Author + information
- Xumin Guan1,
- Xiao Lei Yang1,
- Yi Heng Yang1,
- Xin Tao Li1,
- Khalid BinWaleed1,
- Rong Feng Zhang1,
- Xiang Gao2,
- Si Yan Zhan3,
- Ying Liu1,
- Hui Hua Li1,
- Shou Ling Wu4 and
- Yun Long Xia1
- 1Department of Cardiology, First affiliated Hospital of Dalian Medical University, Dalian, China
- 2Department of Nutritional Sciences, The Pennsylvania State University, PA, USA
- 3School of Public Health, Peking University, Beijing, China
- 4Department of Cardiology, Kailuan General Hospital, Tangshan, China
To prospectively investigate the association of high-density lipoprotein cholesterol(HDL-C) with cancer among Chinese adults with or without diabetes mellitus in Kailuan cohort of China.
This prospective study included 91149 participants (diabetic group: 7912; health control group: 83237) from Kailuan Study who were free of cancer at baseline (2006 to 2007) and followed up for approximately 7.9 years until cancer diagnosis, death or until December 31 2014. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and their 95% confidence intervals (CIs) to estimate the association between HDL-C concentrations and cancer risk, adjusting for age, gender, cigarette smoking, alcohol consumption, physical activity, total cholesterol (TC), hypertension, diabetes mellitus and BMI at baseline.
We identified 2495 incident cancer during the follow-up. We did not find significant association between higher HDL-C concentrations and higher cancer risk after adjustment for potential confounders (P trend=0.150). There was a significant interaction between HDL-C and diabetes mellitus on incident cancer risk (P for interaction = 0.003). In diabetic group (7912), 281(3.6%) participants developed cancer during follow-up. In multivariable analysis, compared with the lowest quartile (<1.27mmol/L), the upper-most quartile of HDL-C (≥1.77) decrease 39% risk of cancer (HR 0.61, 95% CI 0.43-0.87, P trend=0.044). In health control group (83237), 2214 (2.7%) participants developed cancer during follow-up. In multivariable analysis, compared with the lowest quartile (<1.28mmol/L), the upper-most quartile of HDL-C (≥1.76) increased 17% risk of cancer (HR 1.17, 95% CI 1.04-1.32, P trend=0.008); In addition, the associations between HDL-C and cancer risk in participants with or without diabetes mellitus were not changed after we excluded incident cancers during the first two years follow-up .
This study suggested that high HDL-C concentrations were associated with decreased cancer risk in participants with diabetes, but not in those without diabetes.