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

Abstract

Abstract Purpose: The association between blood lipid levels and the risk of developing liver cancer remains a subject of ongoing debate. In order to elucidate this association, we conducted a meta-analysis by systematically incorporating data from all relevant prospective cohort studies. Method: We conducted a systematic search in PubMed, Embase, Web of Science, and The Cochrane Library, covering data from the inception of these databases up to July, 2023. This study included prospective cohort studies related to lipid profiles (e.g., total cholesterol, triglycerides, high-density lipoprotein, and low-density lipoprotein) that reported hazard ratios (HRs) or relative risks (RRs) with their corresponding 95% confidence intervals (95%CIs) to investigate their association with the risk of liver cancer. During the analysis process, we used fixed-effect 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, we identified 12 studies from a total of 11,904 articles, which were included in the meta-analysis. These studies encompassed a combined population of 10,765,221 participants, including 31,055 cases of liver cancer events. The analysis results revealed that the highest versus lowest pooled risk ratio for serum total cholesterol (TC) concentration was 0.45 (95% CI = 0.35-0.58, I2 = 78%). For triglycerides (TGs), the risk ratio was 0.67 (95% CI = 0.46-0.96, I2 = 86%), while for high-density lipoprotein (HDL-C), the risk ratio was 0.72 (95% CI = 0.58-0.90, I2 = 65%). Regarding low-density lipoprotein (LDL-C), the risk ratio was 0.51 (95% CI = 0.23-1.13, I2 = 93%). Conclusion: The findings of this study indicate a negative association between serum levels of total cholesterol, triglycerides, and high-density lipoprotein with liver cancer, suggesting that higher concentrations of these lipids are associated with a reduced risk of liver cancer. However, no significant association has been found between low-density lipoprotein and liver cancer at present.