Source: DGNews  |  Posted 3 years ago

NEW YORK -- August 26, 2008 -- Low levels of low-density lipoprotein (LDL) cholesterol, as well as high levels, are associated with cancer in patients with type 2 diabetes, according to a study published in the August issue of the Canadian Medical Association Journal.

"LDL cholesterol levels below 2.80 mmol/L and levels of at least 3.90 mmol/L were both associated with markedly elevated risk of cancer among patients who did not use statins," the authors wrote.

Juliana Chan, MD, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China, and colleagues examined the risk association between LDL cholesterol and cancer among 6,107 Chinese patients with type 2 diabetes.

All patients were free of cancer at enrolment and statin use was known. However, the study excluded people on statins as statins obscured the association between LDL cholesterol and all-site cancer.

During a median follow-up period of 4.90 years, cancer developed in 270 (4.4%) of the patients. Among the 3,800 patients who did not receive statin therapy, the risk association between, LDL cholesterol and cancer was represented by a V-shaped curve.

Compared with patients whose LDL cholesterol was at least 2.80 mmol/L but less than 3.80 mmol/L, the risk of cancer or death from any cause, or the composite outcome of cancer or death, was greater among those with an LDL cholesterol level of less than 2.80 mmol/L (hazard ratio [HR] = 1.74; 95% confidence interval [CI], 1.20-2.52) and those with an LDL cholesterol level of 3.80 mmol/L or greater (HR = 1.87; 95% CI, 1.29-2.71).

Regarding clinical implications, the authors suggest "the use of these levels as risk markers may help clinicians to assess their patients more fully and thus to prevent premature deaths in patients who have high risk."

In a related commentary, Frank Hu, MD, PhD, and Eric Ding, ScD, Harvard School of Public Health, Boston, Massachusetts, said that confounding factors such as indication for the use of statins, lifestyle, and socioeconomic status must be considered when looking at the association of high levels of LDL cholesterol and the risk of cancer.

"Low serum cholesterol is commonly observed in individuals with ill health and those with unhealthy lifestyle characteristics such as smoking and heavy drinking," said Dr. Hu.

SOURCE: Canadian Medical Association Journal