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

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.