Low serum LDL cholesterol levels are associated with elevated mortality from liver cancer in Japan: the Ibaraki Prefectural health study

Tohoku J Exp Med. 2013 Mar;229(3):203-11. doi: 10.1620/tjem.229.203.


Liver cancer a global public health concern and well known for poor prognosis. The association between low total cholesterol level and liver cancer has been reported. However, the association between low low-density lipoprotein (LDL) cholesterol levels and liver cancer is still unclear. The aim of this study was to examine the relationship between LDL cholesterol level and liver cancer mortality. A total of 16,217 persons (5,551 men and 10,666 women) aged 40-79 years in 1993 were followed until 2008. LDL cholesterol levels were divided into four categories (<80 mg/dl, 80-99 mg/dl, 100-119 mg/dl, and ≥120 mg/dl). Hazard ratio of LDL cholesterol level for liver cancer mortality was calculated using a multivariable Cox proportional hazards model. Covariates were age, sex, alanine transaminase, body mass index, alcohol intake and smoking status, all of which were correlated with LDL cholesterol levels. There were 51 deaths (32 men and 19 women) from liver cancer. Multivariable hazard ratios of liver cancer deaths for LDL cholesterol levels of <80 mg/dl was 4.33 (95% confident interval [CI]: 1.94, 9.68), for LDL cholesterol levels of 80-99 mg/dl was 1.03 (95% CI: 0.42, 2.53), and for LDL cholesterol levels of ≥120 mg/dl was 0.43 (95% CI: 0.20, 0.92) compared with LDL cholesterol levels of 100-199 mg/dl (p for trend<0.01). Therefore, low LDL cholesterol levels are associated with elevated risk of liver cancer mortality. Low LDL cholesterol may be a predictive marker for death due to liver cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Cholesterol, LDL / blood*
  • Fasting / blood
  • Female
  • Health*
  • Humans
  • Japan / epidemiology
  • Kaplan-Meier Estimate
  • Liver Cirrhosis / complications
  • Liver Neoplasms / blood*
  • Liver Neoplasms / mortality*
  • Male
  • Middle Aged
  • Proportional Hazards Models


  • Cholesterol, LDL