Table 3. Risk of advanced colorectal adenoma according to quintiles of plasma inflammatory marker levels in the Nurses' Health Study (1990-2008)a.
| Biomarker | Quintile 1 | Quintile 2 | Quintile 3 | Quintile 4 | Quintile 5 | Ptrend |
|---|---|---|---|---|---|---|
| MIC-1 | ||||||
| Median, ng/L | 398 | 505 | 596 | 707 | 951 | |
| No. of cases/controls | 131/148 | 150/148 | 131/147 | 145/148 | 181/147 | |
| Age-adjusted OR (95% CI)b | 1.00 (referent) | 1.19 (0.86-1.64) | 1.06 (0.75-1.49) | 1.17 (0.83-1.65) | 1.52 (1.06-2.18) | 0.03 |
| MV-adjusted OR (95% CI)c | 1.00 (referent) | 1.20 (0.86-1.68) | 1.00 (0.70-1.42) | 1.13 (0.79-1.63) | 1.49 (1.01-2.18) | 0.05 |
| MV-adjusted OR (95% CI)d | 1.00 (referent) | 1.19 (0.84-1.67) | 1.01 (0.70-1.44) | 1.10 (0.76-1.60) | 1.55 (1.03-2.32) | 0.04 |
| CRP | ||||||
| Median, mg/L | 0.43 | 0.91 | 1.70 | 2.99 | 6.32 | |
| No. of cases/controls | 127/150 | 137/152 | 131/151 | 169/151 | 190/150 | |
| Age-adjusted OR (95% CI)b | 1.00 (referent) | 1.06 (0.77-1.47) | 1.04 (0.75-1.46) | 1.32 (0.96-1.83) | 1.49 (1.09-2.05) | 0.06 |
| MV-adjusted OR (95% CI)c | 1.00 (referent) | 1.00 (0.71-1.40) | 0.96 (0.68-1.36) | 1.15 (0.81-1.63) | 1.26 (0.89-1.79) | 0.21 |
| MV-adjusted OR (95% CI)d | 1.00 (referent) | 0.93 (0.66-1.33) | 0.95 (0.66-1.36) | 1.10 (0.77-1.59) | 1.10 (0.76-1.59) | 0.62 |
| IL-6 | ||||||
| Median, ng/L | 0.42 | 0.67 | 0.96 | 1.42 | 2.64 | |
| No. of cases/controls | 126/147 | 183/147 | 121/146 | 148/147 | 155/146 | |
| Age-adjusted OR (95% CI)b | 1.00 (referent) | 1.49 (1.06-2.09) | 0.97 (0.68-1.38) | 1.18 (0.84-1.65) | 1.23 (0.88-1.71) | 0.59 |
| MV-adjusted OR (95% CI)c | 1.00 (referent) | 1.33 (0.94-1.89) | 0.79 (0.54-1.16) | 0.93 (0.64-1.35) | 0.99 (0.69-1.42) | 0.64 |
| MV-adjusted OR (95% CI)d | 1.00 (referent) | 1.33 (0.93-1.89) | 0.77 (0.52-1.14) | 0.91 (0.62-1.33) | 0.96 (0.65-1.42) | 0.53 |
| sTNFR-2 | ||||||
| Median, μg/L | 1.97 | 2.38 | 2.64 | 3.01 | 3.71 | |
| No. of cases/controls | 153/152 | 140/151 | 145/152 | 155/151 | 164/151 | |
| Age-adjusted OR (95% CI)b | 1.00 (referent) | 0.92 (0.66-1.28) | 0.96 (0.69-1.34) | 1.03 (0.74-1.44) | 1.10 (0.78-1.54) | 0.41 |
| MV-adjusted OR (95% CI)c | 1.00 (referent) | 0.86 (0.61-1.21) | 0.91 (0.64-1.29) | 0.92 (0.65-1.31) | 0.99 (0.68-1.42) | 0.83 |
| MV-adjusted OR (95% CI)d | 1.00 (referent) | 0.86 (0.60-1.23) | 0.90 (0.63-1.29) | 0.88 (0.61-1.28) | 0.89 (0.60-1.33) | 0.69 |
Abbreviations: CI, confidence interval; CRP, C-reactive protein; IL-6, interleukin-6; MIC-1, macrophage inhibitory cytokine-1; MV, multivariable; OR, odds ratio; sTNFR-2, soluble tumor necrosis factor receptor 2.
The number of pairs of subjects with missing measurements were excluded from the analysis: 19 for MIC-1, 3 for CRP, and 24 for IL-6.
Age-adjusted models accounted for matching factors (date of endoscopy [i.e., had to be performed during the same 2-year period], birth year, indication for endoscopy, time period of any prior endoscopy, month and year of blood draw, and fasting status).
Multivariable-adjusted models accounted for matching factors and were adjusted for family history of colorectal cancer (yes or no), multivitamin use (yes or no), pack-years of smoking before age 30 (0, 0-7.9, ≥8), alcohol consumption (0-0.14, 0.15-1.9, 2.0-7.4, ≥7.5 g/d), body mass index (<21, 21-22.9, 23-24.9, 25-29.9, ≥30 kg/m2), physical activity (≤5, 5.1-10, 10.1-20, >20 MET-hours/week), regular aspirin/NSAID use (yes or no), postmenopausal status and hormone use (premenopausal, postmenopausal with ever or never using hormone therapy), calcium intake (in tertiles), and Alternative Healthy Eating Index (in tertiles).
Multivariable-adjusted models were additionally adjusted for the other plasma markers omitting the main exposure (i.e., MIC-1, CRP, IL-6, and sTNFR-2).