It remains unclear whether serum lipids influence colorectal cancer (CRC) risk.
We 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.
During 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).
Serum 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.
Serum cardiometabolic and liver function markers in relation to colorectal cancer risk and survival
Colorectal cancer is the third most common cancer and the second leading cause of cancer death in the world. It shared several metabolic risk factors with cardiovascular disease and type 2 diabetes. Despite the link, it remains be established how markers of cardiometabolic conditions are associated with the onset and outcome of colorectal cancer. Another interesting link is between liver disease and colorectal cancer. Patients with chronic liver diseases have been demonstrated to be more likely to develop colorectal cancer. Also, most patients with advanced colorectal cancer die from distant spread into the liver. Recent studies on the gut bacteria have shown a potential relationship between liver-derived metabolites and colorectal cancer mediated through bacterial actions. These data all indicate the importance of better understanding the role of liver function in colorectal cancer. Therefore, in this study, we aim to provide a comprehensive assessment of cardiometabolic biomarkes and liver function tests in relation to colorectal cancer using the soon-to-be released serum biochemistry marker data.
|Lead investigator:||Dr Mingyang Song|
|Lead institution:||Harvard School of Public Health|