In multivariable Cox models for HFH, cancer remained independently associated with risk across progressive adjustments: age-adjusted hazard ratio (HR) 1.42 (95% CI, 1.08-1.87), age-and-sex adjusted HR 1.40 (1.06-1.85), and fully adjusted HR 1.38 (1.02-1.87) after additional control for diabetes, CKD, and NT-proBNP. This evidence concerns the gene NPPB and diabetes mellitus.