目前关于循环胆红素与结直肠癌 (CRC) 风险之间关联的证据并不一致。在这项前瞻性研究中，我们调查了 78,467 名年龄在 40-78 岁的韩国成年人中，诊断前总胆红素和间接胆红素循环水平与结直肠癌风险之间的关系。 ，考虑潜在的非线性和性别差异。使用 Cox 比例风险回归估计与 CRC 风险相关的风险比 (HR) 和 95% 置信区间 (CI)。在中位 7.9 年的随访期间，记录了 539 例 CRC 病例。在多变量调整模型中，比较最高与最低三分位（P-线性趋势 = 0.003），总胆红素水平较高与男性和女性的 CRC 风险降低 26%（CI：42% 至 7%）相关。 ）。在男性中观察到 U 形关联，总胆红素约为 0.8mg/dL（=13.7μmol/L）时风险最低（非线性 P=0.01）。尽管这种关联在女性中基本上是无效的，但没有证据表明性别影响会发生变化（P-交互作用 = 0.73）。间接胆红素与结直肠癌风险之间的关联相似。韩国成年人中总胆红素和间接胆红素循环水平较高与结直肠癌风险呈负相关。这些关联在男性中呈强烈反向且呈 U 形。© 2024。作者，获得 Springer Nature Limited 的独家许可。

Current evidence on associations between circulating bilirubin and colorectal cancer (CRC) risk is inconsistent.In this prospective study, we investigated associations of pre-diagnostic circulating levels of total and indirect bilirubin with CRC risk in 78,467 Korean adults aged 40-78 years at recruitment, considering potential non-linearity and sex differences. Hazard ratios (HR) and 95% confidence intervals (CI) for associations with CRC risk were estimated with Cox proportional hazard regression.During a median 7.9-year follow-up, 539 incident CRC cases were recorded. In multivariable-adjusted models, higher levels of total bilirubin were associated with a 26% (CI: 42% to 7%) lower risk of CRC among men and women combined, comparing the highest with the lowest tertile (P-linear trend = 0.003). A U-shaped association was observed in men, with the lowest risk at approximately 0.8 mg/dL (=13.7 μmol/L) of total bilirubin (P for non-linearity = 0.01). Although the association was largely null in women, there was no evidence for effect modification by sex (P-interaction = 0.73). Associations between indirect bilirubin and CRC risk were similar.Higher circulating levels of total and indirect bilirubin were inversely associated with the risk of CRC among Korean adults. The associations were strongly inverse and U-shaped among men.© 2024. The Author(s), under exclusive licence to Springer Nature Limited.