title: HDL cholesterol and cancer risk among patients with type 2 diabetes.
abstract: OBJECTIVE
  To investigate the relationship between HDL cholesterol (HDL-C) and cancer risk among type 2 diabetic patients.
  
  
  METHODS
  We performed a retrospective cohort study of 14,169 men and 23,176 women with type 2 diabetes. Cox proportional hazards regression models were used to estimate the association of various levels of HDL cholesterol (HDL-C) with cancer risk.
  
  
  RESULTS
  During a mean follow-up period of 6.4 years, 3,711 type 2 diabetic patients had a cancer diagnosis. A significant inverse association between HDL-C and the risk of cancer was found among men and women. The multivariable-adjusted hazard ratios (HRs) of cancer at various levels of HDL-C at baseline (<30, 30-39.9, 40-49.9, 50-59.9, 60-69.9, 70-79.9, and ≥80 mg/dL) were 1.00, 0.87, 0.95, 1.01, 0.61, 0.45, and 0.37, respectively, in men (Ptrend = 0.027) and 1.00, 0.98, 0.88, 0.85, 0.84, 0.86, and 0.84, respectively, in women (Ptrend = 0.025). When stratified by race, BMI, smoking status, or medication use, the inverse association was still present. With an updated mean of HDL-C used in the analysis, the inverse association of HDL-C with cancer risk did not change. The inverse association substantially attenuated after excluding patients who died of or were diagnosed with cancer during the first 2 years of follow-up.
  
  
  CONCLUSIONS
  The study suggests an inverse association of HDL-C with cancer risk among men and women with type 2 diabetes, whereas the effect of HDL-C was partially mediated by reverse causation.
authors.affiliation: Pennington Biomedical Research Center, Baton Rouge, LA Department of Endocrinology, China Japan Friendship Hospital, Beijing, China.
authors.forename: Wenhui
authors.initials: W
authors.lastname: Zhao
authors.affiliation: Pennington Biomedical Research Center, Baton Rouge, LA Beijing University of Traditional Chinese Medicine, Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Guan
authors.affiliation: Pennington Biomedical Research Center, Baton Rouge, LA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Horswell
authors.affiliation: Pennington Biomedical Research Center, Baton Rouge, LA Tianjin Women's and Children's Health Center, Tianjin, China.
authors.forename: Weiqin
authors.initials: W
authors.lastname: Li
authors.affiliation: Pennington Biomedical Research Center, Baton Rouge, LA.
authors.forename: Yujie
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Louisiana Tumor Registry, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA.
authors.forename: Xiaocheng
authors.initials: X
authors.lastname: Wu
authors.affiliation: Pennington Biomedical Research Center, Baton Rouge, LA gang.hu@pbrc.edu.
authors.forename: Gang
authors.initials: G
authors.lastname: Hu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D008076:Cholesterol, HDL / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008145:Louisiana / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D008076:Cholesterol, HDL