The association between serum lipids and colorectal neoplasm: a systemic review and meta-analysis

Abstract

Objective: There have been inconsistent results published regarding the relationship between dyslipidaemia and an increased risk of colorectal neoplasia (CRN), including colorectal adenoma (CRA) and colorectal cancer (CRC). We conducted a meta-analysis to explore the relationship between dyslipidaemia and CRN. Design: We identified studies by performing a literature search using PubMed, EMBASE and the Science Citation Index through October 2013. Setting: We analysed thirty-three independent studies reporting the association between CRN and at least one of the selected lipid components, including total cholesterol (TC), TAG, HDL-cholesterol (HDL-C) and LDL-cholesterol (LDL-C). Subjects: CRN cases (n 21 809) were identified. Results: Overall, people with high levels of serum TAG (risk ratio (RR) = 1·08; 95 % CI 1·05, 1·12, P < 0·00001) and LDL-C (RR = 1·07; 95 % CI 1·00, 1·14, P = 0·04) presented an increased prevalence of CRN. Subgroup analyses revealed that high levels of serum TC (RR = 1·04; 95 % CI 1·01, 1·09, P = 0·02), TAG (RR = 1·06; 95 % CI 1·03, 1·10, P = 0·0009) and LDL-C (RR = 1·11; 95 % CI 1·04, 1·19, P = 0·003) increased the risk of CRA but not of CRC. No association between serum HDL-C and risk for CRN (including CRA and CRC) was observed. Conclusions: Both TAG and LDL-C were significantly associated with an increasing prevalence of CRN. High levels of serum TC, TAG and LDL-C were positively associated with CRA but not with CRC. No significant association was observed between levels of serum HDL-C and CRN. Keywords Serum lipids Colorectal adenomaColorectal cancer TAG Meta-analysis Colorectal cancer (CRC) is reported to be the fourth most commonly diagnosed cancer and is the second most common cause of cancer deaths in North America (1) . CRC is believed to arise from colorectal adenoma (CRA) through a sequence from adenoma to adenocarcinoma as a consequence of a limited set of molecular events that largely originate with a relatively benign adenoma that progresses to cancer (2) . Accumulated data indicate that metachronous lesions occur at a rate of 20 to 30 % per year in post-polypectomy patients. The propensity to develop CRA identifies a sizeable subgroup of the population at an enhanced risk for subsequent adenoma formation and colorectal carcinoma. This indicates that identifying risk factors associated with CRN is essential for the reduction of colorectal carcinoma.The positive association between obesity and CRA prevalence demonstrates an underlying dose-response relationship according to BMI (3) . Timely screening of obese patients for CRA is thus recommended. Dyslipidaemia is an important component of metabolic syndrome and is demonstrated to contribute to colorectal tumorigenesis through insulin resistance, oxidative stress and inflammatory † The first three authors contributed equally to this work.

Potential anti-tumor effect of a nanoliposomal antiPCSK9 vaccine in mice bearing colorectal cancer

“…However, there have been no data on the effect of PCSK9 inhibition on cancer progression. Dyslipidemia, particularly an increased plasma level of LDL-C, has been reported to be significantly correlated with a higher risk and incidence of colon cancer [9][10][11][12]. However, the effects of pharmacological LDL-C lowering on cancer has remained unclear.…”

“…Abnormal levels of plasma lipids have been shown to be significantly associated with colon carcinoma risk [1][2][3][4][5][6][7][8]. Higher levels of low-density lipoprotein (LDL) cholesterol (LDL-C) have been reported to correlate with higher prevalence [9,10] and risk [11,12] of colon cancer. LDL-C is mainly cleared from the bloodstream by the liver's LDL receptors (LDLRs).…”

Expression of long‑chain fatty acid receptor GPR40 is associated with cancer progression in colorectal cancer: A retrospective study

“…Several factors linking CRC risk with diabetes have been proposed, such as increased expression of insulin-like growth factors; oxidative stress ( 18 ); advanced glycation end-products (AGE; which may enhance malignant potential of colorectal cells) ( 5 , 20 ); and activation of the renin-angiotensin system ( 21 ). Hypertriglyceridemia or hyper low-density lipoproteinemia is associated with colonic adenomas, though the risk contribution of these factors is controversial ( 22 , 23 ).…”

Decreased serum apolipoprotein A1 levels are associated with poor survival and systemic inflammatory response in colorectal cancer

“…Abnormal levels of lipids have been linked with cancer risk and progression in several malignancies 11 . However, high serum APOA1 and HDL levels have been associated with a decreased risk of several cancers 12, 13 , as well as premalignant lesions, including colorectal adenomas 14–16 and CRC 15, 17, 18 . Moreover, decreased serum APOA1 levels in CRC patients have been reported 19, 20 , but to our knowledge, the relationships between serum APOA1 levels and clinicopathological parameters of CRC are unclear.…”