Xie Y, Jiang Y, Wu Y, Su X, Zhu D, Gao P, Yuan H, Xiang Y, Wang J, Zhao Q, Xu K, Zhang T, Man Q, Chen X, Zhao G, Jiang Y, Suo C
Department of Epidemiology, School of Public Health and Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
Songjiang District Center for Disease Control and Prevention, Shanghai, China.
J Endocrinol Invest. 2024 Feb;47(2):367-376. doi: 10.1007/s40618-023-02153-w. Epub 2023 Jul 17.
Serum lipid levels are associated with cancer risk. However, there still have uncertainties about the single and combined effects of low lipid levels on cancer risk.
A prospective cohort study of 33,773 adults in Shanghai between 2016 and 2017 was conducted. Total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels were measured. Cox proportional hazard models were used to assess the association of single and combined lipids with overall, lung, colon, rectal, thyroid gland, stomach, and female breast cancers. The effect of the combination of abnormal lipid score and lifestyle on cancer was also estimated.
A total of 926 incident cancer cases were identified. In the RCS analysis, hazard ratios (HRs) of overall cancer for individuals with TC < 5.18 mmol/L or with LDL-C < 3.40 mmol/L were higher. Low TC was associated with higher colorectal cancer risk (HR [95% CI] = 1.76 [1.09-2.84]) and low HDL-C increased thyroid cancer risk by 90%. Abnormal lipid score was linearly and positively associated with cancer risk, and smokers with high abnormal lipid scores had a higher cancer risk, compared to non-smokers with low abnormal lipid scores (P < 0.05).
Low TC levels were associated with an increased risk of overall and colorectal cancer. More attention should be paid to participants with high abnormal lipid scores and unhealthy lifestyles who may have a higher risk of developing cancer. Determining the specific and comprehensive lipid combinations that affect tumorigenesis remains a valuable challenge.
血清脂质水平与癌症风险相关。然而，低脂质水平对癌症风险的单一及联合影响仍存在不确定性。
对2016年至2017年间上海的33773名成年人进行了一项前瞻性队列研究。测量了总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（HDL-C）水平。使用Cox比例风险模型评估单一和联合脂质与总体、肺癌、结肠癌、直肠癌、甲状腺癌、胃癌和女性乳腺癌的关联。还估计了异常脂质评分与生活方式的组合对癌症的影响。
共确定了926例新发癌症病例。在RCS分析中，TC<5.18 mmol/L或LDL-C<3.40 mmol/L的个体患总体癌症的风险比（HR）更高。低TC与较高的结直肠癌风险相关（HR [95%CI]=1.76 [1.09 - 2.84]），低HDL-C使甲状腺癌风险增加90%。异常脂质评分与癌症风险呈线性正相关，与脂质评分低的非吸烟者相比，脂质评分高的吸烟者患癌风险更高（P<0.05）。
低TC水平与总体和结直肠癌风险增加相关。应更多关注脂质评分异常高且生活方式不健康的参与者，他们可能患癌风险更高。确定影响肿瘤发生的具体和综合脂质组合仍然是一项有价值的挑战。
