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Effect of Low HDL Cholesterol on Cancer Risk in Type 2 Diabetes Patients

Low HDL increases the risk of heart disease but does it also increase the risk of cancer?…

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In this study, data from type 2 diabetic patients was analyzed to determine whether HDL cholesterol (HDL-C) could be associated with cancer risk.

Researchers conducted a retrospective cohort study consisting of 14,169 men and 23,176 women with type 2 diabetes. The association between HDL-C at various levels and cancer risk was estimated using Cox proportional hazard regression models.

Out of all those who participated in the study, 3,711 patients were diagnosed with cancer throughout a mean follow-up period of 6.4 years. Among those men and women who were diagnosed, there was a significant inverse relationship between HDL-C and cancer risk. The multivariable-adjusted hazard ratios (HRs) of cancer at baseline HDL-C levels of <30, 30–39.9, 40–49.9, 50–59.9, 60–69.9, 70–79.9, and ≥80 mg/dL for men and women were 1.00 and 1.00, 0.87 and 0.98, 0.95 and 0.88, 1.01 and 0.85, 0.61 and 0.84, 0.45 and 0.86, and 0.37 and 0.84, respectively (p trend = 0.027 in men and 0.025 in women). This inverse relationship was still present when patients were stratified by race, BMI, smoking status, or medication use, and it did not change when an updated mean HDL-C was used in the analysis, but it became greatly attenuated after the patients who died of or were diagnosed with cancer during the first 2 years of follow-up were excluded.

As the results indicated, there was an inverse association between HDL-C and cancer risk in patients with type 2 diabetes. The instances of cancer diagnosis increased as HDL-C levels decreased among the men and women of this study. This effect of HDL-C was partially mediated by reverse causation.

Practice Pearls:

  • There is an inverse association between HDL-C and cancer risk.
  • The risk of cancer has been shown to increase with the decrease in HDL-C.
  • This inverse relationship remained present even when the mean of HDL-C was updated and when the patients were stratified by race, BMI, smoking status, or medication.

Published online on Sep 11, 2014 in Diabetes Care.