Purpose@#The
association of
serum lipids with
gastric cancer is controversial. We clarified the
role of
serum lipids in the development, progression, and
prognosis of
gastric cancer. @*Materials and
Methods@#In total, 412
patients diagnosed with
gastric cancer were prospectively recruited, and 2,934 control subjects
who underwent
screening endoscopy were enrolled from December 2013 to March 2017 to conduct a
case-control study in a tertiary center.
Serum lipid profiles, including total
cholesterol,
high-density lipoprotein cholesterol (HDL-C),
low-density lipoprotein cholesterol (LDL-C),
triglyceride (TG),
apolipoprotein A-I (
apoA-I), and
apolipoprotein B, and clinicopathologic characteristics were analyzed. @*Results@#The
gastric cancer group showed significantly lower HDL-C, higher LDL-C, and lower
apoA-I level than the
control group. In
multivariate analysis, old age (
odds ratio [OR], 1.051; p < 0.001),
smoking (OR, 1.337; p < 0.001), a
family history of
gastric cancer (OR, 2.038; p < 0.001),
Helicobacter pylori seropositivity (OR, 4.240; p < 0.001), lower HDL-C (OR, 0.712; p=0.020), and higher LDL-C (p=0.002) were significant
risk factors for
gastric cancer. Lower HDL-C and higher LDL-C remained significant after
adjustments for covariates, including age and
sex. In a subgroup
analysis of the
gastric cancer group, lower TG levels were associated with undifferentiated
histology. No
serum lipids were associated with overall
survival. @*Conclusion@#Lower HDL-C and higher LDL-C were associated with the
risk of
gastric cancer, even after adjusting for age,
sex, and other factors. In the
gastric cancer group, undifferentiated
histology was associated with lower TG levels.