Abstract LB415: Association between waist circumference, body mass index, high-density lipoprotein cholesterol level, and risk of chronic myeloid leukemia
Authors: Kim Ka Young , Han Kyung Do , Lee Sung-Eun 
Published: April 2024

Abstract
Advances in the treatment of chronic myeloid leukemia (CML) have resulted in increased prevalence. However, a more comprehensive understanding of its pathogenesis and epidemiology is necessary. Recent studies suggested the association between altered lipid metabolism and carcinogenesis, prompting an investigation of the relationship between metabolic disorders and incidence of CML. Thus, we conducted a study to examine the association between waist circumference, body mass index (BMI), high-density lipoprotein cholesterol (HDL-C), and the incidence of CML.Using data from the Korean National Health Insurance Service from 2009 to 2017, a competing risks regression was conducted to examine the hazard ratios of CML in 3,879,560 individuals aged 20 years and above. During a mean of 10.13±1.24 years of follow-up, there were a total of 848 cases of CML, including 539 male and 309 female patients.1) Individuals in the group with a waist circumference equal to or greater than 100cm had the greatest risk of CML (adjusted hazard ratio [aHR], 95% CI = 1.593, 1.058-2.398), compared to those with a waist circumference from 80 to less than 85cm.2) Those with a BMI less than 18.5 showed the lowest incidence of CML ([aHR], 95% CI = 0.509, 0.278–0.931) in comparison to the reference population with a BMI between 18.5 and 22.9.3) Individuals in the highest quartile of HDL-C had the lowest risk of CML ([aHR], 95% CI = 0.795, 0.657–0.961) compared to those in the lowest HDL-C quartile.A large waist circumference was significantly associated with increased risk of CML, whereas a low BMI and high HDL-C were associated with a reduced risk of CML. This suggests that a large waist circumference may be an independent risk factor of CML, whereas a low BMI and high HDL-C may be association with a protective effect against CML.

Table 1. Risk of chronic myeloid leukemia by subgroups of waist circumference, bodey mass index, and high-density lipoprotein cholesterol level. Waist circumference (cm) N Case Duration IR (1000,000 PY) HR (95% CI) Model 1 Model 2 Model 3 Model 4 Model 5 &lt;80.0 1,424,747 236 14493864.7 16.2830 0.644 (0.533, 0.778) 0.858 (0.707, 1.041) 0.859 (0.707, 1.045) 0.836 (0.662, 1.055) 0.853 (0.675, 1.078) 80.0 - 84.9 921,040 193 9344290.4 20.6540 0.816 (0.669, 0.995) 0.876 (0.718, 1.069) 0.876 (0.717, 1.069) 0.866 (0.705, 1.063) 0.843 (0.685, 1.037) 85.0 - 89.9 769,528 197 7785119.0 25.3050 1 (Ref.) 1 (Ref.) 1 (Ref.) 1 (Ref.) 1 (Ref.) 90.0 - 94.9 451,608 116 4551043.2 25.4890 1.008 (0.801, 1.267) 0.963 (0.766, 1.212) 0.965 (0.767, 1.215) 0.976 (0.771, 1.234) 1.016 (0.802, 1.286) 95.0 - 99.9 201,541 68 2022854.6 33.6160 1.329 (1.009, 1.751) 1.267 (0.962, 1.670) 1.274 (0.966, 1.681) 1.302 (0.970, 1.747) 1.401 (1.044, 1.880) ≥100 111,096 38 1108876.8 34.2690 1.356 (0.958, 1.919) 1.352 (0.955, 1.915) 1.365 (0.962, 1.938) 1.421 (0.959, 2.105) 1.593 (1.058, 2.398) Model 1 was not adjusted.Model 2 was adjusted for age and sex.Model 3 was adjusted for age, sex, household income, smoking, alcohol consumption, regular exercise, diabetes mellitus, hypertension, dyslipidemia, and chronic kidney disease.Model 4 was adjusted for age, sex, household income, smoking, alcohol consumption, regular exercise, diabetes mellitus, hypertension, dyslipidemia, chronic kidney disease, and BMI (Continuous).Model 5 was adjusted for age, sex, household income, smoking, alcohol consumption, regular exercise, diabetes mellitus, hypertension, dyslipidemia, chronic kidney disease, and BMI (5 level). Body mass index N Case Duration IR (1000,000 PY) HR (95% CI) Model 1 Model 2 Model 3 Model 4 Model 5 &lt;18.5 143,144 11 1421140.8 0.0077 0.410 (0.225, 0.749) 0.496 (0.272, 0.906) 0.505 (0.276, 0.921) 0.586 (0.319, 1.077) 0.509 (0.278, 0.931) 18.5 - 22.9 1,512,449 290 15308105.8 0.0189 1 (Ref.) 1 (Ref.) 1 (Ref.) 1 (Ref.) 1 (Ref.) 23.0 - 24.9 955,515 239 9697732.1 0.0246 1.300 (1.096, 1.543) 1.131 (0.952, 1.343) 1.120 (0.942, 1.331) 0.998 (0.828, 1.203) 1.060 (0.873, 1.287) 25.0 - 29.9 1,130,207 274 11476143.9 0.0239 1.260 (1.068, 1.486) 1.075 (0.910, 1.269) 1.060 (0.895, 1.256) 0.842 (0.675, 1.051) 0.878 (0.699, 1.104) ≥30.0 138,245 34 1402926.2 0.0242 1.280 (0.897, 1.826) 1.234 (0.865, 1.761) 1.218 (0.849, 1.747) 0.786 (0.500, 1.236) 0.765 (0.483, 1.211) Model 1 was not adjusted.Model 2 was adjusted for age and sex.Model 3 was adjusted for age, sex, household income, smoking, alcohol consumption, regular exercise, diabetes mellitus, hypertension, dyslipidemia, and chronic kidney disease.Model 4 was adjusted for age, sex, household income, smoking, alcohol consumption, regular exercise, diabetes mellitus, hypertension, dyslipidemia, chronic kidney disease, and waist circumference (Continuous).Model 5 was adjusted for age, sex, household income, smoking, alcohol consumption, regular exercise, diabetes mellitus, hypertension, dyslipidemia, chronic kidney disease, and waist circumference (5 level). HDL-C level N Case Duration IR (1000,000 PY) HR (95% CI) Model 1 Model 2 Model 3 Model 4 Q1 (Lowest) 1,007,163 277 10156736.52 0.0273 1 (Ref.) 1 (Ref.) 1 (Ref.) 1 (Ref.) Q2 910,627 202 9242549.22 0.0219 0.802 (0.669, 0.961) 0.851 (0.710, 1.021) 0.853 (0.711, 1.023) 0.851 (0.709, 1.021) Q3 979,148 177 9948872.05 0.0178 0.653 (0.540, 0.788) 0.720 (0.596, 0.870) 0.724 (0.598, 0.876) 0.721 (0.596, 0.873) Q4 (Highest) 982,622 192 9957890.96 0.0193 0.708 (0.589, 0.851) 0.789 (0.656, 0.949) 0.798 (0.660, 0.965) 0.795 (0.657, 0.961) Model 1 was not adjusted.Model 2 was adjusted for age and sex.Model 3 was adjusted for age, sex, household income, smoking, alcohol consumption, regular exercise, diabetes mellitus, hypertension, dyslipidemia, chronic kidney disease, and BMI (5 level).Model 4 was adjusted for age, sex, household income, smoking, alcohol consumption, regular exercise, diabetes mellitus, hypertension, dyslipidemia, chronic kidney disease, and dyslipidemia medication. HDL-C high-density lipoprotein cholesterl, IR incidence rate, PY person-years, HR hazard ratio, CI confidence interval.
Citation Format: Ka Young Kim, Kyung Do Han, Sung-Eun Lee. Association between waist circumference, body mass index, high-density lipoprotein cholesterol level, and risk of chronic myeloid leukemia [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr LB415.