Is Low Cholesterol and Triglycerides a Sign of Pancreatic Cancer?

Is there any basis for this statement?

Recently, I came across a physician citing a study from the United States indicating that a decrease in triglycerides and cholesterol could be a precursor to pancreatic cancer.
Is there any basis for this? According to the citation: In May of this year, American scholars proposed a new theory describing three phases of changes that occur in the body "before the onset of pancreatic cancer."
The first phase (30 to 18 months before pancreatic cancer diagnosis) involves the initial appearance of hyperglycemia, which can even occur up to three years prior to the diagnosis, although no noticeable changes in body tissues are observed at this time.

The second phase (18 to 6 months before diagnosis) sees a continued rise in blood glucose levels, while lipid levels (total cholesterol, low-density lipoprotein, and triglycerides) decrease, along with a reduction in body weight and subcutaneous fat.
At this stage, visceral fat and muscle mass remain unchanged, and high-density lipoprotein levels also do not vary.

The third phase (6 months to diagnosis) is characterized by the majority of individuals exhibiting hyperglycemia, alongside decreases in lipid levels, subcutaneous fat, visceral fat, and muscle mass, leading to noticeable weight loss.

ip, 30~39 year old female. Ask Date: 2020/05/31

Dr. Chen Shidian reply Gastroenterology and Hepatology

Further research is needed.

Reply Date: 2020/05/31

More Info

The assertion that low cholesterol and triglycerides may be indicators of pancreatic cancer is indeed a topic of ongoing research and debate within the medical community. Recent studies, including the one referenced, suggest that changes in metabolic parameters, such as elevated blood sugar levels and decreased lipid levels, can occur in the months or even years leading up to a pancreatic cancer diagnosis.

In the first stage, which occurs 30 to 18 months prior to diagnosis, elevated blood sugar levels are often the first sign. This can be attributed to the cancer's impact on insulin production and glucose metabolism. As the disease progresses into the second stage (18 to 6 months before diagnosis), it has been observed that while blood sugar continues to rise, levels of triglycerides and cholesterol may begin to decline. This paradoxical decrease in lipid levels can be attributed to the body's altered metabolism in response to the tumor's presence, which may lead to increased energy expenditure and changes in fat storage.

The third stage, occurring 6 months to the point of diagnosis, typically presents with significant weight loss, further decreases in triglycerides and cholesterol, and persistent high blood sugar levels. This stage often reflects the advanced nature of the disease, where the body is unable to maintain normal metabolic functions due to the cancer's systemic effects.

It is important to note that while these metabolic changes can be indicative of pancreatic cancer, they are not definitive markers. Many other conditions can lead to similar changes in blood sugar and lipid levels, including diabetes, liver disease, and other malignancies. Therefore, while low cholesterol and triglycerides may be associated with pancreatic cancer in some patients, they should not be used in isolation to diagnose the disease.

Moreover, the relationship between pancreatic cancer and lipid metabolism is complex. The pancreas plays a crucial role in fat digestion and metabolism, and pancreatic cancer can disrupt these processes, leading to alterations in lipid profiles. However, the exact mechanisms by which pancreatic cancer influences lipid metabolism are still being studied.

In clinical practice, the presence of low cholesterol and triglycerides, particularly in conjunction with other symptoms such as unexplained weight loss, jaundice, or new-onset diabetes, should prompt further investigation. This may include imaging studies, such as CT scans or MRIs, and possibly a biopsy to confirm or rule out pancreatic cancer.

In conclusion, while there is emerging evidence suggesting that low cholesterol and triglycerides may be associated with pancreatic cancer, more research is needed to establish a clear causal relationship. It is essential for healthcare providers to consider the full clinical picture, including patient history, symptoms, and other diagnostic findings, when evaluating the risk of pancreatic cancer. Regular monitoring and a comprehensive approach to patient care are crucial in managing potential pancreatic disorders.

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