多项研究已对碳水化合物和脂质代谢对头颈部癌（HNC）风险的作用进行了调查，但结果存在矛盾。我们对1985-1996年间有9种生物标志物的瑞典AMORIS队列中的561,388个个体进行了一项研究，包括碳水化合物、脂质和载脂蛋白代谢方面的血液测试结果。我们通过2020年考察这些生物标志物与未来HNC风险的关联，并证明了癌前几十年这些标志物的时间变化。我们发现，血液中葡萄糖、总胆固醇（TC）、三酰甘油（TG）和载脂蛋白A-I（ApoA-I）的水平与HNC的风险呈正相关。每增加一个标准偏差，风险比（HR）为葡萄糖为1.05（95％置信区间[CI] 1.02-1.09），TC为1.09（95％ CI 1.05-1.13），TG为1.13（95％ CI 1.08-1.17），ApoA-I为1.11（95％ CI 1.04-1.19）。这些关联主要针对鳞状细胞癌，而不是腺癌。与对照组相比，HNC患者，尤其是鳞状细胞癌患者，在诊断前30年中持续表现出较高的葡萄糖、TC、TG和ApoA-I水平。总之，该研究的发现为人类癌症的发生中早期碳水化合物和脂质代谢的参与增加了新的高质量证据。版权所有©2023年作者。Elsevier B.V.保留所有权利。

Multiple studies have investigated the role of carbohydrate and lipid metabolism on the risk of head and neck cancer (HNC), with however conflicting results. We performed a study of 561,388 individuals of the Swedish AMORIS Cohort with blood test results on nine biomarkers for carbohydrate, lipid, and apolipoprotein metabolism during 1985-1996. We examined the associations of these biomarkers with the future risk of HNC through 2020 and demonstrated the temporal changes of these biomarkers during the decades before cancer diagnosis. We found that there was a positive association between blood level of glucose, total cholesterol (TC), triglycerides (TG), and Apoprotein A-I (ApoA-I) and the risk of HNC. Per standard deviation increase, the hazard ratio (HR) was 1.05 (95% confidence interval [CI] 1.02-1.09) for glucose, 1.09 (95% CI 1.05-1.13) for TC, 1.13 (95% CI 1.08-1.17) for TG, and 1.11 (95% CI 1.04-1.19) for ApoA-I. The associations were primarily noted for squamous cell carcinoma but not adenocarcinoma. Compared to controls, patients with HNC, primarily squamous cell carcinoma, showed constantly higher levels of glucose, TC, TG, and ApoA-I during the 30 years before diagnosis. In conclusion, findings of the study add new and high-quality evidence to the early involvement of carbohydrate and lipid metabolism in the oncogenesis of human cancer.Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.