Kim Seohyun, Kim Gyuri, Cho So Hyun, Oh Rosa, Kim Ji Yoon, Lee You-Bin, Jin Sang-Man, Hur Kyu Yeon, Kim Jae Hyeon
Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea.
Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Front Oncol. 2023 Oct 5;13:1254339. doi: 10.3389/fonc.2023.1254339. eCollection 2023.
We investigated the association between total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglyceride (TG) variability and cancer patient mortality risk.
We retrospectively analyzed 42,539 cancer patients who were not receiving lipid-lowering agents and who had at least three TC measurements within 2 years of their initial cancer diagnosis. Using a multivariable Cox regression model, the risk of mortality was evaluated.
In multivariable analysis, Q2 (adjusted hazard ratio [aHR]: 1.32, 95% confidence interval (CI): 1.24-1.41), Q3 (aHR: 1.66, 95% CI: 1.56-1.76), and Q4 (aHR: 1.96, 95% CI: 1.84-2.08) of coefficient of variation (CV) in TC were significantly associated with mortality risk compared to Q1, showing a linear association between higher TC variability and mortality ( for trend<0.001). Q2 (aHR: 1.34, 95% CI: 1.06-1.77), Q3 (aHR: 1.40, 95% CI: 1.06-1.85), and Q4 (aHR: 1.50, 95% CI: 1.14-1.97) were all significantly associated with a higher risk of death compared to Q1 in multivariable Cox regression for the association between CV in LDL and all-cause mortality ( for trend=0.005).
In cancer patients who do not receive lipid-lowering agents, high variability in total cholesterol and LDL cholesterol levels was found to pose significant role in mortality risk.
我们研究了总胆固醇(TC)、低密度脂蛋白(LDL)胆固醇、高密度脂蛋白(HDL)胆固醇和甘油三酯(TG)变异性与癌症患者死亡风险之间的关联。
我们回顾性分析了42539例未接受降脂药物治疗且在初次癌症诊断后2年内至少进行了三次TC测量的癌症患者。使用多变量Cox回归模型评估死亡风险。
在多变量分析中,与第一四分位数(Q1)相比,TC变异系数(CV)的第二四分位数(Q2)(调整后风险比[aHR]:1.32,95%置信区间[CI]:1.24-1.41)、第三四分位数(Q3)(aHR:1.66,95%CI:1.56-1.76)和第四四分位数(Q4)(aHR:1.96,95%CI:1.84-2.08)与死亡风险显著相关,表明较高的TC变异性与死亡率之间存在线性关联(趋势P<0.001)。在多变量Cox回归分析中,LDL的CV与全因死亡率之间的关联中,与Q1相比,Q2(aHR:1.34,95%CI:1.06-1.77)、Q3(aHR:1.40,95%CI:1.06-1.85)和Q4(aHR:1.50,95%CI:1.14-1.97)均与较高的死亡风险显著相关(趋势P=0.005)。
在未接受降脂药物治疗的癌症患者中,发现总胆固醇和LDL胆固醇水平的高变异性在死亡风险中起重要作用。