ALB and cancer: As shown in Fig. 4a, the joint mediating effect of the metabolites contributed 19.7% to the total effect of the MEDAS score on overall cancer risk, among which, total lipids in VLDL, total cholines, omega-3 fatty acids, albumin, free cholesterol in IDL, and total lipids in large HDL accounted for − 9.7%, − 9.7%, 18.2%, − 7.8%, 6.7%, and 16.6% respectively.