Tamakoshi A, Ohno Y, Suzuki S, Kawamura T, Wakai K, Nakamura R
Department of Preventive Medicine, Nagoya University School of Medicine.
Nihon Koshu Eisei Zasshi. 1994 May;41(5):393-403.
Epidemiological studies which examine an association between low serum cholesterol level and cancer risk of all sites were reviewed and a summary of major findings are as follows: (1) In most reports, low serum cholesterol level, which associated with cancer of all sites, cancer deaths/incidence occurred within a few years after cholesterol measurement were performed. This short-term association is believed to be a preclinical cancer effect, i.e., preclinical cancer itself reduces serum cholesterol level. (2) A long-term inverse association between serum cholesterol and cancer risk of all sites was observed in some studies. This association cannot be explained by either a preclinical cancer effect or by chance. The epidemiological implications of this association was discussed in depth. (3) A long-term inverse association between serum cholesterol level and cancer mortality/incidence was observed mainly in men, but not in women. In a few studies which reported an inverse association in women, follow-up periods were rather short. (4) A few epidemiological studies conducted in Japan also detected a long-term inverse relationship between serum cholesterol level and cancer risk of all sites in men, but not in women. Since low serum cholesterol level may possibly be a risk factor for cancer of all sites, further investigation involving experimental studies on animals and longitudinal population-based study appear to be necessary for confirmation of this factor.
对考察低血清胆固醇水平与所有部位癌症风险之间关联的流行病学研究进行了综述，主要研究结果总结如下：（1）在大多数报告中，低血清胆固醇水平与所有部位的癌症相关，在进行胆固醇测量后的几年内出现癌症死亡/发病率。这种短期关联被认为是临床前癌症效应，即临床前癌症本身会降低血清胆固醇水平。（2）在一些研究中观察到血清胆固醇与所有部位癌症风险之间存在长期的负相关。这种关联既不能用临床前癌症效应来解释，也不能用偶然性来解释。深入讨论了这种关联的流行病学意义。（3）血清胆固醇水平与癌症死亡率/发病率之间的长期负相关主要在男性中观察到，而在女性中未观察到。在少数报告女性存在负相关的研究中，随访期相当短。（4）在日本进行的一些流行病学研究也检测到男性血清胆固醇水平与所有部位癌症风险之间存在长期负相关，而女性中未观察到。由于低血清胆固醇水平可能是所有部位癌症的一个危险因素，因此似乎有必要进行进一步的研究，包括动物实验研究和基于人群的纵向研究，以证实这一因素。
