机构：[1]Department of Gastrointestinal Surgery/Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.[2]National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China.首都医科大学宣武医院[3]Key Laboratory of Cancer Food for Special Medical Purposes for State Market Regulation, Beijing, China.[4]Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China.[5]Department of General Surgery, Kailuan General Hospital, Tangshan, China.[6]Cardiovascular Research Institute, University of California, San Francisco.[7]Department of Genetics, Yale University School of Medicine, New Haven, Connecticut.[8]State Key Laboratory of Medical Molecular Biology, Department of Biochemistry and Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.[9]Department of Pathology, Shanxi Medical University, Taiyuan, Shanxi, China.[10]Department of Cardiology, Kailuan General Hospital, Tangshan, China.
The onset age of nonalcoholic fatty liver disease (NAFLD) is decreasing, and whether earlier ages of NAFLD onset are associated with increased cancer risk is currently unclear.To explore the association between NAFLD new-onset age and cancer risk.This cohort study was conducted among 179 328 participants included in the Kailuan Cohort Study between 2006 and 2021. In total, 46 100 incident NAFLD cases were identified. For each case, a participant matched by age (older or younger by 1 year) and sex was randomly selected to create a new matched study cohort. Data were analyzed from December 2022 through April 2023.Onset of NAFLD.The association between the onset age of NAFLD and the risk of different cancer types was evaluated using weighted Cox regression models. Population-attributable fractions (PAFs) were used to quantify the association of NAFLD with cancer risk at different ages.Among 63 696 participants (mean [SD] age, 51.37 [12.43] years; 10 932 females [17.2%] and 52 764 males [82.8%]), 31 848 individuals had NAFLD and 31 848 individuals were in the control group. During a median (IQR) follow-up of 10.16 (7.89-11.67) years, 2415 patients were diagnosed with cancer. Compared with the matched group, patients aged less than 45 years at NAFLD onset exhibited a higher risk of cancer (average hazard ratio [AHR], 1.52; 95% CI, 1.09-2.12), and as the onset age of NAFLD increased, the cancer risk decreased (ages 45-54 years: AHR, 1.50; 95% CI, 1.15-1.97; ages 55-64 years: AHR, 1.13; 95% CI, 0.97-1.33; ages >65 years: AHR, 0.75; 95% CI, 0.45-1.27; P for interaction < .001). Among patients aged less than 45 years at NAFLD onset, cancers were mainly digestive system and lung cancers, with AHR values of 2.00 (95% CI, 1.08-3.47) and 2.14 (95% CI, 1.05-4.36), respectively. PAFs also showed that in patients aged less than 45 years at NAFLD onset, 17.83% (95% CI, 4.92%-29.86%) of cancer risk was attributable to NAFLD..This study found that NAFLD was associated with increased cancer risk and there was an interaction with onset age, such that the younger the onset age of NAFLD, the greater the cancer risk.
基金：
This work was supported by grant 2022YFC2009600 from the National Key Research and
Development Program to Dr. H. Shi.
第一作者机构：[1]Department of Gastrointestinal Surgery/Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.[2]National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China.[3]Key Laboratory of Cancer Food for Special Medical Purposes for State Market Regulation, Beijing, China.[4]Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China.
共同第一作者：
通讯作者：
通讯机构：[1]Department of Gastrointestinal Surgery/Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.[2]National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China.[3]Key Laboratory of Cancer Food for Special Medical Purposes for State Market Regulation, Beijing, China.[4]Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China.[*1]Department of Gastrointestinal Surgery/Clinical Nutrition, Beijing Shijitan Hospital Capital Medical University, 10 Tieyi Rd, Haidian District, Beijing 100038, China
推荐引用方式(GB/T 7714)：
Liu Chenan,Liu Tong,Zhang Qingsong,et al.New-Onset Age of Nonalcoholic Fatty Liver Disease and Cancer Risk[J].JAMA NETWORK OPEN.2023,6(9):doi:10.1001/jamanetworkopen.2023.35511.
APA：
Liu Chenan,Liu Tong,Zhang Qingsong,Jia Pingping,Song Mengmeng...&Shi Hanping.(2023).New-Onset Age of Nonalcoholic Fatty Liver Disease and Cancer Risk.JAMA NETWORK OPEN,6,(9)
MLA：
Liu Chenan,et al."New-Onset Age of Nonalcoholic Fatty Liver Disease and Cancer Risk".JAMA NETWORK OPEN 6..9(2023)
医学