PLoS Medicine (Sep 2020)

The relationship between circulating lipids and breast cancer risk: A Mendelian randomization study.

  • Kelsey E Johnson,
  • Katherine M Siewert,
  • Derek Klarin,
  • Scott M Damrauer,
  • VA Million Veteran Program,
  • Kyong-Mi Chang,
  • Philip S Tsao,
  • Themistocles L Assimes,
  • Kara N Maxwell,
  • Benjamin F Voight

DOI
https://doi.org/10.1371/journal.pmed.1003302
Journal volume & issue
Vol. 17, no. 9
p. e1003302

Abstract

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BackgroundA number of epidemiological and genetic studies have attempted to determine whether levels of circulating lipids are associated with risks of various cancers, including breast cancer (BC). However, it remains unclear whether a causal relationship exists between lipids and BC. If alteration of lipid levels also reduced risk of BC, this could present a target for disease prevention. This study aimed to assess a potential causal relationship between genetic variants associated with plasma lipid traits (high-density lipoprotein, HDL; low-density lipoprotein, LDL; triglycerides, TGs) with risk for BC using Mendelian randomization (MR).Methods and findingsData from genome-wide association studies in up to 215,551 participants from the Million Veteran Program (MVP) were used to construct genetic instruments for plasma lipid traits. The effect of these instruments on BC risk was evaluated using genetic data from the BCAC (Breast Cancer Association Consortium) based on 122,977 BC cases and 105,974 controls. Using MR, we observed that a 1-standard-deviation genetically determined increase in HDL levels is associated with an increased risk for all BCs (HDL: OR [odds ratio] = 1.08, 95% confidence interval [CI] = 1.04-1.13, P ConclusionsWe observed that genetically elevated plasma HDL and LDL levels appear to be associated with increased BC risk. Future studies are required to understand the mechanism underlying this putative causal relationship, with the goal of developing potential therapeutic strategies aimed at altering the cholesterol-mediated effect on BC risk.