Research Papers:
Thyroid cancer risk in the Swedish AMORIS study: the role of inflammatory biomarkers in serum
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Abstract
Arunangshu Ghoshal1,9, Hans Garmo1,2, Rhonda Arthur1, Paul Carroll8, Lars Holmberg1, Niklas Hammar3,4, Ingmar Jungner5, Håkan Malmström6,10, Mats Lambe2,6, Göran Walldius7 and Mieke Van Hemelrijck1,3
1King’s College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology and Urology Research, London, UK
2Regional Cancer Centre, Uppsala University, Uppsala, Sweden
3Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
4AstraZeneca R&D, Mölndal, Sweden
5Department of Medicine, Clinical Epidemiological Unit, Karolinska Institutet and CALAB Research, Stockholm, Sweden
6Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
7Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
8Endocrinology Department, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
9Department of Palliative Medicine, Tata Memorial Hospital, Mumbai, India
10Biostatistics, Research & Development, Swedish Orphan Biovitrum AB, Stockholm, Sweden
Correspondence to:
Arunangshu Ghoshal, email: [email protected]
Keywords: albumin; AMORIS cohort; cox analysis; serum inflammatory markers; thyroid cancer
Received: July 25, 2017 Accepted: November 07, 2017 Published: December 04, 2017
ABSTRACT
Chronic inflammation is one of the underlying risks associated with thyroid cancer. We ascertained the association between commonly measured serum biomarkers of inflammation and the risk of thyroid cancer in Swedish Apolipoprotein-related MORtality RISk (AMORIS) study. 226,212 subjects had baseline measurements of C-reactive protein, albumin and haptoglobin. Leukocytes were measured in a subgroup of 63,845 subjects. Associations between quartiles and dichotomized values of inflammatory markers and risk of thyroid cancer were analysed using multivariate Cox proportional hazard models. 202 individuals were diagnosed with thyroid cancer during a mean follow-up of 19.6 years. There was a positive association between lower albumin levels and risk of developing thyroid cancer [Hazard Ratio for albumin ≤ 40 g/L: 1.50 (95% Confidence Interval = 1.04–2.16)]. When stratified by a metabolic score, we observed similar association for albumin with higher HR among those with metabolic score ≥ 1, as compared to those with metabolic score of 0 [HR 1.98 (95% CI = 1.11-3.54) vs 1.17 (95% CI = 0.72–1.89)] (P = 0.19). Apart from albumin, none of the serum markers of inflammation studied showed a link with the risk of developing thyroid cancer–suggesting that the role of inflammation may be more complicated and requires assessment of more specialised measurements of inflammation.
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