Background

Recent studies showed inverse relationship between hypercholesterolemia and the risk of gastric cancer, especially among male. However evidence among female is inconsistent. We aimed to investigate the relationship between cholesterol level and the risk of gastric cancer among female according to menopausal status.

Methods

We analyzed the data from a population-based prospective cohort of female ≥ 30 years old who underwent cancer screening and general health screening provided by the Korean National Health Insurance Corporation in 2009. Under quartile stratification of the level of cholesterol components, we calculated the hazard ratio (HR) for gastric cancer incidence until 2018 for each level group according to the menopausal status at 2009.

Results

Among total 2,722,614 individuals, 17,649 gastric cancer cases developed after mean 8.26 years of follow-up (premenopausal 3746/1180666; postmenopausal 13,903/1541948). Total cholesterol, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) showed inverse relationship with the risk of gastric cancer among postmenopausal women (adjusted HR (95% confidence interval) for the highest quartile vs. lowest quartile and p-for-trend: 0.88 (0.84–0.92) and < 0.001 for total cholesterol; 0.89 (0.85–0.92) and < 0.001 for HDL-C; 0.92 (0.89–0.97) and 0.001 for LDL-C), whereas none showed statistically significant risk relationship among premenopausal women. Triglyceride was not independently related with gastric cancer risk among both pre- and postmenopausal women.

Conclusions

Cholesterol levels, including total cholesterol, HDL-C, and LDL-C, are inversely related with the risk of gastric cancer among postmenopausal women, but not among premenopausal women.

中文翻译：

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全国队列研究：胆固醇水平与绝经后妇女患胃癌的风险呈负相关

背景

最近的研究表明，高胆固醇血症与胃癌风险之间存在反比关系，尤其是在男性中。然而，女性中的证据并不一致。我们旨在根据绝经状态调查女性胆固醇水平与胃癌风险之间的关系。

方法

我们分析了 2009 年韩国国民健康保险公司提供的接受癌症筛查和一般健康筛查的 30 岁以上女性人群前瞻性队列的数据。在胆固醇成分水平的四分位数分层下，我们计算了风险根据 2009 年绝经状态，各水平组截至 2018 年胃癌发病率的比率（HR）。

结果

在总共 2,722,614 人中，17,649 例胃癌病例在平均 8.26 年的随访后发展（绝经前 3746/1180666；绝经后 13,903/1541948）。总胆固醇、高密度脂蛋白胆固醇 (HDL-C) 和低密度脂蛋白胆固醇 (LDL-C) 与绝经后女性患胃癌的风险呈负相关（最高四分位数的调整后 HR（95% 置信区间）与最低四分位数和p- 趋势：0.88 (0.84–0.92) 和 < 0.001 总胆固醇；HDL-C 为 0.89 (0.85–0.92) 和 < 0.001；0.92（0.89-0.97）和 0.001 的 LDL-C），而绝经前妇女之间没有显示出统计学上显着的风险关系。甘油三酯与绝经前和绝经后妇女的胃癌风险无关。

结论

胆固醇水平，包括总胆固醇、HDL-C 和 LDL-C，与绝经后妇女患胃癌的风险呈负相关，但在绝经前妇女中则没有。