402-1819
Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd., EPS 8011, MSC 7240, Bethesda, MD 20892, USASearch for more papers by this authorJinbo Chen
Department of Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA
Search for more papers by this authorYu-Tang Gao
Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China
Search for more papers by this authorAsif Rashid
Department of Pathology, M.D. Anderson Cancer Center, Houston, TX
Search for more papers by this authorShih-Chen Chang
Department of Discovery Medicine and Epidemiology, AstraZeneca, Wilmington, DE
Search for more papers by this authorMing-Chang Shen
Shanghai Tumor Hospital, Fudan University, Shanghai, China
Search for more papers by this authorBing-Sheng Wang
Zhongshan Hospital, Fudan University, Shanghai, China
Search for more papers by this authorTian-Quan Han
Department of Surgery, Ruijin Hospital, Second Medical University, Shanghai, China
Search for more papers by this authorBai-He Zhang
Institute of Oriental Hepatobiliary Surgery, Second Military University, Shanghai, China
Search for more papers by this authorKim N. Danforth
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, Bethesda, MD
Search for more papers by this authorMichelle D. Althuis
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, Bethesda, MD
Search for more papers by this authorAnn W. Hsing
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, Bethesda, MD
Search for more papers by this authorAbstract
Biliary tract cancers, encompassing the gallbladder, extrahepatic bile ducts and ampulla of Vater, are rare but highly fatal malignancies. Gallstones, the predominant risk factor for biliary cancers, are linked with hyperlipidemia. As part of a population-based case-control study conducted in Shanghai, China, we examined the associations of serum lipid levels with biliary stones and cancers. We included 460 biliary cancer cases (264 gallbladder, 141 extrahepatic bile duct, and 55 ampulla of Vater), 981 biliary stone cases and 858 healthy individuals randomly selected from the population. Participants completed an in-person interview and gave overnight fasting blood samples. Participants in the highest quintile of triglycerides (≥160 mg/dl) had a 1.4-fold risk of biliary stones (95% CI = 1.1–1.9), a 1.9-fold risk of gallbladder cancer (95% CI = 1.3–2.8), and a 4.8-fold risk of bile duct cancer (95% CI = 2.8–8.1), compared to the reference group (third quintile: 90–124 mg/dl). Participants in the lowest quintile of high-density lipoprotein (HDL) (<30 mg/dl) had a 4.2-fold risk of biliary stones (95% CI = 3.0–6.0), an 11.6-fold risk of gallbladder cancer (95% CI = 7.3–18.5), and a 16.8-fold risk of bile duct cancer (95% CI = 9.1–30.9), relative to the reference group (third quintile: 40–49 mg/dl). In addition, total cholesterol, low-density lipoprotein (LDL) and apolipoprotein A (apo A) were inversely associated with biliary stones; whereas low levels as well as high levels of total cholesterol, LDL, apo A and apolipoprotein B (apo B) were associated with excess risks of biliary tract cancers. Our findings support a role for serum lipids in gallstone development and biliary carcinogenesis. © 2007 Wiley-Liss, Inc.
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