Fasting Blood Glucose, Cholesterol, and Risk of Primary Liver Cancer: The Kailuan Study

PURPOSE: The influence of fasting blood glucose (FBG) and cholesterolemia primary liver cancer (PLC) in China was analyzed via a large prospective cohort study based on a community population, and the combined effects between them were investigated. MATERIALS AND METHODS: Overall, 98,936 staff from the Kailuan Group who participated in and finished physical examinations between 2006 and 2007 were included in the cohort study. Their medical information was collected and they were followed up after examination. The correlations of serum FBG or total cholesterol (TC) with PLC were analyzed. Then, we categorized all staff into four groups: normal FBG/non-hypocholesterolemia, normal FBG/hypocholesterolemia, elevated FBG/non-hypocholesterolemia, elevated FBG/hypocholesterolemia, and normal FBG/non-hypocholesterolemia was used as a control group. The combined effects of elevated FBG and hypocholesterolemia with PLC were analyzed using the Age-scale Cox proportional hazard regression model. RESULTS: During 1,134,843.68 person-years follow-up, a total of 388 PLC cases occurred. We found the elevated FBG and hypocholesterolemia increase the risk for PLC, respectively. Compared with the non-hypocholesterolemia/normal FBG group, the risk of PLC was significantly increased in the non-hypocholesterolemia/elevated FBG group (hazard artio [HR], 1.19; 95% confidence interval [CI], 0.88 to 1.62) and hypocholesterolemia/normal FBG group (HR, 1.53; 95% CI, 1.19 to 1.97), and in the hypocholesterolemia/elevated FBG group (HR, 3.16; 95% CI, 2.13 to 4.69). And, a significant interaction effect was found of FBG and TC on PLC. All results were independent from the influence of liver disease. CONCLUSION: Elevated serum FBG and hypocholesterolemia are risk factors for PLC, especially when combined. Thus, for the prevention and treatment of PLC, serum FBG and TC levels should be investigated.