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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