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Table 3 Incidence rate ratios (IRR) and 95% confidence intervals of hepatocellular carcinoma according to categories of and per 1 unit increase in serum anti-LPS and anti-flagellin immunoglobulin levels, EPIC study, 1992–2010

From: Exposure to bacterial products lipopolysaccharide and flagellin and hepatocellular carcinoma: a nested case-control study

Biomarker IRR (95% CI)   OR per ↑1 unit
Q1 Q2 Q3 Q4 P trend
Anti-LPS IgG + IgA, n case/control 20/35 25/34 35/35 59/35   
 Matching factorsa Ref. 1.34 (0.61–2.98) 2.74 (1.13–6.65) 11.17 (3.46–36.00) <0.0001 2.19 (1.59–3.03)
 Multivariableb Ref. 1.64 (0.56–4.83) 2.52 (0.76–8.39) 17.16 (3.52–83.50) 0.001 2.58 (1.65–4.03)
  + dietary factorsc Ref. 1.65 (0.54–5.04) 2.67 (0.77–9.31) 20.06 (3.88–103.0) 0.001 2.68 (1.69–4.23)
  + Fischer’s ratiod Ref. 2.52 (0.70–9.08) 2.17 (0.55–8.63) 13.65 (1.91–97.80) 0.017 2.05 (1.25–3.36)
Anti-Flagellin IgG + IgA, n case/control 22/34 25/36 37/35 55/34   
 Matching factorsa Ref. 1.09 (0.5–2.38) 2.35 (1.03–5.37) 7.11 (2.46–20.55) <0.0001 2.18 (1.56–3.06)
 Multivariableb Ref. 1.05 (0.37–2.93) 2.87 (1.00–8.20) 7.78 (2.19–27.57) 0.001 2.31 (1.51–3.54)
  + dietary factorsc Ref. 1.21 (0.40–3.59) 3.07 (1.05–9.01) 6.72 (1.88–24.02) 0.003 2.25 (1.47–3.47)
  + Fischer’s ratiod Ref. 1.52 (0.43–5.37) 4.37 (1.21–15.84) 3.59 (0.79–16.35) 0.025 1.80 (1.12–2.90)
Anti-LPS IgG + Anti-Flagellin IgG, n case/control 24/34 29/36 40/34 46/35   
 Matching factorsa Ref. 1.23 (0.58–2.63) 2.11 (0.99–4.52) 4.08 (1.43–11.64) 0.006 2.02 (1.43–2.85)
 Multivariableb Ref. 1.40 (0.53–3.68) 2.92 (1.06–8.06) 5.80 (1.46–23.02) 0.007 2.47 (1.56–3.91)
  + dietary factorsc Ref. 1.43 (0.52–3.92) 3.45 (1.18–10.07) 5.37 (1.31–22.10) 0.007 2.57 (1.60–4.12)
  + Fischer’s ratiod Ref. 1.18 (0.39–3.60) 3.89 (1.12–13.58) 2.71 (0.42–17.29) 0.056 1.97 (1.15–3.36)
Anti-LPS IgA + Anti-Flagellin IgA, n case/control 18/35 27/34 27/35 67/35   
 Matching factorsa Ref. 2.16 (0.82–5.72) 2.23 (0.85–5.87) 8.47 (3.01–23.86) <0.0001 1.83 (1.43–2.36)
 Multivariableb Ref. 4.00 (0.96–16.63) 4.91 (1.15–20.9) 14.22 (3.02–66.90) 0.001 1.99 (1.39–2.86)
  + dietary factorsc Ref. 5.34 (1.21–23.68) 4.73 (1.06–21.16) 14.97 (3.04–73.50) 0.001 1.98 (1.37–2.86)
  + Fischer’s ratiod Ref. 2.65 (0.55–12.84) 4.49 (0.94–21.6) 8.40 (1.64–43.12) 0.009 1.65 (1.11–2.45)
Anti-LPS IgG + IgA + Anti-Flagellin IgG + IgA, n case/control 23/34 22/35 37/35 57/35   
 Matching factorsa Ref. 0.97 (0.46–2.08) 2.25 (1.03–4.91) 8.72 (2.78–27.29) <.00001 1.57 (1.31–1.88)
 Multivariableb Ref. 1.54 (0.59–4.02) 2.78 (0.94–8.21) 14.01 (2.99–65.60) 0.001 1.72 (1.34–2.21)
  + dietary factorsc Ref. 1.71 (0.63–4.68) 2.78 (0.92–8.35) 13.31 (2.78–63.70) 0.002 1.71 (1.33–2.21)
  + Fischer’s ratiod Ref. 1.75 (0.58–5.27) 2.19 (0.63–7.66) 11.76 (1.70–81.40) 0.021 1.48 (1.13–1.94)
  1. aIRRs and 95% confidence intervals were estimated by conditional logistic regression conditioned on the matching factors
  2. bBase model further adjusted for smoking status (never, former, current), body mass index (continuous), baseline alcohol intake (continuous), coffee intake (continuous), lifetime alcohol drinking pattern (always heavy, periodically heavy, former heavy, never heavy, former light, light, and never drinker), physical activity (active, moderately active, moderately inactive, inactive), and level of education (none, primary school, secondary school, more than secondary school, not specified)
  3. cMultivariable model + baseline dietary fiber (g/day), fish and seafood products (g/day), and total energy (kcal/day)
  4. dMultivariable model + Fischer ratio calculated as the molar ratio of branched-chain amino acids (leucine, valine, isoleucine) to aromatic amino acids (phenylalanine, tyrosine, histidine, tryptophan), an indicator of hepatic functional reserve and the severity of liver dysfunction