Gastroenterology, School of Medicine, Kyungpook National University Chilgok Hospital, Kyungpook National University, 807 Hoguk-Ro, Buk-Gu, Daegu, 702-210, Korea.
Department of Statistics, Kyungpook National University, Buk-Gu, Daegu, Korea.
Gastric Cancer. 2024 May;27(3):451-460. doi: 10.1007/s10120-024-01477-7. Epub 2024 Feb 28.
The relationship between high-density lipoprotein cholesterol (HDL-C) and gastroesophageal cancer is not constant.
In this population-based cohort study, 4.518 million cancer-free individuals among those who underwent national cancer screening in 2010 were enrolled and followed up until December 2017. HDL-C level was classified into eight groups at 10 mg/dL intervals. The risk of gastroesophageal cancers by HDL-C was measured using adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs).
During 8 years of follow-up, 38,362 gastric and 3022 esophageal cancers developed. Low HDL-C level was associated with an increased risk of gastric cancer; aHR was 1.19 (95% CI 1.09-1.30) for HDL-C < 30 mg/dL, 1.07 (95% CI 1.03-1.12) for HDL-C of 30-39 mg/dL, and 1.07 (95% CI 1.03-1.12) for HDL-C of 40-49 mg/dL comparing to HDL-C of 60-69 mg/dL. HDL-C was positively associated with esophageal cancer risk; aHR was 1.30 (1.12-1.51) for HDL-C of 70-79 mg/dL, 1.84 (1.53-2.22) for HDL-C of 80-89 mg/dL, 2.10 (1.67-2.61) for HDL-C ≥ 90 mg/dL. These site-specific effects of HDL-C were robust in sensitivity analyses. The range of HDL-C for the lowest cancer risk was different by sex and site. The hazardous effect of low HDL-C on gastric cancer was prominent in never and past smokers, and extremely high HDL-C increased gastric cancer risk (aHR 1.19; 95% CI 1.04-1.36) only in current smokers. Unfavorable effect of high HDL-C on gastroesophageal cancer risk was remarkable in smokers.
Low HDL-C increased the risk of gastric cancer, wherein high HDL-C was associated with esophageal cancer risk with discrepancies by sex and smoking status.
高密度脂蛋白胆固醇（HDL-C）与胃食管癌的关系并非一成不变。
本项基于人群的队列研究纳入了 2010 年接受国家癌症筛查的 451.8 万名无癌症个体，并随访至 2017 年 12 月。以 10mg/dL 为间隔将 HDL-C 水平分为 8 组。采用校正危害比（aHR）和 95%置信区间（CI）评估 HDL-C 与胃食管癌风险的关系。
在 8 年的随访期间，发生了 38362 例胃癌和 3022 例食管癌。低 HDL-C 水平与胃癌风险增加相关；与 HDL-C 水平为 60-69mg/dL 相比，HDL-C 水平 <30mg/dL 时的 aHR 为 1.19（95%CI 1.09-1.30），HDL-C 水平为 30-39mg/dL 时的 aHR 为 1.07（95%CI 1.03-1.12），HDL-C 水平为 40-49mg/dL 时的 aHR 为 1.07（95%CI 1.03-1.12）。HDL-C 与食管癌风险呈正相关；与 HDL-C 水平为 60-69mg/dL 相比，HDL-C 水平为 70-79mg/dL 时的 aHR 为 1.30（1.12-1.51），HDL-C 水平为 80-89mg/dL 时的 aHR 为 1.84（1.53-2.22），HDL-C 水平为 ≥90mg/dL 时的 aHR 为 2.10（1.67-2.61）。这些特定部位的 HDL-C 作用在敏感性分析中是稳健的。不同性别和部位的最低癌症风险的 HDL-C 范围不同。低 HDL-C 对胃癌的危害性作用在从不吸烟者和既往吸烟者中更为显著，极高的 HDL-C 水平会增加胃癌风险（aHR 1.19；95%CI 1.04-1.36），仅在当前吸烟者中如此。高 HDL-C 对胃食管癌风险的不利影响在吸烟者中尤为显著。
低 HDL-C 会增加胃癌风险，而高 HDL-C 与食管癌风险相关，其与性别和吸烟状况的差异有关。
