Association between serum lipids and breast cancer risk in premenopausal women: systematic review and meta-analysis

Abstract

Objective: Associations between serum lipids and their individual components with premenopausal breast cancer risk are unclear. This meta-analysis summarized the literature on serum lipids and premenopausal breast cancer risk to elucidate their relationship.

Methods: Eligible studies were identified by searching the PubMed, Embase, China National Knowledge Infrastructure, and Wanfang databases until 31 December 2020. Standardized mean difference (SMD) scores with 95% confidence intervals (95%CIs) were used to assess the impact of serum lipids on premenopausal breast cancer risk. The I² statistic was calculated to measure the percentage of heterogeneity, and Egger's test was performed to measure publication bias.

Results: Thirteen studies were included. The SMD scores of triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) were 12.90 (95%CI: 7.19-18.61) and 31.43 (95%CI: 8.72-54.15), respectively. The SMD scores of total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) were not significantly different between the groups. The included studies were highly heterogeneous. There were no publication biases found in TC, LDL-C, or HDL-C analyses, whereas publication bias was present in the TG analysis.

Conclusions: TG and LDL-C were higher in premenopausal breast cancer patients than in women without breast cancer. However, no significant differences were found in TC or HDL-C levels.

Keywords: Premenopausal breast cancer; low-density lipoprotein cholesterol; meta-analysis; serum lipid; triglyceride; tumor biomarker.

Figure 1.

Flow diagram depicting the literature search and study selection.

Figure 2.

Forest plot depicting the standardized mean difference (SMD) scores and 95% confidence intervals for studies comparing the serum lipid levels of premenopausal breast cancer patients with those of healthy women: (a) triglycerides (TG), (b) low-density lipoprotein cholesterol (LDL-C), (c) total cholesterol (TC), and (d) high-density lipoprotein cholesterol (HDL-C).