Association between L-α-glycerylphosphorylcholine use and risk of kidney cancer: A nationwide representative retrospective cohort study

초록

Background: L-α-glycerylphosphorylcholine (α-GPC) is widely prescribed for cognitive impairment and Alzheimer's dementia. Previous cohort studies have reported that dietary free choline intake was associated with decreased kidney cancer risk. The oncologic safety of supplemental α-GPC remains uncertain given its role in producing trimethylamine N-oxide (TMAO), a metabolite implicated in renal injury and certain malignancies. This study aimed to test the hypothesis whether α-GPC use was associated with the reduction of incident kidney cancer. Methods: Using the Korean National Health Insurance Service database, we conducted a nationwide retrospective cohort study among adults aged ≥ 50 who underwent health screening in 2009–2010. After exclusion criteria and 1:5 exact propensity score matching, 81,970 α-GPC users and 409,801 non-users were analyzed using Cox proportional hazards models. Incident kidney cancer events were identified from 2011 to 2024. Results: α-GPC use was not associated with kidney cancer risk (adjusted HR 0.95, 95% CI 0.84–1.08; 280 events in α-GPC users, 1570 in non-users). Results were consistent across lag-time sensitivity analyses and subgroup analyses by age, sex, income, Charlson comorbidity index, and estimated glomerular filtration rate. Conclusions: α-GPC use was not associated with incident kidney cancer in this large Korean cohort. Further studies in diverse populations are warranted in order to confirm these findings. © 2026

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