Dip in serum cholesterol tied to higher pancreatic cancer risk

A recent decrease in total cholesterol levels may signal an aggravated risk of pancreatic cancer, reports a study. On the other hand, high serum cholesterol in the preceding years may exert a protective effect against pancreatic cancer.

“Taken together, our findings provide evidence to support total cholesterol in the recent past, but not the long-term, may be inversely associated with the incidence of pancreatic cancer,” the researchers said.

Drawing from the database of the Korean National Health Insurance Service—Health Screening Cohort, the researchers included 215 pancreatic cancer patients and compared these against 645 age- and sex-matched controls. Patients were divided into four according to the level of cholesterol over the last 11 years: desirable (<200 mg/dL; n=119), borderline high I (200–219 mg/dL; n=54), borderline high II (220–239 mg/dL; n=27), and high (≥240 mg/dL; n=15). [Nutrients 2022;14:4938]

Multivariable-adjusted conditional logistic regression analysis revealed that patients who had high cholesterol in the 3-year period before the index date were half as likely to develop pancreatic cancer than those with desirable cholesterol levels (odds ratio [OR], 0.50, 95 percent confidence interval [CI], 0.27–0.93).

Stratified analysis showed that this effect was pronounced in women (OR, 0.32, 95 percent CI, 0.13–0.80) but not in men.

Such an effect was absent for both borderline-high cholesterol subgroups. Moreover, cholesterol levels showed no significant impact on pancreatic cancer risk when measured 7 to 4 years and 11 to 8 years before the study’s index date. Total cholesterol measurements over the 11-year study period were also unrelated to pancreatic cancer risk.

To track longitudinal changes in serum cholesterol, the present study made use of repeated cholesterol measurements. Through this methodology, “our study suggested the importance of timing in the relationship between total serum cholesterol level and pancreatic cancer incidence,” the researchers said, pointing out that most other articles on this subject have “inconsistent reported results.”

Recent cholesterol trends

After looking at cholesterol control in recent years, the researchers then assessed more near-term impacts of changes in serum cholesterol levels.

Compared with participants whose cholesterol had remained <240 mg/dL over the past 11 years, recent hypercholesterolaemia (levels increasing from <240 to ≥240 mg/dL) was associated with a lower risk of pancreatic cancer (OR, 0.45, 95 percent CI, 0.20–1.03). In contrast, recent resolution of hypercholesterolaemia (from ≥240 to <240 mg/dL) aggravated such risk by nearly 90 percent (OR, 1.89, 95 percent CI, 0.95–3.75).

Of note, consistent hypercholesterolaemia showed no clear interaction with the risk of pancreatic cancer (OR, 0.71, 95 percent CI, 0.30–1.66).

“To the best of our knowledge, this study is the first to explore the temporal timing of total cholesterol and pancreatic cancer incidence in a long-period setting,” the researchers said.

“This study provides insight into the early detection of pancreatic cancer with an easily tested serum biomarker,” they added.