Purpose: Previous studies have shown that serum carcinoembryonic antigen (CEA) is independently associated with metabolic syndrome (MetS). However, these studies were mainly cross-sectional analyses, and cause was not clarified. In the present study, two bidirectional cohort studies were conducted to investigate the bidirectional associations between CEA and MetS using a Chinese male sample cohort.Methods: The initial longitudinal cohort included 9,629 Chinese males enrolled from January 2010 to December 2015. Two bidirectional cohorts were conducted in the study: subcohort A (from CEA to MetS, n=6,439) included participants without MetS at baseline to estimate the risk of developing incident MetS; subcohort B (from MetS to CEA, n=8,533) included participants without an elevated CEA level (Hyper-CEA) at baseline to examine the risk of developing incident Hyper-CEA. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models.Results: In subcohort A, the incidence densities of MetS among participants with and without Hyper-CEA were 84.56 and 99.28 per 1000 person-years, respectively. No significant effects of Hyper-CEA on incident MetS were observed in subcohort A (HR, 0.89; 95% CI, 0.71 to 1.12; P=0.326). In subcohort B, a higher incidence density of Hyper-CEA was found among participants with Mets (33.42 and 29.13 per 1000 person-years for those with and without MetS, respectively). For nonsmoking participants aged > 65 years, MetS increased the risk of incident Hyper-CEA (HR, 1.87; 95% CI, 1.09 to 3.20; P=0.022).Conclusion: For the direction of CEA on incident MetS, no significant association was observed. For the direction of MetS on incident Hyper-CEA, MetS in nonsmoking elderly men could increase the risk of incident Hyper-CEA, while this association was not found in other stratified participants. The clinical implications of the association between CEA and MetS should be interpreted with caution.
Purpose: Previous studies have shown that serum carcinoembryonic antigen (CEA) was independently associated with metabolic syndrome (MetS) risk. However, these studies were mainly cross-sectional analyses and cause has not been clarified. In the current study, we conducted two bidirectional cohort studies to investigate the bidirectional associations between CEA and MetS using a Chinese male sample cohort.Methods: The initial longitudinal cohort included 9,629 Chinese males from January 2010 to December 2015. Two bidirectional cohorts were conducted in the study: subcohort A (from CEA to MetS, n=6,439) included participants without MetS at baseline to estimate the risk of developing incident MetS; subcohort B (form MetS to CEA, n=8,533) included participants without elevated CEA level (Hyper-CEA) at baseline to examine the risk of developing incident Hyper-CEA. Hazard ratios were estimated using Cox proportional hazards models.Results: In subcohort A, the incidence densities of MetS were 85.47 and 99.25 per 1000 person-years with and without Hyper-CEA, respectively. Comparing without Hyper-CEA at baseline, participants with Hyper-CEA had a 0.89 (95% CI, 0.71 to 1.12)-fold hazard ratio of developing incidence MetS (P=0.326). In subcohort B, the incidence densities of Hyper-CEA were 33.42 and 29.13 per 1000 person-years for those with and without MetS, respectively. Participants with MetS had no significantly associated with incident Hyper-CEA (hazard ratio, 1.02; 95% CI, 0.84 to 1.22; P=0.864) in the general Chinese participants. Meanwhile, in the stratified analysis, MetS was might significantly associated with increased incident Hyper-CEA in men with age > 65-year and nonsmoking.Conclusion: CEA has no association with incident MetS. CEA should be interpreted carefully in MetS patients. Meanwhile, we need pay more attention to MetS in nonsmoking elderly men. They might have a higher risk of developing cancer.
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