Is high-density lipoprotein a preventive factor for venous thromboembolism in patients with lung cancer

Jingyu Chen, Kunpeng Bu, Dimei Huang, Bixun Li

Department of Comprehensive Internal Medicine, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China

Introduction: Lung cancer is a malignant tumor with the highest mortality and morbidity, and its common complication is venous thromboembolism (VTE). We aim to investigate the blood lipid level, demographic data, and related risk factors of patients with lung cancer-related VTE, and provide meaningful biomarkers for its early prevention.

Materials and methods: All study subjects were from newly diagnosed lung cancers with VTE who were hospitalized in the Guangxi Medical University Cancer Hospital between December 2013 and December 2019. Using propensity score matching (PSM) (1 to 1 ratio), a total of 89 VTE groups and 89 non-VTE groups were included in the data analysis. Univariate analysis of blood lipids, baseline data, and related hematological indicators of the two groups, and the independent risk factors were screened out through binary classification logistics regression.

Results: In multivariate logistics regression, independent risk factors for VTE in lung cancer included stage IV patients, elevated leukocyte (>9.5x10*9/L), and high levels of D dimer(>1.44mg/L). Increased levels of leukocyte and D dimer had moderate predictive value for VTE [AUC 0.802 (95% CI, 0.739-0.866)]. For patients younger than 65, high-density lipoprotein (HDL) ≥ 1 mmol/L were associated with a lower risk of VTE, and high levels of HDL (≥1 mmol/L) had a lower risk of VTE than low levels of HDL (<1 mmol/L) (OR 0.138, 0.035-0.544).

Conclusion: In patients with lung cancer, elevated leukocyte and D dimer may increase the risk of VTE. High levels of HDL may decrease the risk of VTE, and HDL is a possible protective factor.