Serum lipid levels and risk of lymphoid malignancies in the UK Biobank study

Abnormal circulating lipid levels have been suggested in relation to lymphoid malignancy (LM) risk.

We studied UK Biobank participants (n = 403,625) with serum data for cholesterol (total [TC], high-density lipoprotein [HDL], direct low-density lipoprotein [LDL]), triglycerides (TG), and apolipoproteins A1 and B (ApoA1, ApoB). We conducted principal component (PC) analysis and multivariate Cox regression models to estimate hazard ratio (HR) overall, by lipid-lowering drug use and follow-up interval.

During an average of 10.5 years of follow-up, 3006 incident LMs occurred (including 667 multiple myelomas [MM], 2193 non-Hodgkin lymphomas [NHL]). Among medication non-users, most lipid levels were inversely associated with risk of most endpoints (HR_Q4vsQ1range: 0.37 to 0.79), especially closer to diagnosis. In contrast LDL/HDL ratio and PC1 (highly loaded in LDL and ApoB) were consistently positively associated with chronic/small lymphocytic leukaemia risk in each follow-up period and with NHL and B-cell NHL risk within 5 years. Further, LD, ApoB and TG levels were positively associated with MM risk after 10+ years (HR_1-SDrange = 1.26 to 1.60).

Lipid depletion closer to LM diagnosis might reflect cancer cell metabolism and warrants further work examining individuals with precursor conditions. The MM-specific long-term risk might reflect the known MM-obesity association.