Lipids, apolipoproteins, carbohydrates, and risk of hematological malignancies

Abstract

Previous studies have investigated the role of metabolic factors in risk of hematological malignancies with contradicting findings. Existing studies are generally limited by potential concern of reverse causality and confounding by inflammation. Therefore, we aimed to investigate the associations of glucose, lipid, and apolipoprotein biomarkers with the risk of hematological malignancy. We performed a study of over 560,000 individuals of the Swedish AMORIS cohort, with measurements of biomarkers for carbohydrate, lipid, and apolipoprotein metabolism during 1985-1996 and follow-up until 2020. We conducted a prospective cohort study and used Cox models to investigate the association of nine different metabolic biomarkers (glucose, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), LDL-C/HDL-C, triglyceride (TG), apolipoprotein B (ApoB), apolipoprotein A-I (ApoA I), and ApoB/ApoA-I) with risk of hematological malignancy, after excluding the first five years of follow-up and adjustment for inflammatory biomarkers. We observed a decreased risk of hematological malignancy associated with one SD increase of TC (HR 0.93; 95% CI 0.91-0.96), LDL-C (HR 0.94; 95% CI 0.91-0.97), HDL-C (HR 0.92; 95% CI 0.86-0.99), and ApoA-I (HR 0.96; 95% CI 0.93-0.996). Our study highlights a decreased risk of hematological malignancy associated with a higher level of TC, LDL-C, HDL-C, and ApoA-I.

Keywords: Apolipoproteins; Cohort study; Hematological malignancy; Lipids; Metabolism.

Fig. 1

Mean concentrations of blood biomarkers of lipid, carbohydrate, and apolipoprotein metabolism during the 30 years before the diagnosis of hematological malignancy, comparing patients with hematological malignancy (solid line) to the matched controls (dashed line) A. Any hematological malignancy; B. Acute myeloid leukemia; C. Multiple myeloma; D. Hodgkin lymphoma; E. Non-Hodgkin lymphoma; F. Chronic lymphoid leukemia The curves were generated using the locally weighted scatterplot smoothing methods for the mean concentrations based on all available blood samples during the 30-year period, for both cases of hematological malignancy and their matched controls. TC: total cholesterol; LDL-C: low-density lipoprotein cholesterol; HDL-C: high-density lipoprotein cholesterol; TG: triglycerides; ApoA-I: apolipoprotein A-I; ApoB: apolipoprotein B