Metabolic Abnormalities and Risk for Colorectal Cancer in the Physicians' Health Study

Stürmer, Til; Buring, Julie E.; Lee, I-Min; Gaziano, J. Michael; Glynn, Robert J.

doi:10.1158/1055-9965.epi-06-0391

Cited by 115 publications

(104 citation statements)

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“…Nevertheless, four out of five previous prospective studies (excluding a very small study of 54 cases 26 ), consistently reported a 1.4-1.5-fold significant increased risk of incident or fatal colorectal cancer in subjects with three or more MetS factors present (Table 5). [22][23][24][25] The fifth study showed no such association. 14 In that study, however, hyperglycaemiaFa strong risk factor in our and other studiesFwas not included as a factor of the MetS.…”

Section: Discussionmentioning

confidence: 97%

“…Interestingly, diastolic blood pressure was the only variable that showed an increased risk across quartiles. High blood pressure has in most, 22,23,26,33 but not all, 24,34 previous studies been related to a moderate, but mostly non-significant, increased risk of colorectal cancer incidence or mortality. Based on our observations, we suggest that the WHO cut-off points of risk factors, originally set for prediction of CVD, may also be suitable for estimates of colorectal cancer risk.…”

Section: 4mentioning

confidence: 97%

“…20,21 Despite using different definitions of the MetS, most prospective studies that investigated the joint effect of several MetS factors have shown an increased risk of colorectal cancer incidence or mortality in subjects with several factors present. [22][23][24][25][26] However, in some of these studies the effect of single and combined factors was of similar magnitude, [22][23][24] and one study showed no association between the MetS and colorectal cancer risk. 14 The aim of this prospective study was to investigate the association between factors of the MetSFobesity, hypertension and hyperglycaemiaFas well as circulating metabolic factors strongly related to the MetSFC-peptide, glycated haemoglobin (HbA1c), leptin and adiponectinFwith colorectal cancer risk.…”

Section: Introductionmentioning

confidence: 99%

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Components of the metabolic syndrome and colorectal cancer risk; a prospective study

et al. 2007

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Objective: To examine the relation of well-known factors of the metabolic syndrome (MetS) as well as related circulating factors, with risk of colorectal cancer. Methods: We performed a case control study of 306 colorectal cancer cases and 595 matched controls nested in the Northern Sweden Health and Disease Cohort. Levels of C-peptide, glycated haemoglobin (HbA1c), leptin and adiponectin were measured in cryopreserved samples. Body mass index (BMI), systolic and diastolic blood pressure and fasting and post-load plasma glucose, had been measured in a subcohort. Conditional logistic regression was used to calculate odds ratios (OR) of disease, including risk assessments for the MetS factors: obesity (BMI430 kg m À2 ), hypertension (blood pressure X140/90 mmHg or use of anti-hypertensive drugs) and hyperglycaemia (fasting glucose X6.1 mmol l À1 or post-load glucose in capillary plasma X8.9 mmol l À1 ). Results: None of the studied variables were significantly associated with risk across quartiles. Presence of obesity, hypertension and hyperglycaemia significantly increased the risk of colorectal cancer; OR for three vs null factors was 2.57 (95% Confidence Interval [CI] 1.20-5.52; P trend ¼ 0.0021), as compared to a 30 to 70% increased risk for the factors in single. Similarly, top decile levels of C-peptide, HbA1c and leptin/adiponectin ratio were associated with an increased risk; ORs for top vs deciles 1-9 were 1.56 (95% CI 0.93-2.62; P ¼ 0.090), 1.83 (95% CI 1.00-3.36; P ¼ 0.051) and 1.50 (95% CI 0.83-2.71; P ¼ 0.18), respectively. Conclusions: Our study support the view that components of the MetS increase risk of colorectal cancer, and further suggests that only very high levels of metabolic factors confer an increased risk.

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Section: Discussionmentioning

confidence: 97%

Section: 4mentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Components of the metabolic syndrome and colorectal cancer risk; a prospective study

et al. 2007

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“…Nine studies were conducted in the USA (16,18,20,32,35,(37)(38)(39)(40) , one in Sweden (42) , five in Korea (6,9,10,22,27) , two in China (23,30) , eight in Japan (8,24,26,28,29,31,36,43) , one in Austria (41) and three in European countries (4,17,34) (Tables 1 and 2). Pooled analysis showed a significant association between serum TAG and CRN (n 29 studies; summary RR = 1·08; 95 % CI 1·05, 1·12, P < 0·00001; Fig.…”

Section: Study Characteristicsmentioning

confidence: 99%

The association between serum lipids and colorectal neoplasm: a systemic review and meta-analysis

Tian

Wang

et al. 2015

Public Health Nutr.

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Objective: There have been inconsistent results published regarding the relationship between dyslipidaemia and an increased risk of colorectal neoplasia (CRN), including colorectal adenoma (CRA) and colorectal cancer (CRC). We conducted a meta-analysis to explore the relationship between dyslipidaemia and CRN. Design: We identified studies by performing a literature search using PubMed, EMBASE and the Science Citation Index through October 2013. Setting: We analysed thirty-three independent studies reporting the association between CRN and at least one of the selected lipid components, including total cholesterol (TC), TAG, HDL-cholesterol (HDL-C) and LDL-cholesterol (LDL-C). Subjects: CRN cases (n 21 809) were identified. Results: Overall, people with high levels of serum TAG (risk ratio (RR) = 1·08; 95 % CI 1·05, 1·12, P < 0·00001) and LDL-C (RR = 1·07; 95 % CI 1·00, 1·14, P = 0·04) presented an increased prevalence of CRN. Subgroup analyses revealed that high levels of serum TC (RR = 1·04; 95 % CI 1·01, 1·09, P = 0·02), TAG (RR = 1·06; 95 % CI 1·03, 1·10, P = 0·0009) and LDL-C (RR = 1·11; 95 % CI 1·04, 1·19, P = 0·003) increased the risk of CRA but not of CRC. No association between serum HDL-C and risk for CRN (including CRA and CRC) was observed. Conclusions: Both TAG and LDL-C were significantly associated with an increasing prevalence of CRN. High levels of serum TC, TAG and LDL-C were positively associated with CRA but not with CRC. No significant association was observed between levels of serum HDL-C and CRN. Keywords Serum lipids Colorectal adenomaColorectal cancer TAG Meta-analysis Colorectal cancer (CRC) is reported to be the fourth most commonly diagnosed cancer and is the second most common cause of cancer deaths in North America (1) . CRC is believed to arise from colorectal adenoma (CRA) through a sequence from adenoma to adenocarcinoma as a consequence of a limited set of molecular events that largely originate with a relatively benign adenoma that progresses to cancer (2) . Accumulated data indicate that metachronous lesions occur at a rate of 20 to 30 % per year in post-polypectomy patients. The propensity to develop CRA identifies a sizeable subgroup of the population at an enhanced risk for subsequent adenoma formation and colorectal carcinoma. This indicates that identifying risk factors associated with CRN is essential for the reduction of colorectal carcinoma.The positive association between obesity and CRA prevalence demonstrates an underlying dose-response relationship according to BMI (3) . Timely screening of obese patients for CRA is thus recommended. Dyslipidaemia is an important component of metabolic syndrome and is demonstrated to contribute to colorectal tumorigenesis through insulin resistance, oxidative stress and inflammatory † The first three authors contributed equally to this work.

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“…3 Many studies have shown that general obesity as measured by BMI is positively associated with colon or colorectal cancer in men, [4][5][6][7][8][9][10][11] whereas weaker or no associations have been found in women. 4,6,8,[12][13][14] Findings for rectal cancer risk in association with height, weight or BMI have been inconsistent and nonsignificant.…”

Section: )mentioning

confidence: 99%

Self-reported and measured anthropometric data and risk of colorectal cancer in the EPIC–Norfolk study

Park

Keogh

et al. 2011

Int J Obes

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Background: Epidemiological studies have shown inconsistent results for the association between body size and colorectal cancer (CRC) risk. Inconsistencies may be because of the reliance on self-reported measures of body size. Objective: We examined the association of self-reported and directly assessed anthropometric data (body height, weight, body mass index (BMI), waist, hip, waist-to-hip ratio (WHR) and chest circumference) with CRC risk in the EPIC-Norfolk study. Design: A total of 20 608 participants with complete self-reported and measured height and weight and without any history of cancer were followed up an average of 11 years, during which 357 incident CRC cases were recorded. Hazard Ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models. Results: After adjustment for confounders, HRs among women in the highest quintile of the body size measure relative to the lowest quintile showed that measured height (HR ¼ 1.98, 95% CI ¼ 1.19-3.28, P trend ¼ 0.009), measured waist circumference (HR ¼ 1.65, 95% CI ¼ 0.97-2.86, P trend ¼ 0.009) and measured WHR (HR ¼ 2.07, 95% CI ¼ 1.17-3.67, P trend ¼ 0.001) were associated with increased CRC risk. Associations using corresponding self-reported measures were attenuated and not statistically significant. Conversely, the association of BMI with CRC risk in women was weaker using measured BMI (HR ¼ 1.57, 95% CI ¼ 0.91-2.73, P trend ¼ 0.05) compared with self-reported BMI (HR ¼ 1.97, 95% CI ¼ 1.18-3.30, P trend ¼ 0.02). In men no significantly increased CRC risk was observed with any of the anthropometric measures. Conclusions: Measured height, waist circumference and WHR were associated with CRC risk in women, whereas any significant associations with those measures were attenuated when self-reported data were used.

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Metabolic Abnormalities and Risk for Colorectal Cancer in the Physicians' Health Study

Cited by 115 publications

References 60 publications

Components of the metabolic syndrome and colorectal cancer risk; a prospective study

Components of the metabolic syndrome and colorectal cancer risk; a prospective study

The association between serum lipids and colorectal neoplasm: a systemic review and meta-analysis

Self-reported and measured anthropometric data and risk of colorectal cancer in the EPIC–Norfolk study

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