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Serum lipids and risk of obesity-related cancers in postmenopausal women

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Abstract

Purpose

Obesity, which is commonly accompanied by dyslipidemia, is associated with an increased risk of certain cancers. However, the association of serum lipids with specific obesity-related cancers is unclear.

Methods

We examined the association of baseline lipids (total cholesterol, low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], and triglycerides) with risk of developing seven obesity-related cancers in a subcohort of 24,208 participants in the Women’s Health Initiative. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for quartiles of lipids with cancers of the breast, colorectum, pancreas, endometrium, ovary, and kidney, and multiple myeloma.

Results

Total cholesterol and LDL-C showed no association with these outcomes. HDL-C was inversely associated, and triglycerides were positively associated, with several cancers. However, after adjustment for other lipids or insulin, consideration of preclinical disease, and exclusion of women taking statins, most associations were attenuated and no longer significant. Only the inverse association of HDL-C with pancreatic cancer (HR for highest vs. lowest quartile 0.52, 95% CI 0.32–0.85, p for trend 0.007) and the positive association of triglycerides with kidney cancer (HR for highest vs. lowest quartile 3.21, 95% CI 1.63–6.33, p for trend = 0.0001) remained significant. However, the inverse association of HDL-C with pancreatic cancer was no longer significant when women who lost substantial weight before diagnosis were excluded.

Conclusions

Our results suggest that when possible sources of confounding and bias are taken into account there are few robust associations of lipids with obesity-related cancers.

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Acknowledgments

We thank the Women’s Health Initiative investigators, staff, and the trial participants for their outstanding dedication and commitment. Women’s Health Initiative Investigators—Program Office (National Heart, Lung, and Blood Institute, Bethesda, MD) Jacques Roscoe, Shari Ludlum, Dale Burden, Joan McGowan, Leslie Ford, and Nancy Geller. Clinical Coordinating Center (Fred Hutchinson Cancer Research Center, Seattle, WA) Garnet Anderson, Ross Prentice, Andrea LaCroix, and Charles Kopperberg. Investigators and Academic Centers (Brigham and Women’s Hospital, Harvard Medical School, Boston, MA) JoAnn E, Manson; (MedStar Health Research Institute/Howard University, Washington, DC) Barbara V Howard; (Stanford Prevention Research Center, Stanford, CA) Marcia L. Stefanick; (The Ohio State University, Columbus, OH) Rebecca Jackson; (University of Arizona, Tucson/Phoenix, AZ) Cynthia A. Thompson; (University at Buffalo, Buffalo, NY) Jean Wactawski-Wende; (University of Florida, Gainesville/Jacksonville, FL) Marian Limacher; (University of Iowa, Iowa City/Davenport, IA) Robert Wallace; (University of Pittsburgh, Pittsburgh, PA) Lewis Kuller; (City of Hope Comprehensive Cancer Center, Duarte, CA) Rowan T. Chlebowski; (Wake Forest University School of Medicine, Winston-Salem, NC) Sally Shumaker. Women’s Health Initiative Memory Study (Wake Forest University School of Medicine, Winston-Salem, NC) Sally Shumaker. Additional information A full list of all the investigators who have contributed to Women’s Health Initiative science appears at: https://www.whi.org/researchers/Documents%20%20Write%20a%20Paper/WHI%20Investigator%20Long%20List.pdf.

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Authors and Affiliations

  1. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, 10461, USA

    Geoffrey C. Kabat, Mimi Y. Kim, Sylvia Wassertheil-Smoller & Thomas E. Rohan

  2. Medical Oncology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA

    Rowan T. Chlebowski

  3. Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA

    Mara Z. Vitolins

Authors
  1. Geoffrey C. Kabat
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  2. Mimi Y. Kim
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  3. Rowan T. Chlebowski
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  4. Mara Z. Vitolins
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  5. Sylvia Wassertheil-Smoller
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  6. Thomas E. Rohan
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Correspondence to Geoffrey C. Kabat.

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Kabat, G.C., Kim, M.Y., Chlebowski, R.T. et al. Serum lipids and risk of obesity-related cancers in postmenopausal women. Cancer Causes Control 29, 13–24 (2018). https://doi.org/10.1007/s10552-017-0991-y

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  • DOI: https://doi.org/10.1007/s10552-017-0991-y

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