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Familial Risk of Renal Cell Cancer and Interaction with Obesity and Hyperglycemia: A Population-Based Study

Authors
Lee, Sung WonKim, Hyun JungKazmi, Sayada ZartashaChoi, Yoon JungHong, GahwiKim, Young ShinSwan, HeatherCha, JaewooKang, TaeukHann, Hoo JaeAhn, Hyeong Sik
Issue Date
8월-2022
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Keywords
carcinoma; renal cell; gene-environment interaction; obesity; hyperglycemia
Citation
JOURNAL OF UROLOGY, v.208, no.2, pp.251 - +
Indexed
SCIE
SCOPUS
Journal Title
JOURNAL OF UROLOGY
Volume
208
Number
2
Start Page
251
End Page
+
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/142740
DOI
10.1097/JU.0000000000002506
ISSN
0022-5347
Abstract
Purpose: We quantified the familial risk of renal cell cancer (RCC) among firstdegree relatives (FDRs) on a population level, and examined interactions between family history and body mass index or blood glucose. Materials and Methods: Using the National Health Insurance database, which covers the entire Korean population, and the National Health Screening Program, we constructed a cohort of 5,524,403 individuals with blood-related FDRs and their lifestyle factors from 2002 to 2018. We calculated familial risk using incidence risk ratios (IRRs) with 95% confidence intervals, which compares the risk of individuals with and without FDR. The combined effect and interaction of a given risk factor and family history of RCC were measured by the relative excess risk due to interaction. Results: Individuals with affected FDRs showed a 2.29-fold (95% CI 1.68-3.13) increased risk of disease. Familial risk adjusted for lifestyle factors showed minimal attenuation (IRR 2.25; 95% CI: 1.65-3.08), suggesting that genetic predisposition is the main contributor in the familial aggregation of RCC. Individuals with both a positive family history and overweight/obesity (IRR 3.71, 95% CI 2.50-4.92) or hyperglycemia (IRR 4.52, 95% CI 2.59-6.45) had a significantly higher risk that exceeded the sum of their individual risks, suggesting an interaction that was statistically significant (relative excess risk due to interaction 95% CI: 0.91, -0.21-2.12; 2.21, 0.28-4.14). Conclusions: Our findings suggest an interaction between genetic and environmental factors, namely obesity and hyperglycemia. Individuals with both factors should be considered a high-risk group and advised to undergo genetic counseling.
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