Nationwide Cohort Study: Cholesterol Level is Inversely Related with the Risk of Gastric Cancer Among Postmenopausal Women

Overview

Journal Gastric Cancer

Specialties Gastroenterology
Oncology

Date 2021 Sep 1

PMID 34468870

Citations 13

Authors

Joo Hyun Lim

Cheol Min Shin

Kyungdo Han

Juhwan Yoo

Eun Hyo Jin

Yoon Jin Choi

Dong Ho Lee

Affiliations

Soon will be listed here.

Abstract

Background: Recent studies showed inverse relationship between hypercholesterolemia and the risk of gastric cancer, especially among male. However evidence among female is inconsistent. We aimed to investigate the relationship between cholesterol level and the risk of gastric cancer among female according to menopausal status.

Methods: We analyzed the data from a population-based prospective cohort of female ≥ 30 years old who underwent cancer screening and general health screening provided by the Korean National Health Insurance Corporation in 2009. Under quartile stratification of the level of cholesterol components, we calculated the hazard ratio (HR) for gastric cancer incidence until 2018 for each level group according to the menopausal status at 2009.

Results: Among total 2,722,614 individuals, 17,649 gastric cancer cases developed after mean 8.26 years of follow-up (premenopausal 3746/1180666; postmenopausal 13,903/1541948). Total cholesterol, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) showed inverse relationship with the risk of gastric cancer among postmenopausal women (adjusted HR (95% confidence interval) for the highest quartile vs. lowest quartile and p-for-trend: 0.88 (0.84-0.92) and < 0.001 for total cholesterol; 0.89 (0.85-0.92) and < 0.001 for HDL-C; 0.92 (0.89-0.97) and 0.001 for LDL-C), whereas none showed statistically significant risk relationship among premenopausal women. Triglyceride was not independently related with gastric cancer risk among both pre- and postmenopausal women.

Conclusions: Cholesterol levels, including total cholesterol, HDL-C, and LDL-C, are inversely related with the risk of gastric cancer among postmenopausal women, but not among premenopausal women.

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References

Mozaffarian D, Benjamin E, Go A, Arnett D, Blaha M, Cushman M . Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation. 2015; 133(4):e38-360. DOI: 10.1161/CIR.0000000000000350. View

Karr S . Epidemiology and management of hyperlipidemia. Am J Manag Care. 2017; 23(9 Suppl):S139-S148. View

Kitahara C, Berrington de Gonzalez A, Freedman N, Huxley R, Mok Y, Jee S . Total cholesterol and cancer risk in a large prospective study in Korea. J Clin Oncol. 2011; 29(12):1592-8. PMC: 3082977. DOI: 10.1200/JCO.2010.31.5200. View

Wulaningsih W, Garmo H, Holmberg L, Hammar N, Jungner I, Walldius G . Serum Lipids and the Risk of Gastrointestinal Malignancies in the Swedish AMORIS Study. J Cancer Epidemiol. 2012; 2012:792034. PMC: 3437288. DOI: 10.1155/2012/792034. View

Knekt P, Reunanen A, Aromaa A, Heliovaara M, Hakulinen T, Hakama M . Serum cholesterol and risk of cancer in a cohort of 39,000 men and women. J Clin Epidemiol. 1988; 41(6):519-30. DOI: 10.1016/0895-4356(88)90056-x. View

Schatzkin A, Hoover R, Taylor P, Ziegler R, Carter C, Albanes D . Site-specific analysis of total serum cholesterol and incident cancer in the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study. Cancer Res. 1988; 48(2):452-8. View

Tornberg S, Holm L, Carstensen J, Eklund G . Cancer incidence and cancer mortality in relation to serum cholesterol. J Natl Cancer Inst. 1989; 81(24):1917-21. DOI: 10.1093/jnci/81.24.1917. View

Law M, Thompson S . Low serum cholesterol and the risk of cancer: an analysis of the published prospective studies. Cancer Causes Control. 1991; 2(4):253-61. DOI: 10.1007/BF00052142. View

Delahaye F, Bruckert E, Thomas D, Emmerich J, Richard J . [Serum cholesterol and cancer. Is there a causal relationship?]. Arch Mal Coeur Vaiss. 1992; 85 Spec No 3:37-45. View

10.

Strasak A, Pfeiffer R, Brant L, Rapp K, Hilbe W, Oberaigner W . Time-dependent association of total serum cholesterol and cancer incidence in a cohort of 172,210 men and women: a prospective 19-year follow-up study. Ann Oncol. 2009; 20(6):1113-20. PMC: 2685450. DOI: 10.1093/annonc/mdn736. View

11.

Ahn J, Lim U, Weinstein S, Schatzkin A, Hayes R, Virtamo J . Prediagnostic total and high-density lipoprotein cholesterol and risk of cancer. Cancer Epidemiol Biomarkers Prev. 2009; 18(11):2814-21. PMC: 3534759. DOI: 10.1158/1055-9965.EPI-08-1248. View

12.

Asano K, Kubo M, Yonemoto K, Doi Y, Ninomiya T, Tanizaki Y . Impact of serum total cholesterol on the incidence of gastric cancer in a population-based prospective study: the Hisayama study. Int J Cancer. 2007; 122(4):909-14. DOI: 10.1002/ijc.23191. View

13.

Sipponen P, Correa P . Delayed rise in incidence of gastric cancer in females results in unique sex ratio (M/F) pattern: etiologic hypothesis. Gastric Cancer. 2002; 5(4):213-9. DOI: 10.1007/s101200200037. View

14.

Lindblad M, Ye W, Rubio C, Lagergren J . Estrogen and risk of gastric cancer: a protective effect in a nationwide cohort study of patients with prostate cancer in Sweden. Cancer Epidemiol Biomarkers Prev. 2004; 13(12):2203-7. View

15.

Freedman N, Chow W, Gao Y, Shu X, Ji B, Yang G . Menstrual and reproductive factors and gastric cancer risk in a large prospective study of women. Gut. 2007; 56(12):1671-7. PMC: 2095686. DOI: 10.1136/gut.2007.129411. View

16.

Pfeilschifter J, Koditz R, Pfohl M, Schatz H . Changes in proinflammatory cytokine activity after menopause. Endocr Rev. 2002; 23(1):90-119. DOI: 10.1210/edrv.23.1.0456. View

17.

De Bosscher K, Vanden Berghe W, Haegeman G . Cross-talk between nuclear receptors and nuclear factor kappaB. Oncogene. 2006; 25(51):6868-86. DOI: 10.1038/sj.onc.1209935. View

18.

Speir E, Yu Z, Takeda K, Ferrans V, Cannon 3rd R . Antioxidant effect of estrogen on cytomegalovirus-induced gene expression in coronary artery smooth muscle cells. Circulation. 2000; 102(24):2990-6. DOI: 10.1161/01.cir.102.24.2990. View

19.

Sherwin R, Wentworth D, Cutler J, Hulley S, Kuller L, Stamler J . Serum cholesterol levels and cancer mortality in 361,662 men screened for the Multiple Risk Factor Intervention Trial. JAMA. 1987; 257(7):943-8. View

20.

Song Y, Sung J, Kim J . Which cholesterol level is related to the lowest mortality in a population with low mean cholesterol level: a 6.4-year follow-up study of 482,472 Korean men. Am J Epidemiol. 2000; 151(8):739-47. DOI: 10.1093/oxfordjournals.aje.a010272. View