Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, 300211, China.
Department of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510230, Guangdong, China.
Sci Rep. 2024 Nov 24;14(1):29096. doi: 10.1038/s41598-024-80190-y.
Often linked with the risk of various diseases, blood low-density lipoprotein cholesterol (LDL-C) levels are typically deemed more favorable when lower. The objective of this investigation is to elucidate the link between blood LDL-C levels and the risk of prostate cancer (PCa) in middle-aged and older men without hypertension in the United States. Utilizing continuous data from the National Health and Nutrition Examination Survey (NHANES) database spanning 2003-2010, a selection of 1,223 non-hypertensive men aged ≥ 40 years was made from a pool of 41,156 participants, ensuring no missing information. Regression analyses were employed to investigate the correlation between blood LDL-C levels and the PCa risk, while identifying potential inflection points indicative of threshold effects. Additionally, we scrutinized the linkage between cholesterol-lowering prescription drug usage and PCa. In our study of 2,224 participants, we found no significant correlation between blood LDL-C levels and the PCa risk after adjusting for confounding variables (Odds Ratio = 0.99; P-value > 0.05). However, upon conducting a subgroup analysis, we discovered a meaningful correlation between lower blood LDL-C levels and an increased PCa risk in the non-hypertensive population (Odds Ratio = 0.99; P-value < 0.05). Meanwhile, we identified a threshold effect and a tipping point at an LDL-C levels of 67 mg/dl. Furthermore, a significant correlation was identified between cholesterol-lowering prescription drug usage and a heightened PCa risk in the non-hypertensive population (Odds Ratio = 18.87; P-value < 0.05; P for interaction < 0.05). Our results indicate that in non-hypertensive middle-aged and older men residing in the United States, lower blood LDL-C levels are not necessarily better and the PCa risk escalates when blood LDL-C levels drop below 67 mg/dl, which may guide early screening and prognosis of PCa in specific populations. This finding calls for further validation via larger sample sizes and a more in-depth analysis of PCa history.
通常与各种疾病的风险相关联，血液中低密度脂蛋白胆固醇（LDL-C）水平通常较低时更为有利。本研究的目的是阐明美国中年和老年男性中无高血压的血液 LDL-C 水平与前列腺癌（PCa）风险之间的联系。利用 2003-2010 年国家健康和营养检查调查（NHANES）数据库中的连续数据，从 41156 名参与者中选择了 1223 名无高血压的≥40 岁男性，确保没有缺失信息。采用回归分析研究血液 LDL-C 水平与 PCa 风险之间的相关性，同时确定指示阈值效应的潜在拐点。此外，我们还研究了降胆固醇处方药使用与 PCa 之间的联系。在我们对 2224 名参与者的研究中，我们发现调整混杂变量后，血液 LDL-C 水平与 PCa 风险之间没有显著相关性（比值比=0.99；P 值>0.05）。然而，在进行亚组分析时，我们发现非高血压人群中血液 LDL-C 水平较低与 PCa 风险增加之间存在有意义的相关性（比值比=0.99；P 值<0.05）。同时，我们发现了一个阈值效应和一个 LDL-C 水平为 67mg/dl 的转折点。此外，我们发现非高血压人群中降胆固醇处方药使用与 PCa 风险升高之间存在显著相关性（比值比=18.87；P 值<0.05；P 值交互作用<0.05）。我们的结果表明，在美国居住的非高血压中年和老年男性中，血液 LDL-C 水平较低并不一定更好，当血液 LDL-C 水平降至 67mg/dl 以下时，PCa 风险会升高，这可能为特定人群的 PCa 早期筛查和预后提供指导。这一发现需要通过更大的样本量和更深入的 PCa 病史分析来进一步验证。
