Correlation between HDL-C Level and Lung Cancer: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 LIULi-mei ^1,2 , CHENHua ¹ , XIEMeng-yao ¹ , WANGDan ³ ,  YUANYong-hua ^1,4,5,6

1. Department of Pharmacy, Children's Hospital of Chongqing Medical University, Chongqing 400014, China;
2. Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China;
3. Department of Pharmacy, Nanchong Central Hospital, Nanchong 637900, China;
4. Pediatric Research Institute, Children's Hospital of Chongqing Medical University, Ministry of Education key Laboratory of Child Development and Disorders, Chongqing 400014, China;
5. China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China;
6. Department of Clinical Pharmacy, Chongqing Medical University, Chongqing 400016, China;

Corresponding author：

YUANYong-hua, Email: yonghuayuancq@163.com

Keywords：

HDL-C; Lung cancer; Systematic review; Meta-analysis

DOI：

10.7507/1672-2531.20160192

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the correlation between HDL-C level and lung cancer. Methods Such databases as PubMed, EBSCO, ISI Web of Science, The Cochrane Library (Issue 8, 2015), VIP, and CNKI Data were electronically searched from inception to September 23^th, 2015 to collect studies about the correlation between HDL level and lung cancer. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed using Stata 12.0 software. Results Fifteen studies involving 2 015 lung cancer patients and 15 505 controls were finally included. The results of meta-analysis showed that the total HDL-C level in the lung cancer group was lower than that in the control group (SMD=-0.68, 95%CI-0.97 to -0.40, P=0.000). Further subgroup analysis showed that the incidence of lung cancer of different clinical classification (SMD_Ⅰ~Ⅱ=-0.65, 95%CI -1.07 to -0.23, P=0.002; SMD_Ⅲ~Ⅳ=-0.61, 95%CI -0.73 to -0.50, P=0.000), different pathological types (the small cell lung cancer excluded) (SMD_AC=-0.76, 95%CI -1.13 to -0.38, P=0.000; SMD_SC=-1.51, 95%CI -2.47 to -0.56, P=0.010; SMD_SCLC=-1.19, 95%CI -1.42 to -0.95, P=0.000), different quality scores (SMD_{≥6 score}=-0.60, 95%CI -0.89 to -0.29, P=0.000; SMD_{< 6 score}=-0.77, 95%CI -1.48 to -0.0, P=0.015), the number of different studies (SMD_{≥100 cases}=-0.48, 95%CI -0.80 to -0.15, P=0.004; SMD_{< 100 cases}=-0.80, 95%CI -1.33 to -0.27, P=0.003), smoking (SMD=-1.47, 95%CI -2.51 to -0.43, P=0.006) and Asia (SMD=-0.92, 95%CI -1.21 to -0.63, P=0.000) was correlated with the level of HDL-C. Conclusion The level of HDL-C is related to the incidence of lung cancer, and low HDL-C level may increase the risk of lung cancer. In view of the limitations of the studies, the above conclusions need a great many large samples and adjust the smoking status of the prospective cohort study at home and abroad to verify.

Citation： LIULi-mei, CHENHua, XIEMeng-yao, WANGDan, YUANYong-hua. Correlation between HDL-C Level and Lung Cancer: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2016, 16(11): 1263-1269. doi: 10.7507/1672-2531.20160192 Copy

1.	NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines TM). Available at:https://www.nccn.org/professionals/physician_gls/pdf/sclc.pdf.
2.	Ferlay J, Shin H R, Bray F, et al. Estimates of worldwide burden of cancer in 2008:GLOBOCAN 2008. Int J Cancer, 2010, 127(12):2893-2917.
3.	World Health Organization/Media centre/Fact sheets/Cancer. Available at:http://www.who.int/mediacentre/factsheets/fs297/en/.
4.	卢锋峰.非小细胞肺癌患者血脂代谢特点及其对预后影响.福州:福建医科大学, 2013.
5.	俸家富, 陈渝春.癌肿患者血清抗氧化维生素与脂质的变化.现代实用医学, 2003, 15(9):545-548.
6.	赵莉莉, 毛用敏.高密度脂蛋白:影响血管内皮功能的双刃剑.天津医药, 2015, 4(43):439-442.
7.	Barter P, Gotto AM, LaRosa JC, et al. HDL cholesterol, very low levels of LDL cholesterol and cardiovascular events. N Engl J Med, 2007, 357(13):1301-1310.
8.	Regnström J, Nilsson J, Tornvall P, et al. Susceptibility to low-density lipoprotein oxidation and coronary atherosclerosis in man. Lancet, 1992, 339(8803):1183-1186.
9.	Kucharska-Newton AM, Rosamond WD, Schroeder JC, et al. HDL-cholesterol and the incidence of lung cancer in the Atherosclerosis Risk in Communities study. Lung Cancer, 2008, 61(3):292-300.
10.	Dilman VM, Berstein LM, Ostroumova MN, et al. Peculiarities of hyperlipidaemia in tumour patients. Br J Cancer, 1981, 43(5):637-643.
11.	高艳红, 张妍, 田亚平, 等.不同类型的肿瘤患者的血脂分析.标记免疫分析与临床, 2010, 17(5):277-280.
12.	Wells GA, Shea B, O'Connell D. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Available at:http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp (accessed 23 September 2015).
13.	Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics, 1994, 50(4):1088-1101.
14.	Kucharska-Newton AM, Rosamond WD, Schroeder JC, et al. HDL-cholesterol and the incidence of lung cancer in the Atherosclerosis Risk in Communities (ARIC) study. Lung Cancer, 2008, 61(3):292-300.
15.	Chi PD, Liu W, Chen H, et al. High-density lipoprotein cholesterol is a favorable prognostic factor and negatively correlated with C-reactive protein level in non-small cell lung carcinoma. PLoS One, 2014, 9(3):e91080.
16.	谭树芬, 杨宏英, 李树清.癌症患者血脂水平变化.微循环学杂志, 2013, 23(3):1-2, 6.
17.	王瑜敏, 黄海霞, 袁谦.肺癌患者放疗过程中血脂的动态变化及意义.江西医学检验, 2015, 23(2):129-131.
18.	黄爱本, 庞莉, 蒋延文.肺癌患者手术及化疗前后血脂水平的变化及意义.标记免疫分析与临床, 2013, 20(2):65-68.
19.	彭玲, 李达.肺癌与胰岛素抵抗的关系研究.四川医学, 2014, 35(6):685-687.
20.	陈红涛, 张红雨, 谭吉力, 等.血脂及脂蛋白(a)检测在肺癌患者中的价值.中国误诊学杂, 2009, 9(30):7332-7333.
21.	徐永成.早发肝癌、胃癌和肺癌临床实验指标的变化特点及其与15个STR位点的关联.大连:大连医科大学, 2010.
22.	Alexopoulos CG, Blatios B, Avgerinos A. Serum Lipids and Lipoprotein Disorders in Cancer patients. Cancer, 1987, 60(12):3065-3070.
23.	Elkiran ET, Mar N, Aygen B, et al. Serum paraoxonase and arylesterase activities in patients with lung cancer in a Turkish population. BMC Cancer, 2007, 7:48.
24.	Umeki S. Decreases in serum cholesterol levels in advanced lung cancer. Respiration, 1993, 60(3):178-181.
25.	Bulman W, Saqi A, Powell CA. Acquisition and processing of endobronchial lultrasound-guoded transbronchial needle aspiration specimensin the era of targeted lung cancer chemotherapy. Am J Respir Crit Care Med, 2012, 185(6):606-611.
26.	Ruan X, Li Z, Zhang Y, et al. Apolipoprotein A-1possesses an anti-obesity effect associated with increase of energy expenditure and up-regulation of UCP1 in brown fat. J Cell Mol Med, 2011, 15(4):763-772.
27.	Morgan SA, O'Dea K, Sinclair AJ. A low-fat diet supplemented with monounsaturated fat results in less HDL-C lowering than a very-low-fat diet. J Am Diet Assoc, 1997, 97(2):151-156.
28.	伍悦蕾, 陈晓平, 蒋凌云, 等.高血压病患者高密度脂蛋白抗低密度脂蛋白氧化能力降低.中国动脉硬化杂志, 2007, 15(12):909-912.
29.	Rajput S, Wilber A. Roles of inflammation in cancer initiation, progression and metastasis. Front Biosci (ScholEd), 2010, 2:176-183.
30.	Nofer JR, Levkau B, Wolinska I, et al. Suppression of endothelial cell apoptosis by high density lipoproteins (HDL) and HDL-associated lysosphingolipids. J Biol Chem, 2001, 276(37):34480-34485.
31.	Nofer JR, Junker R, Pulawski E, et al. High density lipoproteins induce cell cycle entry in vascular smooth cells via mitogen-activated-protein kinase-dependent pathway. Thromb Haemost, 2001, 85(4):730-735.
32.	莫中成, 欧含笑, 易光辉.载脂蛋白A-1在高密度脂蛋白生物合成中的作用研究进展.生物化学与生物物理进展, 2015, 42(9):788-795.
33.	Shen L, Zhu X, Wang Y, et al. Secreted human apolipoprotein (a) kringle IV-10 and kringle V inhibit angiogenesis and xenografted tumor growth. Biol Chem, 2008, 389(2):135-141.
34.	Yi ZF, Cho SG, Zhao H, et al. A novel peptide from human apolipoprotein (a) inhibits angiogenesis and tumor growth by targeting c-Srcphosphorylation in VEGF-induced human umbilical endothelial cells. Int J Cancer, 2009, 124 (4):843-852.
35.	Garrison RJ, Kannel WB, Feinleib M. Cigarette smoking and HDL cholesterol:the Framingham offspring study. Atherosclerosis, 1978, 30(1):17-25.
36.	赵润栓, 平昭, 郭晔炳, 等.吸烟量与血清高密度脂蛋白胆固醇水平的相关性分析.现代预防医学, 2013, 40(11):2136-2138.
37.	Gepner AD, Piper ME, Johnson HM, et al. Effects of smoking and smoking cessation on lipids and lipoproteins:outcomes from a randomized clinical trial. Am Heart J, 2011, 161(1):145-151.
38.	Bakhru A, Erlinger TP. Smoking Cessation and Cardiovascular Disease Risk Factors:Results from the Third National Health and Nutrition Examination Survey. PLoS Med, 2005, 2(6):el60.
39.	常辉.吸烟对高密度脂蛋白抗氧化功能的影响, 北京:北京协和医学院, 2011.
40.	Church D, Pryor WA. Free-radical chemistry of cigarette smoke and its toxicological implications. Environ Health Perspect, 1985, 64:111-126.
41.	Rye KA, Barter PJ. Antiinflammatory actions of HDL:a new insight. Arteriosc Thromb. Vasc Biol, 2008, 28(11):1890-1891.
42.	Ahn J, Lim U, Weinstein SJ, et al. Pre-diagnostic total and high density lipoprotein cholesterol and risk of cancer. Cancer Epidemiol Biomarkers Prev, 2009, 18(11):2814-2821.

1. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines TM). Available at:https://www.nccn.org/professionals/physician_gls/pdf/sclc.pdf.
2. Ferlay J, Shin H R, Bray F, et al. Estimates of worldwide burden of cancer in 2008:GLOBOCAN 2008. Int J Cancer, 2010, 127(12):2893-2917.
3. World Health Organization/Media centre/Fact sheets/Cancer. Available at:http://www.who.int/mediacentre/factsheets/fs297/en/.
4. 卢锋峰.非小细胞肺癌患者血脂代谢特点及其对预后影响.福州:福建医科大学, 2013.
5. 俸家富, 陈渝春.癌肿患者血清抗氧化维生素与脂质的变化.现代实用医学, 2003, 15(9):545-548.
6. 赵莉莉, 毛用敏.高密度脂蛋白:影响血管内皮功能的双刃剑.天津医药, 2015, 4(43):439-442.
7. Barter P, Gotto AM, LaRosa JC, et al. HDL cholesterol, very low levels of LDL cholesterol and cardiovascular events. N Engl J Med, 2007, 357(13):1301-1310.
8. Regnström J, Nilsson J, Tornvall P, et al. Susceptibility to low-density lipoprotein oxidation and coronary atherosclerosis in man. Lancet, 1992, 339(8803):1183-1186.
9. Kucharska-Newton AM, Rosamond WD, Schroeder JC, et al. HDL-cholesterol and the incidence of lung cancer in the Atherosclerosis Risk in Communities study. Lung Cancer, 2008, 61(3):292-300.
10. Dilman VM, Berstein LM, Ostroumova MN, et al. Peculiarities of hyperlipidaemia in tumour patients. Br J Cancer, 1981, 43(5):637-643.
11. 高艳红, 张妍, 田亚平, 等.不同类型的肿瘤患者的血脂分析.标记免疫分析与临床, 2010, 17(5):277-280.
12. Wells GA, Shea B, O'Connell D. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Available at:http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp (accessed 23 September 2015).
13. Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics, 1994, 50(4):1088-1101.
14. Kucharska-Newton AM, Rosamond WD, Schroeder JC, et al. HDL-cholesterol and the incidence of lung cancer in the Atherosclerosis Risk in Communities (ARIC) study. Lung Cancer, 2008, 61(3):292-300.
15. Chi PD, Liu W, Chen H, et al. High-density lipoprotein cholesterol is a favorable prognostic factor and negatively correlated with C-reactive protein level in non-small cell lung carcinoma. PLoS One, 2014, 9(3):e91080.
16. 谭树芬, 杨宏英, 李树清.癌症患者血脂水平变化.微循环学杂志, 2013, 23(3):1-2, 6.
17. 王瑜敏, 黄海霞, 袁谦.肺癌患者放疗过程中血脂的动态变化及意义.江西医学检验, 2015, 23(2):129-131.
18. 黄爱本, 庞莉, 蒋延文.肺癌患者手术及化疗前后血脂水平的变化及意义.标记免疫分析与临床, 2013, 20(2):65-68.
19. 彭玲, 李达.肺癌与胰岛素抵抗的关系研究.四川医学, 2014, 35(6):685-687.
20. 陈红涛, 张红雨, 谭吉力, 等.血脂及脂蛋白(a)检测在肺癌患者中的价值.中国误诊学杂, 2009, 9(30):7332-7333.
21. 徐永成.早发肝癌、胃癌和肺癌临床实验指标的变化特点及其与15个STR位点的关联.大连:大连医科大学, 2010.
22. Alexopoulos CG, Blatios B, Avgerinos A. Serum Lipids and Lipoprotein Disorders in Cancer patients. Cancer, 1987, 60(12):3065-3070.
23. Elkiran ET, Mar N, Aygen B, et al. Serum paraoxonase and arylesterase activities in patients with lung cancer in a Turkish population. BMC Cancer, 2007, 7:48.
24. Umeki S. Decreases in serum cholesterol levels in advanced lung cancer. Respiration, 1993, 60(3):178-181.
25. Bulman W, Saqi A, Powell CA. Acquisition and processing of endobronchial lultrasound-guoded transbronchial needle aspiration specimensin the era of targeted lung cancer chemotherapy. Am J Respir Crit Care Med, 2012, 185(6):606-611.
26. Ruan X, Li Z, Zhang Y, et al. Apolipoprotein A-1possesses an anti-obesity effect associated with increase of energy expenditure and up-regulation of UCP1 in brown fat. J Cell Mol Med, 2011, 15(4):763-772.
27. Morgan SA, O'Dea K, Sinclair AJ. A low-fat diet supplemented with monounsaturated fat results in less HDL-C lowering than a very-low-fat diet. J Am Diet Assoc, 1997, 97(2):151-156.
28. 伍悦蕾, 陈晓平, 蒋凌云, 等.高血压病患者高密度脂蛋白抗低密度脂蛋白氧化能力降低.中国动脉硬化杂志, 2007, 15(12):909-912.
29. Rajput S, Wilber A. Roles of inflammation in cancer initiation, progression and metastasis. Front Biosci (ScholEd), 2010, 2:176-183.
30. Nofer JR, Levkau B, Wolinska I, et al. Suppression of endothelial cell apoptosis by high density lipoproteins (HDL) and HDL-associated lysosphingolipids. J Biol Chem, 2001, 276(37):34480-34485.
31. Nofer JR, Junker R, Pulawski E, et al. High density lipoproteins induce cell cycle entry in vascular smooth cells via mitogen-activated-protein kinase-dependent pathway. Thromb Haemost, 2001, 85(4):730-735.
32. 莫中成, 欧含笑, 易光辉.载脂蛋白A-1在高密度脂蛋白生物合成中的作用研究进展.生物化学与生物物理进展, 2015, 42(9):788-795.
33. Shen L, Zhu X, Wang Y, et al. Secreted human apolipoprotein (a) kringle IV-10 and kringle V inhibit angiogenesis and xenografted tumor growth. Biol Chem, 2008, 389(2):135-141.
34. Yi ZF, Cho SG, Zhao H, et al. A novel peptide from human apolipoprotein (a) inhibits angiogenesis and tumor growth by targeting c-Srcphosphorylation in VEGF-induced human umbilical endothelial cells. Int J Cancer, 2009, 124 (4):843-852.
35. Garrison RJ, Kannel WB, Feinleib M. Cigarette smoking and HDL cholesterol:the Framingham offspring study. Atherosclerosis, 1978, 30(1):17-25.
36. 赵润栓, 平昭, 郭晔炳, 等.吸烟量与血清高密度脂蛋白胆固醇水平的相关性分析.现代预防医学, 2013, 40(11):2136-2138.
37. Gepner AD, Piper ME, Johnson HM, et al. Effects of smoking and smoking cessation on lipids and lipoproteins:outcomes from a randomized clinical trial. Am Heart J, 2011, 161(1):145-151.
38. Bakhru A, Erlinger TP. Smoking Cessation and Cardiovascular Disease Risk Factors:Results from the Third National Health and Nutrition Examination Survey. PLoS Med, 2005, 2(6):el60.
39. 常辉.吸烟对高密度脂蛋白抗氧化功能的影响, 北京:北京协和医学院, 2011.
40. Church D, Pryor WA. Free-radical chemistry of cigarette smoke and its toxicological implications. Environ Health Perspect, 1985, 64:111-126.
41. Rye KA, Barter PJ. Antiinflammatory actions of HDL:a new insight. Arteriosc Thromb. Vasc Biol, 2008, 28(11):1890-1891.
42. Ahn J, Lim U, Weinstein SJ, et al. Pre-diagnostic total and high density lipoprotein cholesterol and risk of cancer. Cancer Epidemiol Biomarkers Prev, 2009, 18(11):2814-2821.

Chinese Journal of Evidence-Based Medicine

Correlation between HDL-C Level and Lung Cancer: A Meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content