Association between metabolic syndrome and its components and incident colorectal cancer in a prospective cohort study

Abstract

Background Metabolic syndrome (MetS) has been identified as a contributor to cancer development. However, reports concerning the association between MetS and colorectal cancer (CRC) have been inconsistent. This study investigated whether MetS, its components, and the number of components increase the risk of CRC. Methods This was a prospective cohort study of 41,837 participants recruited from August 2002 to December 2014 from the National Cancer Center in South Korea. The participants were followed until December 2017 to identify incident CRC cases. The participants underwent laboratory tests at the baseline. Additionally, a self‐administered questionnaire collected information concerning lifestyle and general characteristics at the baseline. A Cox proportional hazards model was used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) to explore the association between MetS and its components and CRC risk after adjustments for confounding variables. Results In total, 128 incident CRC cases were identified during the follow‐up period. An increased CRC risk was found among participants with MetS (HR, 1.63; 95% CI, 1.08‐2.44). Additionally, elevated blood pressure (HR, 1.50; 95% CI, 1.05‐2.15) and a high fasting glucose level (HR, 1.80; 95% CI, 1.23‐2.63) were associated with an elevated risk of CRC. Notably, an increased risk was identified among participants with abdominal obesity coexisting with another component of MetS. Conclusions These results suggest that MetS is a risk factor for CRC. Greater emphasis should be placed on the importance of CRC screening among individuals with abdominal obesity coexisting with another component of MetS. Lay Summary Colorectal cancer (CRC) ranks as the third most common cancer type in terms of incidence. Metabolic syndrome (MetS) has been identified as a contributor to cancer development. However, the association between MetS and CRC remains controversial because of a lack of consistent findings in previous studies. In this study, the National Cholesterol Education Program's Adult Treatment Panel III guidelines are used for the diagnosis of MetS. MetS is found to be a predictor of CRC. Additionally, the importance of CRC screening among individuals with 2 components of MetS should be emphasized.

Metabolisches Syndrom und Krebsrisiko

“…So treten beim MetS kolorektale Adenome um 50-76 % häufiger auf und dies bereits vor dem 50. Lebensjahr [7,22,23].…”

“…Das MetS kann Malignome von Speiseröhre, Magen, Bauchspeicheldrüse, Leber, Gallenwegen, Darm, Schilddrüse, Niere, postmenopausaler Brust, Zervix und Endometrium verursachen 2 3 4 5 6 7 . Je mehr Komponenten des MetS vorliegen, desto stärker steigt das Krebsrisiko 5 7 8 ( Tab. 1 ).…”

“…Das MetS steigert das Risiko, an Darmkrebs zu erkranken oder daran zu versterben auf etwa das 2-Fache 6 7 21 . In einer großen prospektiven Studie aus Korea waren die Effekte des MetS auf das Darmkrebsrisiko bei Männern ausgeprägter als bei Frauen.…”

“…Das MetS steigert das Krebsrisiko und bedingt eine bis 2,4-fach erhöhte Krebssterblichkeit [2][3][4]. Das MetS kann Malignome von Speiseröhre, Magen, Bauchspeicheldrüse, Leber, Gallenwegen, Darm, Schilddrüse, Niere, postmenopausaler Brust, Zervix und Endometrium verursachen [2][3][4][5][6][7]. Je mehr Komponenten des MetS vorliegen, desto stärker steigt das Krebsrisiko [5,7,8] (▶ Tab.…”

“…Das viszerale Fettgewebe ist ein endokrines Organ, das eine Vielzahl von Zytokinen, Wachstumsfaktoren, Fettsäuren, Mediator-und Transmitterstoffen produziert und dadurch das MetS befördern kann. Synergismen zwischen den verschiedenen Einzelkomponenten des MetS führen dabei oftmals zu einem überadditiven Krebsrisiko[5,7,8]. Das MetS ist zudem mit Änderungen der intesti-nalen Mikrobiota und einer verringerten mikrobiellen Diversität assoziiert.DarmkrebsDarmkrebs (kolorektales Karzinom: KRK) ist die zweithäufigste tumorbedingte Todesursache in Deutschland.…”