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Using NHANES data from 1999 to 2020 covering 18,067 participants, the study applies weighted multivariable logistic regression and restricted cubic spline modeling to assess non-linear patterns, then performs two-piecewise linear regression. Sensitivity analyses include subgroups, multiple imputation, outlier removal, and propensity score matching, while causal inference is tested via univariable and multivariable Mendelian randomization, with robustness supported by replication and meta-analysis.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/association-between-remnant-cholesterol-and-the-risk-of-4-site-specific-cancers-evidence-from-a-cross-sectional-and-mendelian-randomization-study/332346/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/association-between-remnant-cholesterol-and-the-risk-of-4-site-specific-cancers-evidence-from-a-cross-sectional-and-mendelian-randomization-study/332346.png","ImageObject",300,407,{"name":92,"@type":93},"Ezra","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-03","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What relationship between remnant cholesterol and breast cancer risk was observed in the study?","Question",{"text":113,"@type":114},"Multivariable logistic regression showed a significant association between higher serum RC levels and breast cancer risk, and weighted RCS modeling indicated an inverted L-shaped relationship. However, Mendelian randomization evidence and subsequent replication/meta-analysis did not support a significant causal association for breast cancer.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How did the study assess non-linear associations and robustness?",{"text":118,"@type":114},"Non-linear associations were evaluated with restricted cubic spline (RCS) regression and two-piecewise linear regression. Robustness was further tested using sensitivity analyses including subgroup analysis, multiple imputation, outlier removal, and propensity score matching, plus replication and meta-analysis.",{"name":120,"@type":111,"acceptedAnswer":121},"Did Mendelian randomization support a causal link between remnant cholesterol and the cancers studied?",{"text":122,"@type":114},"The primary Mendelian randomization analysis suggested increased risks for breast and colorectal cancer associated with RC. Replication and meta-analysis, however, did not support significant causal associations for breast, lung, colorectal, or prostate cancer.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},332346,1790151569,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":41,"preview_page_count":4},1099514068035,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Li etal. Lipids in Health and Disease (2024) 23:256 Lipids in Health and Disease  \n[https://doi.org/10.1186/s12944-024-02241-7](https://doi.org/10.1186/s12944-024-02241-7)  \nRESEARCH Open Access  \nAssociation between remnant cholesterol   and the risk of 4 site-specific cancers: evidence from a cross-sectional and Mendelian randomization study  \nMengjie Li 1†, Qi Liu2†, Ming Shi 1, Manyi Fu 1 and Guijuan He 1*  \nAbstract  \nBackground Recent studies have implicated remnant cholesterol (RC) in the etiology, progression, and prognosis of cancer. However, very few of them concentrated on the study of the precise relationship between serum RC levels and cancer risk, leaving this subject unexplored. Consequently, this study aims to investigate the association between serum RC levels and 4 site-specific cancers, employing a dual approach that combines observational and mendelian randomization (MR) analysis.  \nMethods Based on data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2020, this study collected data from18,067 participants. To rule out confounders, this study utilized weighted multivariable logistic regression and assessed non-linear associations using restricted cubic spline (RCS) regression, followed by two-piecewise linear regression. Sensitivity analysis conducted in this study included subgroup analysis, multiple imputation, outlier removal, and propensity score matching. To strengthen causal inference, this study employed univariable and multivariable MR analysis. The robustness and reliability of the findings were estimated by the application of replication and meta-analysis.  \nResults The results of multivariable logistic regression analysis demonstrated a significant association between serum RC levels and breast cancer, showing that individuals in the higher logRC category had a higher risk of breast cancer compared to those in the lower category (Q3 vs. Q1: OR = 1 . 71, 95% CI: 1.01–2. 88, P = 0 . 044) . Weighted RCS revealed an inverted L-shape association between RC and the risk of breast cancer (P-nonlinear = 0 . 0386, P-overall = 0 . 010) . Primary MR analysis provided evidence for an increased risk of breast (IVW: OR = 1 . 08, 95% CI: 1.03–1. 12, P = 0 . 000951) and colorectal cancer (IVW: OR = 1 . 12, 95% CI: 1.00-1. 24, P = 0 . 0476) associated with RC. However, the results of replication and meta-analysis did not support a significant causal association of RC with the risk of breast cancer (OR = 1 . 04, 95% CI: 0 .95–1. 13), lung cancer (OR = 0 . 95, 95% CI: 0 .88–1. 03), colorectal cancer (OR = 1 . 05, 95% CI: 0 .92–1. 19), and prostate cancer (OR = 1 . 01, 95% CI: 0 .95–1. 08) .  \n†Mengjie Li and Qi Liu contributed equally to this work.  \n*Correspondence: Guijuan He[sheryhe@163.com](sheryhe@163.com)  \nFull list of author information is available at the end of the article  \n© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://](http://)[ ](http://)[creativecommons.org/l](creativecommons.org/l)icenses/by-nc-nd/4.0/.  \nLi et al. Lipids in Healt","cbCaipUpaBuRRgAq","https://ap.wps.com/l/cbCaipUpaBuRRgAq","pdf",2834032,12,"English","# Abstract\n# Introduction\n# Methods\n# Results\n# Conclusion","[{\"question\":\"What relationship between remnant cholesterol and breast cancer risk was observed in the study?\",\"answer\":\"Multivariable logistic regression showed a significant association between higher serum RC levels and breast cancer risk, and weighted RCS modeling indicated an inverted L-shaped relationship. However, Mendelian randomization evidence and subsequent replication/meta-analysis did not support a significant causal association for breast cancer.\"},{\"question\":\"How did the study assess non-linear associations and robustness?\",\"answer\":\"Non-linear associations were evaluated with restricted cubic spline (RCS) regression and two-piecewise linear regression. Robustness was further tested using sensitivity analyses including subgroup analysis, multiple imputation, outlier removal, and propensity score matching, plus replication and meta-analysis.\"},{\"question\":\"Did Mendelian randomization support a causal link between remnant cholesterol and the cancers studied?\",\"answer\":\"The primary Mendelian randomization analysis suggested increased risks for breast and colorectal cancer associated with RC. Replication and meta-analysis, however, did not support significant causal associations for breast, lung, colorectal, or prostate cancer.\"}]","Association between remnant cholesterol and the risk of 4 site-specific cancers - evidence from a cross-sectional and Mendelian randomization study | PDF",1789997798]