Objective: To assess the association and intensity of baseline TC level with the incidence of lung cancer in men in China. Methods: Since May 2006, all the male workers, including the employees and the retirees in Kailuan Group were recruited in the Kailuan male dynamic cohort study. Information about demographics, medical history, anthropometry and TC level were collected at the baseline interview, as well as the information of newly-diagnosed lung cancer cases during the follow-up period. According to guidelines for blood lipids in Chinese adults and the distribution in the population, TC level was classified into five groups as followed: <160, 160-, 180-, 200- and ≥240 mg/dl, with the second quintile group (160- mg/dl) serving as the referent category. Cox proportional hazards regression model and restricted cubic spline (RCS) model were used to evaluate the association and the nonlinear association between baseline TC level and the risk of lung cancer in the men. Results: By December 31, 2014, for the 109 884 men, a follow up of 763 819.25 person-years was made with a median follow-up period of 7.88 years. During the follow up, 808 lung cancer cases were identified. After adjustment for age, education level, income level, smoking status, alcohol consumption level, history of dust exposure, FPG level and BMI, HR (95%CI) of lung cancer for men with lower TC level (<160 mg/dl) and higher TC level (≥240 mg/dl) were 1.34 (1.04- 1.72) and 1.45 (1.09-1.92), respectively, compared with men with normal TC level (160- mg/dl). The results didn't change significantly after exclusion of newly diagnosed cancer cases within 2 years of follow up and subjects with the history of hyperlipidemia. Conclusion: Our results showed that TC might be associated with higher risk of lung cancer. Men with lower TC level or higher TC level had higher risk for lung cancer. Keep moderate TC level might be one of the effective precaution for the prevention of lung cancer.
目的： 探讨基线TC与中国男性肺癌发病风险的关联及其强度。 方法： 自2006年5月，以开滦集团全体在职及离退休男性职工为调查对象，建立开滦集团男性动态队列并随访。基线调查时收集研究对象的社会人口学、个人疾病史、身体测量指标和TC等基线信息，并利用随访收集肺癌发病结局信息。参考《中国成人血脂异常防治指南》与研究人群TC分布特征，TC按照五分位数进行分组：<160、160~、180~、200~、≥240 mg/dl，以TC 160~mg/dl组为参比组，利用Cox比例风险模型分析基线TC与男性肺癌发病风险的关联性、限制性立方样条曲线分析其非线性关系。 结果： 截至2014年12月31日，109 884名男性进入队列，共计随访763 819.25人年，随访时间M=7.88年，收集肺癌新发病例808例。调整年龄、文化程度、收入、吸烟、饮酒、粉尘暴露史、FPG、BMI后，以160~mg/dl组为对照，TC偏低（<160 mg/dl）和TC升高（≥240 mg/dl）组男性肺癌发生风险分别升高34%（HR=1.34，95%CI：1.04~1.72）和45%（HR=1.45，95%CI：1.09~1.92）。剔除随访2年内肺癌新发病例及有高血脂病史者后，结果无显著变化。 结论： TC与男性肺癌发生相关，TC过高或过低男性的肺癌发病风险均升高，保持适当的TC水平可能是预防和控制肺癌的有效措施之一。.
Keywords: Cohort study; Lung cancer; Male; Prospective study; Total cholesterol.