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Meta-Analysis
. 2015 Nov 10;10(11):e0142669.
doi: 10.1371/journal.pone.0142669. eCollection 2015.

Serum Lipids and Breast Cancer Risk: A Meta-Analysis of Prospective Cohort Studies

Haibo Ni  1 , Huixiang Liu  1 , Rong Gao  1
Affiliations
Meta-Analysis

Serum Lipids and Breast Cancer Risk: A Meta-Analysis of Prospective Cohort Studies

Haibo Ni et al. PLoS One. .

Abstract

Purpose: Epidemiologic studies exploring causal associations between serum lipids and breast cancer risk have reported contradictory results. We conducted a meta-analysis of prospective cohort studies to evaluate these associations.

Methods: Relevant studies were identified by searching PubMed and EMBASE through April 2015. We included prospective cohort studies that reported relative risk (RR) estimates with 95% confidence intervals (CIs) for the associations of specific lipid components (i.e., total cholesterol [TC], high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], and triglycerides [TG]) with breast cancer risk. Either a fixed- or a random-effects model was used to calculate pooled RRs.

Results: Fifteen prospective cohort studies involving 1,189,635 participants and 23,369 breast cancer cases were included in the meta-analysis. The pooled RRs of breast cancer for the highest versus lowest categories were 0.96 (95% CI: 0.86-1.07) for TC, 0.92 (95% CI: 0.73-1.16) for HDL-C, 0.90 (95% CI: 0.77-1.06) for LDL-C, and 0.93 (95% CI: 0.86-1.00) for TG. Notably, for HDL-C, a significant reduction of breast cancer risk was observed among postmenopausal women (RR = 0.77, 95% CI: 0.64-0.93) but not among premenopausal women. Similar trends of the associations were observed in the dose-response analysis.

Conclusions: Our findings suggest that serum levels of TG but not TC and LDL-C may be inversely associated with breast cancer risk. Serum HDL-C may also protect against breast carcinogenesis among postmenopausal women.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow diagram of study selection.
Flow chart shows literature search and selection for prospective cohort studies of serum lipids in relation to breast cancer risk. TC = total cholesterol; HDL-C = high-density lipoprotein cholesterol; LDL-C = low-density lipoprotein cholesterol; TG = and triglycerides.
Fig 2
Fig 2. Forest plot of the highest vs. lowest categories of serum TC levels and breast cancer risk.
Squares indicate study-specific relative risk estimates (size of the square reflects the study-specific statistical weight); horizontal lines indicate 95% confidence intervals (CI); diamond indicates the overall relative risk with its 95% confidence interval.
Fig 3
Fig 3. Forest plot of the highest vs. lowest categories of serum HDL-C levels and breast cancer risk.
Squares indicate study-specific relative risk estimates (size of the square reflects the study-specific statistical weight); horizontal lines indicate 95% confidence intervals (CI); diamond indicates the overall relative risk with its 95% confidence interval.
Fig 4
Fig 4. Forest plot of the highest vs. lowest categories of serum LDL-C levels and breast cancer risk.
Squares indicate study-specific relative risk estimates (size of the square reflects the study-specific statistical weight); horizontal lines indicate 95% confidence intervals (CI); diamond indicates the overall relative risk with its 95% confidence interval.
Fig 5
Fig 5. Forest plot of the highest vs. lowest categories of serum TG levels and breast cancer risk.
Squares indicate study-specific relative risk estimates (size of the square reflects the study-specific statistical weight); horizontal lines indicate 95% confidence intervals (CI); diamond indicates the overall relative risk with its 95% confidence interval.
See this image and copyright information in PMC

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