Abstract
BackgroundIt remains unclear whether serum lipids influence colorectal cancer (CRC) risk.MethodsWe 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.ResultsDuring 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).ConclusionsSerum 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.
Highlights
It remains unclear whether serum lipids influence colorectal cancer (CRC) risk
In the CRC subsite analysis using the fully adjusted model (Table 3), we found a positive association of TG with cancers in the caecum and transverse colon, with the hazard ratios (HRs) per standard deviation (SD) of 1.12 [95% confidence intervals (CIs), 1.00–1.25] and 1.28 [95% CI, 1.08–1.53], respectively; an inverse association was found between ApoA and cancer in the hepatic flexure (HR, 0.73 [95% CI, 0.56–0.96])
A nested case−control study with 1238 first-incident CRC cases and 1:1 matched controls based on European Prospective Investigation into Cancer and Nutrition (EPIC) showed that high concentrations of serum high-density lipoprotein cholesterol (HDL) and ApoA were associated with a decreased risk of colon cancer, while no associations were observed with the risk of rectal cancer.[42]
Summary
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. 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. Colorectal cancer (CRC) is the third most common malignancy and the second leading cause of cancer death worldwide.[1] Obesity and poor diet are considered widely to be the major risk factors for CRC.[2] In obese individuals, adiposopathy, a pathogenic effect due to adipocyte hypertrophy and excessive adipose tissue accumulation, results in abnormal concentrations of circulating lipids through releasing triglycerides (TG), free cholesterol and other body lipids stored in adipocyte and adipose tissues into blood.[3] Given the close link between obesity and dyslipidaemia, the role of lipids in CRC risk and progression is of interest.[4,5,6]. Epidemiological findings on serum lipids and CRC have been conflicting.[12,13,14]
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