Meta-Analysis
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 28, 2015; 21(12): 3711-3719
Published online Mar 28, 2015. doi: 10.3748/wjg.v21.i12.3711
Association of cholesterol with risk of pancreatic cancer: A meta-analysis
Jia Wang, Wei-Jing Wang, Long Zhai, Dong-Feng Zhang
Jia Wang, Wei-Jing Wang, Long Zhai, Dong-Feng Zhang, Department of Epidemiology and Health Statistics, Qingdao University Medical College, Qingdao 266021, Shandong Province, China
Author contributions: Wang J designed the study, collected the data, performed the statistical analysis and wrote the manuscript as the first author; Wang WJ and Zhai L contributed to discussion and wrote the manuscript; and Zhang DF designed the study, contributed to discussion and edited the manuscript as the corresponding author.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dong-Feng Zhang, MD, Professor, Department of Epidemiology and Health Statistics, Qingdao University Medical College, 38 Dengzhou Road, Qingdao 266021, Shandong Province, China. zhangdf1961@126.com
Telephone: +86-532-82991712 Fax: +86-532-83801449
Received: August 16, 2014
Peer-review started: August 17, 2014
First decision: September 27, 2014
Revised: October 7, 2014
Accepted: November 7, 2014
Article in press: November 11, 2014
Published online: March 28, 2015
Abstract

AIM: To evaluate the effect of dietary cholesterol and serum total cholesterol (TC) on the risk of pancreatic cancer.

METHODS: A literature search was performed up to June 2014 in PubMed, EMBASE, China National Knowledge Infrastructure and China Biology Medical literature database for relevant articles published in English or Chinese. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated with a random-effects model.

RESULTS: We included 14 published articles with 439355 participants for dietary cholesterol, and 6 published articles with 1805697 participants for serum TC. For the highest vs lowest category of dietary cholesterol, the pooled RR (95%CI) of pancreatic cancer was 1.308 (1.097-1.559). After excluding two studies (RR > 3.0), the pooled RR (95%CI) was 1.204 (1.050-1.380). In subgroup analysis stratified by study design, the pooled RRs (95%CIs) were 1.523 (1.226-1.893) for case-control studies and 1.023 (0.871-1.200) for cohort studies. The association of dietary cholesterol with the risk of pancreatic cancer was significant for studies conducted in North America [1.275 (1.058-1.537)] and others [2.495 (1.565-3.977)], but not in Europe [1.149 (0.863-1.531)]. No significant association [1.003 (0.859-1.171)] was found between the risk of pancreatic cancer and serum TC.

CONCLUSION: Dietary cholesterol may be associated with an increased risk of pancreatic cancer in worldwide populations, except for Europeans. The results need to be confirmed further.

Keywords: Dietary cholesterol, Serum total cholesterol, Pancreatic cancer, Risk, Meta-analysis

Core tip: Many epidemiological studies have explored the association of cholesterol with the risk of pancreatic cancer, but the results of these studies are conflicting. We conducted the current meta-analysis to evaluate the effect of dietary cholesterol and serum total cholesterol on the risk of pancreatic cancer. The results suggested that dietary cholesterol may be associated with an increased risk of pancreatic cancer. However, the finding needs to be confirmed further.