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卵巢癌风险与血液胆固醇和甘油三酯的关系。

Ovarian Cancer Risk in Relation to Blood Cholesterol and Triglycerides.

机构信息

Division of Cancer Epidemiology and Genetics, NCI, NIH, Bethesda, Maryland.

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah.

出版信息

Cancer Epidemiol Biomarkers Prev. 2021 Nov;30(11):2044-2051. doi: 10.1158/1055-9965.EPI-21-0443. Epub 2021 Aug 17.

Abstract

BACKGROUND

The association between circulating cholesterol and triglyceride levels and ovarian cancer risk remains unclear.

METHODS

We prospectively evaluated the association between cholesterol [total, low-density lipoprotein (LDL-C), and high-density lipoprotein (HDL-C)] and triglycerides and ovarian cancer incidence in a case-control study nested in the Nurses' Health Study (NHS) and NHSII cohorts and a longitudinal analysis in the UK Biobank.

RESULTS

A total of 290 epithelial ovarian cancer cases in the NHS/NHSII and 551 cases in UK Biobank were diagnosed after blood collection. We observed a reduced ovarian cancer risk comparing the top to bottom quartile of total cholesterol [meta-analysis relative risk (95% confidence interval): 0.81 (0.65-1.01), 0.06], with no heterogeneity across studies ( = 0.74). Overall, no clear patterns were observed for HDL-C, LDL-C, or triglycerides and ovarian cancer risk. Comparing triglyceride levels at clinically relevant cut-off points (>200 vs. ≤200 mg/dL) for cases diagnosed more than 2 years after blood draw saw a positive relationship with risk [1.57 (1.03-2.42); = 0.003]. Results were similar by serous/non-serous histotype, menopausal status/hormone use, and body mass index.

CONCLUSIONS

Data from two large cohorts in the United States and United Kingdom suggest that total cholesterol levels may be inversely associated with ovarian cancer risk, while triglycerides may be positively associated with risk when assessed at least 2 years before diagnosis, albeit both associations were modest.

IMPACT

This analysis of two large prospective studies suggests that circulating lipid levels are not strongly associated with ovarian cancer risk. The positive triglyceride-ovarian cancer association warrants further evaluation.

摘要

背景

循环胆固醇和甘油三酯水平与卵巢癌风险之间的关联仍不清楚。

方法

我们前瞻性地评估了胆固醇[总胆固醇、低密度脂蛋白(LDL-C)和高密度脂蛋白(HDL-C)]和甘油三酯与护士健康研究(NHS)和 NHSII 队列中的巢式病例对照研究以及英国生物库中的纵向分析中卵巢癌发病率之间的关联。

结果

NHS/NHSII 中共有 290 例上皮性卵巢癌病例和英国生物库中 551 例病例在采血后被诊断出。与总胆固醇[荟萃分析相对风险(95%置信区间):0.81(0.65-1.01), = 0.06]的最高四分位到最低四分位相比,我们观察到卵巢癌风险降低,各研究之间无异质性( = 0.74)。总体而言,HDL-C、LDL-C 或甘油三酯与卵巢癌风险之间没有明显的模式。与血液采集后 2 年以上诊断的病例相比,将甘油三酯水平与临床相关切点(>200 与≤200mg/dL)进行比较,发现与风险呈正相关[1.57(1.03-2.42); = 0.003]。按浆液性/非浆液性组织学类型、绝经状态/激素使用和体重指数进行分层,结果相似。

结论

来自美国和英国的两项大型队列研究的数据表明,总胆固醇水平可能与卵巢癌风险呈负相关,而当至少在诊断前 2 年评估时,甘油三酯可能与风险呈正相关,尽管这两种关联都较弱。

影响

这项对两项大型前瞻性研究的分析表明,循环脂质水平与卵巢癌风险没有很强的关联。甘油三酯与卵巢癌之间的正相关关系值得进一步评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8609/8568658/ea62c936c6d1/nihms-1734103-f0001.jpg

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