title: Association between prediagnostic glucose, triglycerides, cholesterol and meningioma, and reverse causality.
abstract: Although meningioma is a benign tumour, it may cause significant morbidity. Obesity and diabetes are positively associated with meningioma. To evaluate the potential effects of obesity-related prediagnostic glucose, triglycerides and cholesterol on meningioma and of prediagnostic meningioma on these biomarkers, we conducted a cohort study.
  
  
  
  We identified 41 355 individuals in the Apolipoprotein MOrtality RISk cohort with values for these biomarkers within 15 years before meningioma diagnosis, death, migration or the end of follow-up. We then estimated hazard ratios (HRs) and their interactions with time and age using Cox regression.
  
  
  
  Meningioma was diagnosed in 181 women and 115 men whose median follow-up time was 7 years. Fasting serum glucose level was inversely related to meningioma among women (Ptrend=0.0006) but not men (Ptrend=0.24). Prediagnostic diabetes was inversely related to meningioma in both sexes combined (HR=0.45, 95% confidence interval (CI) 0.29-0.71), as was serum cholesterol within the year before diagnosis (HR=0.50, 95% CI 0.34-0.72).
  
  
  
  Paradoxically, hyperglycaemia is inversely associated with meningioma in women. This finding does not necessarily negate the positive role of obesity or diabetes in meningioma development; rather, it may indicate that their effects depend on the stage of development. Furthermore, the prediagnostic tumour may reduce serum cholesterol levels.
authors.affiliation: Division of Epidemiology, College of Public Health, Ohio State University, Columbus, OH 43210, USA.
authors.forename: Brittany M
authors.initials: BM
authors.lastname: Bernardo
authors.affiliation: Division of Epidemiology, College of Public Health, Ohio State University, Columbus, OH 43210, USA.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Orellana
authors.affiliation: Division of Epidemiology, College of Public Health, Ohio State University, Columbus, OH 43210, USA.
authors.forename: Yiska Lowenberg
authors.initials: YL
authors.lastname: Weisband
authors.affiliation: AstraZenecaR&D, Mölndal 43150, Sweden.|Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
authors.forename: Niklas
authors.initials: N
authors.lastname: Hammar
authors.affiliation: Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
authors.forename: Goran
authors.initials: G
authors.lastname: Walldius
authors.affiliation: Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
authors.forename: Hakan
authors.initials: H
authors.lastname: Malmstrom
authors.affiliation: Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Ahlbom
authors.affiliation: Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Feychting
authors.affiliation: Division of Epidemiology, College of Public Health, Ohio State University, Columbus, OH 43210, USA.|Comprehensive Cancer Center, Ohio State University, Columbus, OH 43210, USA.
authors.forename: Judith
authors.initials: J
authors.lastname: Schwartzbaum
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001053:Apolipoproteins / Q000378:metabolism; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D002784:Cholesterol / Q000097:blood*; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000473:pathology; D005215:Fasting / Q000502:physiology; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000097:blood / Q000209:etiology; D008579:Meningioma / Q000097:blood* / Q000209:etiology*; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D016016:Proportional Hazards Models; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*
chemical_list: D001053:Apolipoproteins; D015415:Biomarkers; D001786:Blood Glucose; D014280:Triglycerides; D002784:Cholesterol; D005947:Glucose