Associations of serum lipid level with risk of gastric cancer: A longitudinal study over 8 years

Abstract Purpose The association of lipid metabolism linked the risk of gastric cancer (GC) was widely debated. We aimed to explore the longitudinal associations between total cholesterol, triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) with the incident risk of GC. Methods The serum lipids were quarterly stratified based on the distribution of GC-free populations. The Cox proportional hazard models and restricted cubic spline models were applied to estimate the hazard ratios (HRs) and dose-response association of GC under different sub-analyses. The interactions of serum lipids on GC incidence were tested by generalized additive models. Results After average 7.2±1.2 years follow-up, 248 primary GCincident cases were collected among 45,642 cancer-free baseline individuals.In total population, the hazard risks (HRs) with 95% confidence interval (CI) of TG (HR=1.53, 95% CI: 1.02-2.29) and LDL-C (HR=2.21, 95% CI: 1.51-3.24) were significantly increased when the Q4 stratum compared with Q1. While decreased HR was found in the Q4 stratum of HDL-C (HR=0.42, 95% CI: 0.26-0.67). Further sub-analyses testified these associations in males solely. The highest GC incident risk was plainly visible when both HDL-C and LDL-C were abnormal (HR=5.38, 95% CI: 3.43-8.45), followed by excess TG and hypo-HDL-C group (HR=2.75, 95% CI: 1.89-4.00) and excess TG and LDL-C group (HR=2.55, 95% CI: 1.78- 3.64) compared with normal lipid group. Conclusion Lipid metabolism abnormalities could be important risk factors for GC. Additionally, a combination of any abnormalities among TG, HDL-C, and LDL-C would interactively elevate the incidence risk of GC.