Serum cholesterol trajectories in the 10 years prior to lymphoma diagnosis
Serum cholesterol trajectories in the 10 years prior to lymphoma diagnosis
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DOI：
10.1007/s10552-017-0987-7
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发表时间：
2018-01-01
影响因子：
2.3
通讯作者：
Johnson, Christine Cole
中科院分区：
文献类型：
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作者：
Alford, Sharon Hensley;Divine, George;Johnson, Christine Cole
目的许多研究表明胆固醇在癌症发展中的作用。在新诊断的淋巴瘤病例中观察到血清胆固醇水平较低。这些分析的目的是检查胆固醇与淋巴瘤发生的时间变化的关系，在10年前诊断淋巴瘤subtype.Methods参与者被选中从1998年至2008年6个国家癌症研究所资助的癌症研究网络健康计划的联合会员，不包括人类免疫缺陷病毒，癌症（淋巴瘤除外），或器官移植。在这一人群中发生的淋巴瘤病例被确定，并与多达五个对照组相匹配。从计划数据库中收集血清总胆固醇、高密度脂蛋白和低密度脂蛋白。在通过偏差统计量为选定的淋巴瘤组织型选择最佳多项式阶次后，拟合多水平、多变量纵向模型，以检查诊断前胆固醇轨迹：霍奇金淋巴瘤（n = 519）和所有非霍奇金淋巴瘤合并（n = 12，635）以及后者的六种亚型。结果对于所有类别，淋巴瘤病例的估计血清总胆固醇在统计学上显著降低，高密度脂蛋白和低密度脂蛋白水平比对照组在诊断/索引日期之前的年份。组间差异最明显的诊断前3-4年，当案件的胆固醇水平急剧下降。结论这项分析是第一次检查前十年的血清胆固醇的变化淋巴瘤诊断。胆固醇水平的下降在诊断前几年就很明显了。我们的研究结果表明，胆固醇相关的途径与淋巴瘤的发生有重要的关系，低胆固醇可能是一个临床前淋巴瘤标志物。
Purpose Many studies suggest a role for cholesterol in cancer development. Serum cholesterol levels have been observed to be low in newly diagnosed lymphoma cases. The objective of these analyses was to examine the time-varying relationship of cholesterol with lymphomagenesis in the 10 years prior to diagnosis by lymphoma subtype.Methods Participants were selected from the combined membership of six National Cancer Institute-funded Cancer Research Network health plans from 1998 to 2008, excluding members with human immunodeficiency virus, cancer (except lymphoma), or organ transplants. Incident lymphoma cases within this population were ascertained and matched with up to five controls. Total serum cholesterol, high-density lipoprotein, and low-density lipoprotein were collected from plan databases. Multilevel, multivariable longitudinal models were fit after choosing the best polynomial order by deviance statistics for selected lymphoma histotypes to examine pre-diagnosis cholesterol trajectories: Hodgkin lymphoma (n = 519) and all nonHodgkin lymphomas combined (n = 12,635) as well as six subtypes of the latter.Results For all categories, lymphoma cases had statistically significantly lower estimated total serum cholesterol, high-density lipoprotein, and low-density lipoprotein levels than controls in the years prior to diagnosis/index date. Between-group differences were most pronounced 3-4 years prior to diagnosis, when cases' cholesterol levels declined steeply.Conclusions This analysis is the first to examine changes in serum cholesterol for a decade prior to lymphoma diagnosis. A drop in cholesterol levels was evident several years before diagnosis. Our results suggest that cholesterol-related pathways have an important relationship with lymphomagenesis and low cholesterol could be a preclinical lymphoma marker.