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Association of serum lipids and abnormal lipid score with cancer risk: a population-based prospective study

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Abstract

Background

Serum lipid levels are associated with cancer risk. However, there still have uncertainties about the single and combined effects of low lipid levels on cancer risk.

Methods

A prospective cohort study of 33,773 adults in Shanghai between 2016 and 2017 was conducted. Total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels were measured. Cox proportional hazard models were used to assess the association of single and combined lipids with overall, lung, colon, rectal, thyroid gland, stomach, and female breast cancers. The effect of the combination of abnormal lipid score and lifestyle on cancer was also estimated.

Results

A total of 926 incident cancer cases were identified. In the RCS analysis, hazard ratios (HRs) of overall cancer for individuals with TC < 5.18 mmol/L or with LDL-C < 3.40 mmol/L were higher. Low TC was associated with higher colorectal cancer risk (HR [95% CI] = 1.76 [1.09–2.84]) and low HDL-C increased thyroid cancer risk by 90%. Abnormal lipid score was linearly and positively associated with cancer risk, and smokers with high abnormal lipid scores had a higher cancer risk, compared to non-smokers with low abnormal lipid scores (P < 0.05).

Conclusions

Low TC levels were associated with an increased risk of overall and colorectal cancer. More attention should be paid to participants with high abnormal lipid scores and unhealthy lifestyles who may have a higher risk of developing cancer. Determining the specific and comprehensive lipid combinations that affect tumorigenesis remains a valuable challenge.

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Data availability

Data for this study are available upon request, which clearly state the title and aim of the research.

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Acknowledgements

This work was supported by the National Key Research and Development Program of China (2019YFC1315804, 2017YFC0907000), an Innovation Grant from Science and Technology Commission of Shanghai Municipality, China (20ZR1405600), the National Natural Science Foundation of China (82073637, 82122060), the Three-Year Action Plan for Strengthening Public Health System in Shanghai (GWV-10.2-YQ32), the Discipline Promotion Program of Shanghai Fourth People’s Hospital (SY-XKZT-2020-1002), and the Local High-Level Discipline Construction Project of Shanghai. The authors would like to acknowledge that Yanfeng Jiang, Xingdong Chen, and Chen Suo have contributed equally to the correspondence work. The authors would also like to thank all the study participants in this study and all workgroup staff of the Community Health Centers from Zhongshan, Xinqiao, Sheshan, and Maogang in the Songjiang district for their contribution to data collection in the field.

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Authors and Affiliations

  1. Department of Epidemiology, School of Public Health and Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China

    Y. Xie, D. Zhu, Y. Xiang, J. Wang, T. Zhang, G. Zhao & C. Suo

  2. Songjiang District Center for Disease Control and Prevention, Shanghai, China

    Y. Jiang, Y. Wu & X. Su

  3. State Key Laboratory of Genetic Engineering, Human Phenome Institute, and School of Life Sciences, Fudan University, Shanghai, China

    P. Gao, H. Yuan & Y. Jiang

  4. Department of Social Medicine, School of Public Health, Fudan University, Shanghai, China

    Q. Zhao

  5. Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China

    K. Xu

  6. Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China

    T. Zhang, X. Chen, Y. Jiang & C. Suo

  7. Yiwu Research Institute of Fudan University, Yiwu, Zhejiang, China

    T. Zhang & X. Chen

  8. Department of Clinical Laboratory, School of Medicine, Shanghai Fourth People’s Hospital, Tongji University, Shanghai, China

    Q. Man

  9. State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, and National Clinical Research Center for Aging and Medicine, Human Phenome Institute, Huashan Hospital, Fudan University, Shanghai, China

    X. Chen

  10. Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China

    C. Suo

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  1. Y. Xie
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  2. Y. Jiang
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Contributions

YJX: conceptualization, formal analysis, and writing—original draft. YGJ: resources and data curation. YLW and XYS: investigation. DLZ, PPG, HBY, JRW, KLX, and TJZ: methodology. YX and QZ: data curation. QHM: resources and funding acquisition. XDC: supervision and funding acquisition. GMZ: supervision and resources. YFJ: supervision and writing—review and editing. CS: conceptualization, supervision, funding acquisition, and writing—review and editing. All authors read and approved the final manuscript.

Corresponding author

Correspondence to C. Suo.

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Xie, Y., Jiang, Y., Wu, Y. et al. Association of serum lipids and abnormal lipid score with cancer risk: a population-based prospective study. J Endocrinol Invest 47, 367–376 (2024). https://doi.org/10.1007/s40618-023-02153-w

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