BMJ open · 2022
Association between proteinuria and incident colorectal cancer: analysis of a nationwide population-based database.
СтатьяНаблюдательное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Matsuoka Satoshi, Kaneko Hidehiro, Okada Akira, Fukui Akira, Yano Yuichiro, Itoh Hidetaka, Morita Kojiro, Fujiu Katsuhito, Michihata Nobuaki, Jo Taisuke, Takeda Norifumi, Morita Hiroyuki, Yamaguchi Satoko, Nakamura Sunao, Nishiyama Akira, Yokoo Takashi, Node Koichi, Yamauchi Toshimasa, Nangaku Masaomi, Yasunaga Hideo, Komuro Issei
Аннотация
OBJECTIVES: This study aimed to assess whether adults with proteinuria were at a higher risk of incident colorectal cancer (CRC) than those without proteinuria using a large-scale population-based database.
DESIGN: A retrospective observational study.
SETTING: The JMDC Claims Database, an administrative health claims database, was used. Data were collected between 2005 and 2020.
PARTICIPANTS: We selected records of participants (n=3 543 705) who underwent health check-ups, including physical examinations, blood tests and urine dipstick tests. We excluded participants who were aged <20 years (n=25 577), had a history of CRC, colorectal disease, renal disease and renal replacement therapy (n=114 888), or had missing data on medications (n=170 145), cigarette smoking (n=14 835), alcohol consumption (n=366 414) or physical activity (n=106 550). Finally, we analysed 2 745 296 participants.
MAIN OUTCOME MEASURES: The primary outcome was CRC at any stage.
RESULTS: Participants were categorised as having no proteinuria (n=2 435 872), trace proteinuria (n=231 153) or positive proteinuria (n=78 271). Over a mean follow-up period of 1189±914 days, 10 615 CRC diagnoses were recorded. The incidence of CRC (95% CI) was lowest in participants without proteinuria (11.7; 95% CI, 11.5 to 11.9 per 10 000 person-years), followed by trace proteinuria (12.5; 95% CI, 11.7 to 13.3 per 10 000 person-years) and positive proteinuria (16.1; 95% CI, 14.6 to 17.7 per 10 000 person-years). After multivariable adjustment, compared with no proteinuria, HRs for incident CRC were 1.20 (95% CI, 1.12 to 1.29) and 1.23 (95% CI, 1.11 to 1.36) for trace and positive proteinuria, respectively. The association between proteinuria and incident CRC existed in participants after multiple imputations for missing data, with a follow-up period of ≥365 days, regardless of age, sex, obesity, hypertension, diabetes mellitus and estimated glomerular filtration rate.
CONCLUSIONS: Trace and positive proteinuria were associated with a greater risk of incident CRC. Assessment of proteinuria could help identify individuals at an increased risk of CRC.
DESIGN: A retrospective observational study.
SETTING: The JMDC Claims Database, an administrative health claims database, was used. Data were collected between 2005 and 2020.
PARTICIPANTS: We selected records of participants (n=3 543 705) who underwent health check-ups, including physical examinations, blood tests and urine dipstick tests. We excluded participants who were aged <20 years (n=25 577), had a history of CRC, colorectal disease, renal disease and renal replacement therapy (n=114 888), or had missing data on medications (n=170 145), cigarette smoking (n=14 835), alcohol consumption (n=366 414) or physical activity (n=106 550). Finally, we analysed 2 745 296 participants.
MAIN OUTCOME MEASURES: The primary outcome was CRC at any stage.
RESULTS: Participants were categorised as having no proteinuria (n=2 435 872), trace proteinuria (n=231 153) or positive proteinuria (n=78 271). Over a mean follow-up period of 1189±914 days, 10 615 CRC diagnoses were recorded. The incidence of CRC (95% CI) was lowest in participants without proteinuria (11.7; 95% CI, 11.5 to 11.9 per 10 000 person-years), followed by trace proteinuria (12.5; 95% CI, 11.7 to 13.3 per 10 000 person-years) and positive proteinuria (16.1; 95% CI, 14.6 to 17.7 per 10 000 person-years). After multivariable adjustment, compared with no proteinuria, HRs for incident CRC were 1.20 (95% CI, 1.12 to 1.29) and 1.23 (95% CI, 1.11 to 1.36) for trace and positive proteinuria, respectively. The association between proteinuria and incident CRC existed in participants after multiple imputations for missing data, with a follow-up period of ≥365 days, regardless of age, sex, obesity, hypertension, diabetes mellitus and estimated glomerular filtration rate.
CONCLUSIONS: Trace and positive proteinuria were associated with a greater risk of incident CRC. Assessment of proteinuria could help identify individuals at an increased risk of CRC.