Abstract
Objective
Disease-induced changes in blood concentrations of lipids may bias etiologic studies.
We analyzed the influence of clinical factors and timing of blood extraction on serum
concentrations of cholesterol and triglycerides in exocrine pancreatic cancer (EPC).
Study Design and Setting
Subjects were 144 incident cases of EPC prospectively recruited in five teaching hospitals
in eastern Spain.
Results
Higher concentrations of cholesterol, triglycerides, and total lipids were observed
among patients with a shorter interval from first symptom of cancer to blood extraction
(IES); but concentrations were lower in patients with longer IES. The relationship
between cholesterol and tumor stage was “n-shaped.” Jaundice and other components
of the cholestatic syndrome increased cholesterol and triglycerides. Invasive diagnostic
tests were associated with lower cholesterol. All these factors were related to changes
>50 mg/dl in cholesterol (P<0.05), even when adjusting by stage. Statistical models including IES, number of invasive
diagnostic tests, jaundice, weight loss, and stage explained over 28% of the variation
in lipid concentrations.
Conclusion
Restriction and adjustment by stage may be insufficient to prevent biases related
to disease progression. Multivariate analyses may allow to control to some extent
the influence of clinical symptoms, procedures, and timing of blood extraction in
studies on the etiological significance of lipids and lipophilic compounds, either
risk factors or protective agents.
Keywords [MeSH]
Keywords
Abbreviations:
CI (Confidence interval), EPC (Exocrine pancreatic cancer), ERCP (Endoscopic retrograde cholangiopancreatography), IDT (Number of invasive diagnostic tests performed before blood extraction), IEA (Interval from blood extraction to hospital admission), IES (Interval from blood extraction to first symptom of the disease), SD (Standard deviation), TNM (Tumor-node-metastasis system), TPHC (Transparietohepatic cholangiography)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 10, 2008
Accepted:
August 9,
2007
Identification
Copyright
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
