Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Int J Cancer. 2022 Aug 15;151(4):518-525. doi: 10.1002/ijc.34032. Epub 2022 May 3.
The causation between lipids and renal cancer remains inconclusive. Our purpose is to explore the causal relationships between the three primary lipid metabolism-related substances, namely triglycerides (TG), low-density lipoprotein (LDL) and high-density lipoprotein (HDL) with the risk of renal cancer using Mendelian randomization (MR) methods. Genetic instruments for lipids were acquired from the UK Biobank. Outcome data were from the FinnGen study (1397 renal cancer cases and 204 070). Single-variable MR (SVMR) and multi-variable MR (MVMR) analyses were conducted with TwoSampleMR package based on R 4.0.3. The random-effect inverse-variance weighted (IVW), MR-Egger, weighted-median method, and weighted mode were the four main computing methods. We found that per 1 SD elevated LDL level was causally associated with renal cancer occurrence based on SVMR (OR, 1.31, 95% CI: 1.05-1.64, P = .016). Similar significant associations were found in other methods. However, the results of SVMR did not support significant associations between TG, and HDL with renal cancer risk in all methods. The association between LDL and renal cancer was still significant in MVMR analysis (OR for IVW method: 1.22 per 1 SD higher trait (SD, 95% CI: 1.11-1.34, P < .001; OR for MR-Egger: 1.22 per 1 SD higher trait, 95% CI: 1.01-1.47, P = .042) when taking TG and HDL into consideration. Our study supported that elevated serum LDL levels is causally associated with an increased risk of renal cancer independent of TG and HDL.
血脂与肾癌之间的因果关系仍不确定。本研究旨在采用孟德尔随机化(Mendelian randomization,MR)方法探讨三种主要脂质代谢相关物质,即甘油三酯(triglyceride,TG)、低密度脂蛋白(low-density lipoprotein,LDL)和高密度脂蛋白(high-density lipoprotein,HDL)与肾癌风险之间的因果关系。血脂的遗传工具来自英国生物银行(UK Biobank)。结果数据来自芬兰遗传研究(FinnGen)(1397 例肾癌病例和 204070 例对照)。单变量 MR(SVMR)和多变量 MR(MVMR)分析采用基于 R 4.0.3 的 TwoSampleMR 包进行。随机效应逆方差加权(inverse-variance weighted,IVW)、MR-Egger、加权中位数法和加权模式是四种主要计算方法。我们发现,基于 SVMR,每升高 1 个标准差 LDL 水平与肾癌发生存在因果关系(比值比,1.31,95%置信区间:1.05-1.64,P=0.016)。在其他方法中也发现了类似的显著关联。然而,在所有方法中,SVMR 的结果均不支持 TG 和 HDL 与肾癌风险之间存在显著关联。在 MVMR 分析中,LDL 与肾癌的关联仍然显著(IVW 方法的比值比:每升高 1 个标准差 LDL 水平,95%置信区间:1.11-1.34,P<0.001;MR-Egger 的比值比:每升高 1 个标准差 LDL 水平,95%置信区间:1.01-1.47,P=0.042),同时考虑了 TG 和 HDL。本研究支持血清 LDL 水平升高与肾癌风险增加之间存在因果关系,且独立于 TG 和 HDL。