Baseline and On-Treatment High-Density Lipoprotein Cholesterol and the Risk of Cancer in Randomized Controlled Trials of Lipid-Altering Therapy
Baseline and On-Treatment High-Density Lipoprotein Cholesterol and the Risk of Cancer in Randomized Controlled Trials of Lipid-Altering Therapy
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DOI：
10.1016/j.jacc.2009.12.069
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发表时间：
2010-06-22
影响因子：
24
通讯作者：
Karas, Richard H.
中科院分区：
文献类型：
--
作者：
Jafri, Haseeb;Alsheikh-Ali, Alawi A.;Karas, Richard H.
目的：我们试图研究高密度脂蛋白胆固醇（HDL-C）水平和癌症的发展风险之间的关系，在大型随机对照试验（RCTs）的血脂改变interventions.Background流行病学数据表明，血清总胆固醇水平和癌症的发病率呈负相关。我们最近在他汀类药物治疗的大型随机对照试验的荟萃分析中报告称，低密度脂蛋白胆固醇水平较低与癌症发病风险显着较高相关。然而，鲜为人知的是HDL-C水平和癌症risk.Methods系统的MEDLINE检索确定的血脂干预RCT与>= 1,000人年的后续行动，提供基线HDL-C水平和癌症发病率之间的关系。使用随机效应荟萃回归分析，我们评估了基线HDL-C和癌症事件之间的关系，在每个RCT arm.Results共确定了24个合格的RCT（28个药物干预组和23个对照组），625,477人年的后续行动和8,185例癌症事件。基线HDL-C水平与癌症发病率呈显著负相关（p = 0.018）。在校正基线低密度脂蛋白胆固醇、年龄、体重指数（BMI）、糖尿病、性别和吸烟状况后，这种负相关仍然存在，因此HDL-C每增加10 mg/dl，（95%置信区间：24%至47%）相对较低的癌症发展率结论高密度脂蛋白胆固醇（HDL-C）与癌症发病风险呈显著负相关，与低密度脂蛋白胆固醇（LDL-C）、年龄、体重指数（BMI）、糖尿病、性别和吸烟无关。（J Am科尔心脏病学杂志2010; 55：2846-54）（C）美国心脏病学会基金会2010年
Objectives We sought to examine the relationship between high-density lipoprotein cholesterol (HDL-C) levels and the risk of the development of cancer in large randomized controlled trials (RCTs) of lipid-altering interventions.Background Epidemiologic data demonstrate an inverse relationship between serum total cholesterol levels and incident cancer. We recently reported that lower levels of low-density lipoprotein cholesterol are associated with a significantly higher risk of incident cancer in a meta-analysis of large RCTs of statin therapy. However, little is known about the relationship between HDL-C levels and cancer risk.Methods A systematic MEDLINE search identified lipid intervention RCTs with >= 1,000 person-years of follow-up, providing baseline HDL-C levels and rates of incident cancer. Using random-effects meta-regressions, we evaluated the relationship between baseline HDL-C and incident cancer in each RCT arm.Results A total of 24 eligible RCTs were identified (28 pharmacologic intervention arms and 23 control arms), with 625,477 person-years of follow-up and 8,185 incident cancers. There was a significant inverse association between baseline HDL-C levels and the rate of incident cancer (p = 0.018). The inverse association persisted after adjusting for baseline low-density lipoprotein cholesterol, age, body mass index (BMI), diabetes, sex, and smoking status, such that for every 10-mg/dl increment in HDL-C, there was a 36% (95% confidence interval: 24% to 47%) relatively lower rate of the development of cancer (p < 0.001).Conclusions There is a significant inverse association between HDL-C and the risk of incident cancer that is independent of LDL-C, age, BMI, diabetes, sex, and smoking. (J Am Coll Cardiol 2010; 55: 2846-54) (C) 2010 by the American College of Cardiology Foundation