Serum high-density lipoprotein cholesterol as a preclinical indicator of non-Hodgkin lymphoma
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Recent evidence suggests that lymphomagenesis may be associated with a decrease in circulating high-density lipoprotein cholesterol (HDL-C), possibly reflecting a common underlying aetiology such as inflammation. To examine the relationship between prediagnostic HDL-C and non-Hodgkin lymphoma (NHL), data on 27074 healthy male smokers aged 50 to 69 years from the Alpha-Tocopherol Beta-Carotene Cancer Prevention Study cohort were analysed; Cox proportional hazards models with age as underlying time metric were used to estimate relative risks and 95% confidence intervals. During follow-up, no association between total or non-HDL cholesterol and the 201 incident NHL cases was found. However, there was an inverse association between HDL-cholesterol and NHL, changing with length of follow-up. High HDL-C was associated with lower risk of all NHL during the first 10 years (P for trend <0.0001), but not with diagnoses during later follow-up. Based on these results, the authors conclude that high HDL-C is associated with low risk of developing NHL in a dose-responsive manner in male smokers, and propose that further prospective investigations on the aetiologic contribution of HDL-C in lymphoma genesis be undertaken, including male non-smokers and female subjects.
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