Zhe Fang1, Mingming He1,2, Mingyang Song3,4,5,6. 1. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 2. Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China. 3. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. mingyangsong@mail.harvard.edu. 4. Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. mingyangsong@mail.harvard.edu. 5. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. mingyangsong@mail.harvard.edu. 6. Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. mingyangsong@mail.harvard.edu.
Abstract
BACKGROUND: It remains unclear whether serum lipids influence colorectal cancer (CRC) risk. METHODS: We conducted a prospective cohort study of 380,087 adults aged 40-69 years in the UK Biobank. Serum high-density cholesterol, low-density cholesterol, total cholesterol, triglycerides, and apolipoprotein A and B were measured. We used Cox proportional hazard models to estimate the multivariable hazard ratios (HRs) of CRC according to one standard deviation (SD) increment in serum lipids. We conducted subgroup analysis by tumour anatomical subsites. RESULTS: During a median of 10.3 years of follow-up, we documented 2667 incident CRC cases. None of the lipid biomarkers was associated with the risk of CRC after adjusting for potential confounding factors, including body mass index and waist circumference. When assessed by cancer subsites, serum triglycerides was associated with an increased risk of cancer in the caecum and transverse colon, with the HR of 1.12 (95% CI, 1.00-1.25) and 1.29 (95% CI, 1.09-1.53), respectively; and apolipoprotein A was associated with a lower risk of hepatic flexure cancer (HR, 0.73, 95% CI, 0.56-0.96). CONCLUSIONS: Serum lipid profiles were not associated with colorectal cancer risk after adjusting for obesity indicators. The potential subsite-specific effects of triglycerides and apolipoprotein A require further confirmation.
BACKGROUND: It remains unclear whether serum lipids influence colorectal cancer (CRC) risk. METHODS: We conducted a prospective cohort study of 380,087 adults aged 40-69 years in the UK Biobank. Serum high-density cholesterol, low-density cholesterol, total cholesterol, triglycerides, and apolipoprotein A and B were measured. We used Cox proportional hazard models to estimate the multivariable hazard ratios (HRs) of CRC according to one standard deviation (SD) increment in serum lipids. We conducted subgroup analysis by tumour anatomical subsites. RESULTS: During a median of 10.3 years of follow-up, we documented 2667 incident CRC cases. None of the lipid biomarkers was associated with the risk of CRC after adjusting for potential confounding factors, including body mass index and waist circumference. When assessed by cancer subsites, serum triglycerides was associated with an increased risk of cancer in the caecum and transverse colon, with the HR of 1.12 (95% CI, 1.00-1.25) and 1.29 (95% CI, 1.09-1.53), respectively; and apolipoprotein A was associated with a lower risk of hepatic flexure cancer (HR, 0.73, 95% CI, 0.56-0.96). CONCLUSIONS: Serum lipid profiles were not associated with colorectal cancer risk after adjusting for obesity indicators. The potential subsite-specific effects of triglycerides and apolipoprotein A require further confirmation.
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