高血脂病人增加罹患膀胱癌之風險: 全人口資料庫研究
賴宗豪1、石宏仁1、溫玉清1、黃俊仁2
1台北市立萬芳醫院 泌尿科；2台北市立萬芳醫院 麻醉科
Hyperlipidemia increase risk of bladder cancer: a population-based study
Chung-Howe Lai1, Hung-Jen Shih1, Yu-Ching Wen1, Chun-Jen Huang2
1Department of Urology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
2Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
Purpose: Hyperlipidemia enhanced systemic inflammatory response and oxidative stress in human. Chronic inflammation is associated to the bladder cancer occurrence in epidemiologic and experimental evidence. However, whether hyperlipidemia is associated with bladder cancer remains unknown. This population-based study elucidated whether hyperlipidemia is associated with an increased risk of bladder cancer.
Materials and Methods: We used a new-exposure design and analyzed data retrieved from Taiwan National Health Insurance Database between January 1, 2000 and December 31, 2013. The cohort of men with newly diagnosed hyperlipidemia and the age- and index date-matched (1: 1) non-hyperlipidemia cohort were tracked for incidence of bladder cancer. The diagnosis of hyperlipidemia and bladder cancer using the International Classification of Diseases, Ninth Revision, Clinical Modification codes. The confounders included this study were diabetes mellitus, hypertension, chronic obstructive pulmonary disease, obesity, uremia, aspirin, non-steroidal anti-inflammatory drugs, metformin, rosiglitazone, pioglitazone use. Hazard ratio (HR) and 95% confidence intervals (CI) were estimated by multivariate Cox proportional hazards regression model adjusted for the propensity score.
Results: A total of 67110subjects (aged 40-99 years), including the hyperlipidemia cohort (n=33555) and the non-hyperlipidemia cohort (n=33555), were identified. Our data revealed that the hyperlipidemia cohort had significantly higher incidences of developing bladder cancer (0.6% versus 0.4%, P < 0.001) comparing to the non-hyperlipidemia cohort. The risks of developing bladder cancer in the hyperlipidemia cohort were significantly higher than the non-hyperlipidemia cohort (bladder cancer: HR = 137, 95% CI = 1.10-1.71, P = 0.005) after propensity score adjustment.
Conclusions: Hyperlipidemia is associated with an increased risk of bladder cancer.