title: Low LDL cholesterol, albuminuria, and statins for the risk of cancer in type 2 diabetes: the Hong Kong diabetes registry.
abstract: OBJECTIVE
  LDL cholesterol <2.80 mmol/l was associated with increased cancer risk in type 2 diabetes. We explored the 1) interaction between low LDL cholesterol and albuminuria and 2) interaction between copresence of these two risk factors and statin use for cancer in type 2 diabetes.
  
  
  METHODS
  We analyzed prospective data for 3,793 Chinese type 2 diabetic patients who remained naive for statin treatment and 1,483 patients in whom statin treatment was initiated during a median follow-up period of 5.24 years. All patients were free of cancer at baseline. Biological interactions were estimated using relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (S). RERI > 0, AP > 0, or S > 1 indicates biological interaction.
  
  
  RESULTS
  In 3,793 statin-naive type 2 diabetic patients, copresence of low LDL cholesterol and albuminuria increased cancer risk by 2.8-fold (hazard ratio 2.77 [95% CI 1.78-4.31]) with significant biological interactions (RERI 1.05 [0.04-2.06]; AP 0.38 [0.09-0.66]). In the whole cohort of 5,276 type 2 diabetic patients, there was interaction between nonuse of statins and copresence of low LDL cholesterol and albuminuria with increased cancer risk (RERI 2.87 [0.64-5.09] and AP 0.60 [0.29-0.90]). Statin nonusers with LDL cholesterol <2.80 mmol/l and albumunuria had a 4.9-fold risk of cancer compared with statin users with or without both risk factors.
  
  
  CONCLUSIONS
  In type 2 diabetes, there was interaction between low LDL cholesterol and albuminuria with increased cancer risks. The latter was attenuated in the presence of statin treatment.
authors: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China. yang.xilin@cuhk.edu.hk
authors: Xilin
authors: X
authors: Yang
authors: Wing Yee
authors: WY
authors: So
authors: Ronald C W
authors: RC
authors: Ma
authors: Gary T C
authors: GT
authors: Ko
authors: Alice P S
authors: AP
authors: Kong
authors: Hailu
authors: H
authors: Zhao
authors: Andrea O Y
authors: AO
authors: Luk
authors: Christopher W K
authors: CW
authors: Lam
authors: Chung Shun
authors: CS
authors: Ho
authors: Peter C Y
authors: PC
authors: Tong
authors: Juliana C N
authors: JC
authors: Chan
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000503:physiopathology*; D008078:Cholesterol, LDL / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D006723:Hong Kong; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D012042:Registries; D012307:Risk Factors
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors