Feed

Objective: To investigate the impact of different low density lipoprotein-cholesterol (LDL-C) levels on the risk of gastrointestinal cancer. Methods: A prospective cohort study was used to observe 126 050 in service and retired employees of Kailuan Group who participated in the physical examination for the first time in 2006 or 2008. A total of 122 734 people were finally included in the statistical analysis. The subjects were divided into five groups according to the baseline quintile of low-density lipoprotein cholesterol, namely Q1 group, Q2 group, Q3 group, Q4 group and Q5 group. The impact of different LDL-C groups on the incidence of gastrointestinal tumors was analyzed by Cox proportional hazard model. Results: During follow-up of (12.83±2.43) years, 1 460 cases of gastrointestinal tumors occurred, including 225 cases of esophageal cancer, 431 cases of gastric cancer and 804 cases of colorectal cancer. Cox proportional hazard model analysis found that after adjusting for age, sex, body mass index, high-sensitivity C-reactive protein, education, smoking, alcohol consumption, diabetes, hypertension, physical exercise, excessive salt intake, family history of cancer and taking lipid-lowering drugs, compared with Q5 group, the hazard ratio (HR) values of gastrointestinal tumors in Q1, Q2, Q3 and Q4 groups were 1.28 (95% CI: 1.08, 1.50), 1.07 (95% CI: 0.90, 1.26), 1.31 (95% CI: 1.11, 1.54) and 1.12 (95% CI: 0.94, 1.33), respectively. The HR values of esophageal cancer were 1.21 (95% CI: 0.80, 1.82), 0.82 (95% CI: 0.52, 1.30), 1.47 (95% CI: 1.00, 2.17) and 0.84 (95% CI: 0.54, 1.31), respectively. The HR values of gastric cancer were 1.05 (95% CI: 0.78, 1.41), 0.84 (95% CI: 0.61, 1.16), 1.21 (95% CI: 0.91, 1.63) and 1.04 (95% CI: 0.77, 1.41), respectively. The HR values of colorectal cancer were 1.44 (95% CI: 1.15, 1.80), 1.28 (95% CI: 1.02, 1.62), 1.31 (95% CI: 1.04, 1.65) and 1.26 (95% CI: 1.00, 1.59), respectively. Conclusions: The decrease of baseline LDL-C level may be a risk factor for gastrointestinal malignant tumors, but low LDL-C increases the risk of malignant tumors in a location dependent manner. Although low LDL-C level increases the risk of colorectal cancer, it has no significant correlation with esophageal cancer and gastric cancer.