Association between blood lipid levels and the risk of liver cancer: a systematic review and meta-analysis

Abstract

Purpose: The association between blood lipid levels and the risk of developing liver cancer remains a subject of ongoing debate. To elucidate this association, we conducted a meta-analysis by systematically incorporating data from all relevant prospective cohort studies.

Methods: We conducted a systematic search of the PubMed, Embase, Web of Science, and Cochrane Library databases covering studies published from database inception through July 2023. This study included prospective cohort studies related to lipid profiles (e.g., total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels) that reported hazard ratios (HRs) or relative risks (RRs) with corresponding 95% confidence intervals (95% CIs) to investigate their association with the risk of liver cancer. During the analysis process, we used fixed-effects or random-effects models based on the level of heterogeneity among the studies and obtained pooled risk ratios using these models. To ensure the robustness and reliability of the study findings, we also conducted sensitivity analyses and publication bias analyses.

Results: After conducting a systematic search, 12 studies were identified from a total of 11,904 articles and were included in the meta-analysis. These studies included a combined population of 10,765,221 participants, among whom 31,055 cases of liver cancer were reported. The analysis revealed that the pooled HR for the serum TC concentration (highest versus lowest) was 0.45 (95% CI = 0.35-0.58, I² = 78%). For TGs, the HR was 0.67 (95% CI = 0.46-0.96, I² = 86%), while for HDL-C, the HR was 0.72 (95% CI = 0.58-0.90, I² = 65%). The HR for LDL-C was 0.51 (95% CI = 0.23-1.13, I² = 93%).

Conclusion: The findings of this study indicate that serum TC, TG, and HDL-C levels are negatively associated with liver cancer risk, suggesting that higher concentrations of these lipids are associated with a reduced risk of liver cancer. However, no significant association has been found between LDL-C levels and liver cancer risk.

Keywords: Blood lipids; Cohort study; Liver neoplasms; Meta-analysis.

Fig. 1

Flowchart of the literature selection process

Fig. 2

Forest plot of the association between total cholesterol and liver cancer risk

Fig. 3

Forest plot of the association between triglyceride levels and liver cancer risk

Fig. 4

Forest plot of the association between high-density lipoprotein cholesterol levels and liver cancer risk

Fig. 5

Forest plot of the association between low-density lipoprotein cholesterol levels and liver cancer risk