Serum lipid alterations in oral squamous cell carcinoma and oral potentially malignant disorders: A systematic review and meta-analysis

Alterations in serum lipids have been linked to systemic and neoplastic diseases, including oral malignancies. Lipid disturbances are reported inconsistently in oral potentially malignant disorders (OPMD) and oral squamous cell carcinoma (OSCC). This systematic review and meta-analysis clarifies lipid profile patterns across OPMD, OSCC, and healthy controls. Following PRISMA 2020 guidelines and PROSPERO registration, a comprehensive database search through November 2025 identified fifty-two eligible case-control studies comparing total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), very-low-density lipoprotein (VLDL), and triglycerides (TGs) between OPMD, OSCC, and healthy individuals. Data were synthesized using a random-effects model, Cochran’s Q and I² statistics for heterogeneity and Risk of Bias. This meta-analysis showed significantly reduced TC, HDL, LDL, VLDL, and TGs in both OSCC and OPMD compared with healthy controls (p < 0.001), with greater reductions in OSCC. Direct comparisons between OSCC and OPMD revealed significant differences in TC (p = 0.025) and LDL (p = 0.04), while HDL and VLDL differences were not significant. High heterogeneity and mild publication bias for TC and TGs were observed. Results indicate an association between lipid profiles and disease stage, but prospective studies are needed to determine causality and diagnostic utility.