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The relationship between cholesterol levels and hematologic malignancy has been identified in population studies. However, it is still unclear if there is a relationship between cholesterol levels and plasma cell neoplasm in European ancestry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospective cohorts included 502,507 individuals from the UK Biobank who were followed up to 2019 and assessed total cholesterol(TC) levels, low\u2010density lipoprotein (LDL) levels, high\u2010density lipoprotein (HDL) levels, apolipoprotein A (ApoA) and apolipoprotein B (ApoB) as risk factors for plasma cell neoplasms with Cox proportional hazard regression and restricted cubic spline model. We also used two\u2010sample Mendelian randomization to determine if the cholesterol level has a causal effect on developing plasma cell neoplasms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We observed 1819 plasma cell neoplasm cases during 14.2\u2009years of follow\u2010up in the UK Biobank. We found higher blood serum cholesterol levels at baseline were associated with a lower risk of plasma cell neoplasm in our study. All lipid profiles we analyzed in this study were inversely associated with plasma cell neoplasm risk (all <jats:italic>p<\/jats:italic><jats:sub>trend<\/jats:sub>\u2009&lt;0.005) but triglycerides did not have such association. However, there was no suggestive association of genetically predicted serum LDL, HDL, and total cholesterol levels with multiple myeloma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Low serum total cholesterol, LDL, HDL, ApoA, and ApoB levels were all associated with increasing the risk of plasma cell neoplasm.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.6649","type":"journal-article","created":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T07:30:02Z","timestamp":1698823802000},"page":"20964-20975","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Low cholesterol levels are associated with increasing risk of plasma cell neoplasm: A UK biobank cohort study"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2975-3713","authenticated-orcid":false,"given":"Linfeng","family":"Li","sequence":"first","affiliation":[{"name":"Department of Hematology, 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