BACKGROUND/AIMS The effect modification by smoking and menopausal status in the association between high-density lipoprotein cholesterol (HDL-C) and liver cancer risk has not been reported. METHODS This population-based cohort study included 4.486 million cancer-free individuals among those who underwent national cancer screening in 2010 and were followed up until December 2017. We conducted analyses in populations that excluded people with chronic hepatitis B, chronic hepatitis C and liver cirrhosis (Model I) and that included those diseases (Model III). HDL-C level was classified into eight groups at 10-mg/dL intervals. Liver cancer risk by HDL-C was measured using adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs). RESULTS During follow-up, 18 795 liver cancers in Model I and 20 610 liver cancers in Model III developed. In Model I, low HDL-C levels (aHR 1.83; 95% CI 1.65-2.04) and extremely high HDL-C levels (aHR 1.24; 95% CI 1.10-1.40) were associated with an increased liver cancer risk compared with a moderate HDL-C level of 50-59mg/dL. This association was similar in both men and women with larger effect size in men (aHR, 1.91; 95% CI, 1.70-2.15). The hazardous association between low HDL-C and liver cancer risk was remarkable in current smokers (aHR, 2.19; 95% CI, 1.84-2.60) and in pre-menopausal women (aHR, 2.91; 95% CI, 1.29-6.58) compared with post-menopausal women (aHR, 1.45; 95% CI, 1.10-1.93). This association was similarly observed in Model III. CONCLUSIONS Low and extremely high HDL-C levels were associated with an increased liver cancer risk. The unfavourable association between low HDL-C and liver cancer was remarkable in smokers and pre-menopausal women.

中文翻译：

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全国队列中高密度脂蛋白胆固醇与肝癌风险之间关联的因素修改。


背景/目的 吸烟和绝经状态对高密度脂蛋白胆固醇 (HDL-C) 与肝癌风险之间关系的影响尚未有报道。方法 这项基于人群的队列研究包括 2010 年接受全国癌症筛查的 448.6 万名无癌症个体，并随访至 2017 年 12 月。我们对排除慢性乙型肝炎、慢性丙型肝炎和肝硬化患者的人群进行了分析。 （模型 I）并且包括这些疾病（模型 III）。 HDL-C 水平按 10 mg/dL 的间隔分为八组。 HDL-C 导致的肝癌风险是使用调整后的风险比 (aHR) 和 95% 置信区间 (CI) 来测量的。结果 随访期间，模型 I 中发生肝癌 18 795 例，模型 III 中发生肝癌 20 610 例。在模型 I 中，与中度 HDL-C 水平相比，低 HDL-C 水平（aHR 1.83；95% CI 1.65-2.04）和极高 HDL-C 水平（aHR 1.24；95% CI 1.10-1.40）与肝癌风险增加相关。 HDL-C 水平为 50-59mg/dL。这种关联在男性和女性中相似，但男性的效应量较大（aHR，1.91；95% CI，1.70-2.15）。相比之下，低 HDL-C 与肝癌风险之间的危险关联在当前吸烟者（aHR，2.19；95% CI，1.84-2.60）和绝经前女性（aHR，2.91；95% CI，1.29-6.58）中非常显着。绝经后女性（aHR，1.45；95% CI，1.10-1.93）。在模型 III 中也类似地观察到了这种关联。结论 低和极高的 HDL-C 水平与肝癌风险增加相关。低 HDL-C 与肝癌之间的不利关联在吸烟者和绝经前女性中尤为明显。