Department of Family Medicine, MacKay Memorial Hospital, No. 92, Section 2, Zhongshan North Road, Taipei City, 10449, Taiwan.
The Department of Medicine, MacKay Medical College, No. 46, Sec. 3, Zhongzheng Rd, New Taipei City, 25245, Taiwan.
Lipids Health Dis. 2021 Oct 10;20(1):133. doi: 10.1186/s12944-021-01570-1.
Blood lipids are essential components for cellular growth. An inverse association between serum lipid levels and risk of cancer has led to a controversy among previous studies. The aim of this prospective cohort study was to investigate the association between blood lipids change and risk of cancer incidence.
A cohort of 4130 Taiwanese adults from the Taiwanese Survey on the Prevalence of Hypertension, Hyperglycemia, and Hyperlipidemia database underwent repeated examinations in 2002 and 2007. Six groups were established based on the combined baseline (lower/higher) and interval change (decreasing/stable/increasing) in plasma lipid levels. Multivariable Cox proportional hazard model was used to investigate the relationship between lipids change and all-cause cancer incidence.
Two hundred and forty cancer events developed over a median follow-up of 13.4 years. Comparing these with individuals with decreasing lower-baseline lipid levels, cancer risk reduction was demonstrated in those with increasing lower-baseline total cholesterol (adjusted hazard ratio [aHR], 0.48; 95% confidence interval [CI], 0.27 to 0.85), low-density lipoprotein cholesterol (LDL-C; aHR, 0.56; 95% CI, 0.35 to 0.92), and non-high-density lipoprotein cholesterol (non-HDL-C) (aHR, 0.54; 95% CI, 0.31 to 0.92) levels. A decreased risk for cancer incidence also presented in participants with stable lower-baseline, decreasing and increasing higher-baseline LDL-C levels, and with decreasing and stable higher-baseline non-HDL-C levels.
The interval decline in lower-baseline total cholesterol, LDL-C, and non-HDL-C levels was linked to a higher risk for all-cause cancer incidence. More attention to a potential cancer risk may be warranted for an unexplained fall in serum lipids.
血脂是细胞生长的重要组成部分。血清脂质水平与癌症风险之间的反比关系导致了先前研究之间的争议。本前瞻性队列研究旨在探讨血脂变化与癌症发病风险之间的关系。
从台湾高血压、高血糖和高血脂症调查数据库中招募了 4130 名台湾成年人参加这项研究，他们在 2002 年和 2007 年接受了重复检查。根据血浆脂质水平的基线（较低/较高）和间隔变化（降低/稳定/增加），将 6 组人群建立。多变量 Cox 比例风险模型用于研究脂质变化与全因癌症发病率之间的关系。
在中位数为 13.4 年的随访中，有 240 例癌症事件发生。与基线脂质水平降低的个体相比，基线总胆固醇（调整后的危险比[aHR]，0.48；95%置信区间[CI]，0.27 至 0.85）、低密度脂蛋白胆固醇（LDL-C；aHR，0.56；95%CI，0.35 至 0.92）和非高密度脂蛋白胆固醇（非-HDL-C）（aHR，0.54；95%CI，0.31 至 0.92）水平增加的个体患癌症的风险降低。稳定的基线较低 LDL-C、下降和增加的基线较高 LDL-C 以及下降和稳定的基线较高非-HDL-C 水平的个体患癌症的风险也降低。
基线总胆固醇、LDL-C 和非-HDL-C 水平的间隔下降与全因癌症发病率升高有关。对于血清脂质不明原因下降，可能需要更多关注潜在的癌症风险。
