Case–Control Study of the Metabolic Syndrome and Metabolic Risk Factors for Endometrial Cancer

Abstract

Background: Metabolic syndrome may predict endometrial cancer risk better than diabetes, hypertension, dyslipidemia, dysglycemia, or weight alone, but few studies have examined this issue.Methods: We conducted a population-based case-control study in Alberta, Canada (2002) that included 515 incident endometrial cancer cases and 962 frequency age-matched controls. Data were collected through in-person interviews, anthropometric measurements, and 8-hour fasting bloods drawn either pre-or postsurgery. Bloods were analyzed using quantitative colorimetric or absorbance-based assays (ELISA), specific to metabolic syndrome markers. Metabolic syndrome was defined using harmonized guidelines requiring presence of !3 of the following risk factors: waist circumference !88 cm, triglycerides !150 mg/dL, high-density lipoprotein cholesterol <50 mg/dL, treatment of previously diagnosed hypertension, and fasting blood glucose !100 mg/dL. OR and 95% CIs for endometrial cancer risk with presence of metabolic syndrome and individual metabolic syndrome components were estimated using logistic regression analysis.Results: Metabolic syndrome was significantly more prevalent among cases (62%) than controls (38%). A statistically significant increased risk for endometrial cancer was observed for metabolic syndrome (OR ¼ 1.53; 95% CI: 1.17-2.00), as well as for some of the individual components of metabolic syndrome including waist circumference !88 cm (OR ¼ 1.57; 95% CI: 1.18-2.08), hypertension (OR ¼ 1.57; 95% CI: 1.18-2.09), and fasting blood glucose !100 mg/dL (OR ¼ 1.31; 95% CI: 1.03-1.67). Some evidence for effect modification by menopausal status and body mass index was also found.Conclusion: Metabolic syndrome is clearly associated with increased endometrial cancer risk. Impact: Targeting the entire metabolic syndrome may optimize endometrial cancer risk reduction. Cancer Epidemiol Biomarkers Prev; 20(11); 2384-95. Ó2011 AACR.

Prevalence of Co-existing Endometrial Carcinoma in Patients with Preoperative Diagnosis of Endometrial Hyperplasia

“…The risk of endometrial cancer shows a significant increase in women diagnosed with metabolic syndrome [14]. In our study the patients diagnosed with preoperative endometrial hyperplasia by endometrial biopsy and then diagnosed with postoperative endometrial cancer; hypertension and diabetes which are components of metabolic syndrome were evaluated.…”

Controversies in EndometrialCancer with Metabolic Syndrome

“…Given that many women with PCOS are obese and have IR, it is unclear whether PCOS is truly an independent risk factor. Friedenreich CM et al reported that Metabolic syndrome with dyslipidaemia increased the risk of developing various cancers specially EC [35]. Three prospective studies have evaluated circulating estrogen levels and EC risk in postmenopausal women, with consistent strong positive association, but the relationship was not studied in premenopausal women [36][37][38].…”

Metabolic Syndrome and Infertility in Women

“…Carcinogenesis is associated with lifestyle factors, with excess weight gain being acknowledged as a major risk factor accounting for almost half of endometrial cancer cases in industrialized countries (69). Metabolic disorders such as obesity and diabetes are thought to increase the risk of developing reproductive health cancers such as endometrial or breast cancer (70). Kurdoglu et al (63) reported that oxidative stress characterized by decreased antixidant and increased oxidant levels that are independent of insulin resistance may play a role in the pathogenesis of polycystic ovarian syndrome in young non-obese women.…”