High-density lipoprotein cholesterol and multiple myeloma: A systematic review and meta-analysis

Anastasios Makris; Antonia Pagkali; Emmanouil Nikolousis; Theodosios D Filippatos; Aris P Agouridis

doi:10.1016/j.athplu.2023.09.003

High-density lipoprotein cholesterol and multiple myeloma: A systematic review and meta-analysis

Atheroscler Plus. 2023 Sep 21:54:7-13. doi: 10.1016/j.athplu.2023.09.003. eCollection 2023 Dec.

Authors

Anastasios Makris^{1

2}, Antonia Pagkali¹, Emmanouil Nikolousis¹, Theodosios D Filippatos³, Aris P Agouridis^{1

4}

Affiliations

¹ School of Medicine, European University Cyprus, Nicosia, Cyprus.
² School of Medicine, National and Kapodistrian University of Athens, Greece.
³ Department of Internal Medicine, School of Medicine, University of Crete, Heraklion, Greece.
⁴ Department of Internal Medicine, German Oncology Center, Limassol, Cyprus.

Abstract

Background and aims: To systematically investigate all relevant evidence on the association between high-density lipoprotein cholesterol (HDL-C) and multiple myeloma (MM).

Methods: We searched PubMed and Cochrane library databases (up to 20 September 2022) for studies with evidence on HDL-C in patients with MM. A qualitative synthesis of published prospective and retrospective studies for the role of HDL-C and other lipid profile parameters in MM was performed. Additionally, a meta-analysis on HDL-C mean differences (MD) between MM cases and controls was performed.

Results: Fourteen studies (3 prospective, 11 retrospective) including 895 MM patients were eligible for this systematic review. Ten studies compared HDL-C levels in MM patients with healthy controls. In these 10 studies (n = 17,213), pooled analyses showed that MM patients had significantly lower HDL-C levels compared to healthy controls (MD: -13.07 mg/dl, 95% CI: -17.83, -8.32, p < 0.00001). Regarding secondary endpoints, total cholesterol (TC) (MD: -22.19 mg/dl, 95% CI: -39.08, -5.30) and apolipoprotein A-I (apoA-I) (-40.20 mg/dl, 95% CI: -55.00, -25.39) demonstrated significant decreases, while differences in low-density lipoprotein cholesterol (LDL-C) (MD: -11.33 mg/dl, 95% CI: -36.95, 14.30) and triglycerides (MD: 9.93 mg/dl, 95% CI: -3.40, 23.26) were not shown to be significant.

Conclusions: HDL-C, as well as TC and apoA-I, levels are significantly decreased in MM. Hence, lipid profile parameters should be taken into account when assessing such patients.

Keywords: HDL-C; High-density lipoprotein cholesterol; Lipid profile; Multiple myeloma.