# Lipids, apolipoproteins, carbohydrates, and risk of hematological malignancies

## TL;DR

This study found that higher levels of certain metabolic biomarkers are linked to a lower risk of blood cancers in a large population.

## Contribution

The study provides new evidence on the protective role of specific lipid and apolipoprotein levels against hematological malignancies.

## Key findings

- Higher total cholesterol is associated with a 7% lower risk of hematological malignancy.
- Increased HDL-C and ApoA-I levels are linked to reduced cancer risk.
- LDL-C also shows a protective effect against blood cancers.

## Abstract

Previous studies have investigated the role of metabolic factors in risk of hematological malignancies with contradicting findings. Existing studies are generally limited by potential concern of reverse causality and confounding by inflammation. Therefore, we aimed to investigate the associations of glucose, lipid, and apolipoprotein biomarkers with the risk of hematological malignancy. We performed a study of over 560,000 individuals of the Swedish AMORIS cohort, with measurements of biomarkers for carbohydrate, lipid, and apolipoprotein metabolism during 1985–1996 and follow-up until 2020. We conducted a prospective cohort study and used Cox models to investigate the association of nine different metabolic biomarkers (glucose, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), LDL-C/HDL-C, triglyceride (TG), apolipoprotein B (ApoB), apolipoprotein A-I (ApoA I), and ApoB/ApoA-I) with risk of hematological malignancy, after excluding the first five years of follow-up and adjustment for inflammatory biomarkers. We observed a decreased risk of hematological malignancy associated with one SD increase of TC (HR 0.93; 95% CI 0.91–0.96), LDL-C (HR 0.94; 95% CI 0.91–0.97), HDL-C (HR 0.92; 95% CI 0.86–0.99), and ApoA-I (HR 0.96; 95% CI 0.93–0.996). Our study highlights a decreased risk of hematological malignancy associated with a higher level of TC, LDL-C, HDL-C, and ApoA-I.

The online version contains supplementary material available at 10.1007/s10654-025-01207-y.