INTRODUCTION:
Stomach cancer is a serious global public health problem. The current burden of stomach cancer and its trends across time and location need to be understood to develop effective preventive strategies.
METHODS:
Data were obtained from the Global Burden of Disease study. The burden of stomach cancer and variations in time and geographical regions were assessed according to the age-standardized rate and estimated annual percentage change (EAPC) of the incidence and mortality rate between 1991 and 2017. We also investigated the associations between the relevant rates and sociodemographic index (SDI).
RESULTS:
Overall, the age-standardized incidence rate (EAPC = −1.36, 95% confidence interval [CI]: −1.47 to −1.25), age-standardized mortality rate (EAPC = −2.2, 95% CI: −2.29 to −2.12), and age-standardized disability-adjusted life years rate (EAPC = −2.52, 95% CI: −2.63 to −2.43) decreased worldwide from 1990 to 2017. This trend varied across different countries and regions and according to sex and age. SDI had a significant negative correlation with the age-standardized mortality rate (
P
< 0.01, r = −0.28) and age-standardized disability-adjusted life years rate (
P
< 0.01, r = −0.31). Similar negative correlations were observed between SDI and the EAPC.
DISCUSSION:
The observed correlation between SDI and disease burden suggests that strategically implementing the screening and eradication of
Helicobacter pylori
, improving the medical level in countries with low SDI, and promoting the implementation of tobacco cessation policies would help reduce the disease burden of stomach cancer.
Serum liver enzymes (alanine aminotransferase [ALT], aspartate aminotransferase [AST], λ-glutamyl transferase [GGT] and alkaline phosphatase [ALP]) are the leading biomarkers to measure liver injury, and they have been reported to be associated with several intrahepatic and extrahepatic diseases in observational studies. We conducted a phenome-wide association study (PheWAS) to identify disease phenotypes associated with genetically predicted liver enzymes based on the UK Biobank cohort. Univariable and multivariable Mendelian randomization (MR) analyses were performed to obtain the causal estimates of associations that detected in PheWAS. Our PheWAS identified 40 out of 1,376 pairs (16, 17, three and four pairs for ALT, AST, GGT and ALP, respectively) of genotype-phenotype associations reaching statistical significance at the 5% false discovery rate threshold. A total of 34 links were further validated in Mendelian randomization analyses. Most of the disease phenotypes that associated with genetically determined ALT level were liver-related, including primary liver cancer and alcoholic liver damage. The disease outcomes associated with genetically determined AST involved a wide range of phenotypic categories including endocrine/metabolic diseases, digestive diseases, and neurological disorder. Genetically predicted GGT level was associated with the risk of other chronic non-alcoholic liver disease, abnormal results of function study of liver, and cholelithiasis. Genetically determined ALP level was associated with pulmonary heart disease, phlebitis and thrombophlebitis of lower extremities, and hypercholesterolemia. Our findings reveal novel links between liver enzymes and disease phenotypes providing insights into the full understanding of the biological roles of liver enzymes.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.