Discrepant effect of high-density lipoprotein cholesterol on esophageal and gastric cancer risk in a nationwide cohort
Background The relationship between high-density lipoprotein cholesterol (HDL-C) and gastroesophageal cancer is not constant. Methods 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...
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Published in | Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association Vol. 27; no. 3; pp. 451 - 460 |
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Main Authors | , , |
Format | Journal Article |
Language | English |
Published |
Singapore
Springer Nature Singapore
01.05.2024
Springer Nature B.V |
Subjects | |
Online Access | Get full text |
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Summary: | Background
The relationship between high-density lipoprotein cholesterol (HDL-C) and gastroesophageal cancer is not constant.
Methods
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).
Results
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.
Conclusions
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. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1436-3291 1436-3305 |
DOI: | 10.1007/s10120-024-01477-7 |