Fats and Facts: A Meta-Analysis of Lipid Biomarkers in Endometrial Cancer

Background: Endometrial cancer (EC) represents one of the most prevalent gynecological malignancies worldwide, with increasing incidence rates attributed to rising obesity, metabolic syndrome, and demographic aging. Recent evidence suggests that dyslipidemia, including elevated triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and reduced high-density lipoprotein cholesterol (HDL-C), may have a significant role in the pathogenesis of EC through inflammatory, oxidative stress, and hormonal mechanisms. Objective: This meta-analysis aims to systematically evaluate the association between serum lipid biomarkers and endometrial cancer risk by synthesizing quantitative data from observational studies. Methods: We conducted a comprehensive search of five electronic databases (PubMed, Web of Science, Scopus, EMBASE, and Cochrane) to identify studies examining lipid biomarkers in patients with EC compared to healthy controls. After screening 639 articles and applying rigorous inclusion/exclusion criteria, six studies were selected for final analysis. The standardized mean differences (SMD) were calculated with 95% confidence intervals using random-effects and fixed-effects models, considering heterogeneity assessed by the I2 statistic. Publication bias was evaluated using funnel plots and Egger’s regression test. Results: The meta-analysis revealed significantly elevated TG levels in EC patients compared to controls (SMD +0.87, 95% CI [+0.65, +1.10]), markedly reduced HDL-C levels (SMD −0.92, 95% CI [−1.15, −0.69]), and increased LDL-C levels (SMD +0.74, 95% CI [+0.50, +0.98]). The heterogeneity was moderate to substantial, with an I2 ranging from 49% to 62%. Subgroup analyses demonstrated stronger associations in Type I EC and obese patients (BMI > 30 kg/m2). Conclusions: This meta-analysis establishes a significant association between dyslipidemia and endometrial cancer risk, with elevated triglycerides and LDL-C conferring increased risk while HDL-C appears protective. These findings support the integration of lipid profiling into EC risk assessment protocols and suggest the potential preventive value of lipid-modulating interventions. Further studies are needed to establish causality and evaluate therapeutic applications.