Cancer Res Treat.  2024 Jul;56(3):825-837. 10.4143/crt.2023.753.

The Persistence of Hypertriglyceridemia and the Risk of Early Onset Colorectal Cancer According to Tumor Subsites: A Nationwide Population-Based Study

• Chang YH
• Shin CM
• Han K
• Jung JH
• Jin EH
• Lim JH
• Kang SJ
• Choi YJ
• Yoon H
• Park YS
• Kim N
• Lee DH

• KMID: 2557669
• DOI: http://doi.org/10.4143/crt.2023.753

Abstract

Purpose
The incidence of early-onset colorectal cancer (EoCRC) is increasing worldwide. The association between hypertriglyceridemia (HTG) and EoCRC risk remains unclear.
Materials and Methods
We conducted a nationwide cohort study of 3,340,635 individuals aged 20-49 years who underwent health checkups between 2009 and 2011 under the Korean National Health Insurance Service. HTG was defined as serum triglyceride (TG) level ≥ 150 mg/dL. According to the change in TG status, participants were categorized into persistent normotriglyceridemia (NTG; group 1), NTG to HTG (group 2), HTG to NTG (group 3), and persistent HTG (group 4) groups. The EoCRC incidence was followed up until 2019.
Results
In total, 7,492 EoCRC cases developed after a mean of 6.05 years of follow-up. Group 4 had the highest risk of EoCRC (adjusted hazard ratio [aHR], 1.097; 95% confidence interval [CI], 1.025 to 1.174). While the risk of rectal cancer was significantly increased in groups 3 and 4 (aHR [95% CI], 1.236 [1.076 to 1.419] and 1.175 [1.042-1.325], respectively), no significant risk differences were observed in right colon cancer. In group 4, male sex and diabetes were associated with a further increased risk of EoCRC (aHR [95% CI], 1.149 [1.082 to 1.221] and 1.409 [1.169 to 1.699], respectively). In addition, there was a dose-response relationship between serum TG levels and the risk of EoCRC (p for trends < 0.0001).
Conclusion
Persistent HTG increased the risk of EoCRC, which was significantly higher only for rectal cancer and marginally higher for other colonic subsites.

Keyword

Colorectal neoplasms; Young-adult; Hypertriglyceridemia

Figure

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  Fig. 1. Flowchart showing the enrollment process for the study cohort. CRC, colorectal cancer.

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  Fig. 2. Flowchart showing the follow-up process of each participant according to triglyceride (TG) status in 2009 and 2011; group 1 (serum TG < 150 mg/dL both in 2009 and 2011), group 2 (serum TG < 150 mg/dL in 2009 and TG ≥ 150 mg/dL in 2011), group 3 (serum TG ≥ 150 mg/dL in 2009 and TG < 150 mg/dL in 2011), and group 4 (serum TG ≥ 150 mg/dL both in 2009 and 2011). EoCRC, early-onset colorectal cancer.

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  Fig. 3. Kaplan-Meier curves depicting the incidence probability for colorectal cancer according to change in triglyceride (TG) status; normal TG-persisted (group 1), normal to hypertriglyceridemia (HTG) (group 2), HTG to normal (group 3) and HTG-persisted (group 4) groups, if incidence age > 50 then censored (p=0.001 by log-rank test).

Reference

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