Metabolic Syndrome and Risks of Colon and Rectal Cancer: The European Prospective Investigation into Cancer and Nutrition Study

Abstract

Metabolic syndrome (MetS) is purportedly related to risk of developing colorectal cancer; however, the association of MetS, as defined according to recent international criteria, and colorectal cancer has not been yet evaluated. In particular, it remains unclear to what extent the MetS components individually account for such an association. We addressed these issues in a nested case-control study that included 1,093 incident cases matched (1:1) to controls by using incidence density sampling. Conditional logistic regression was used to estimate relative risks (RR) and 95% CIs. MetS was defined according to the criteria of the National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATPIII), the International Diabetes Federation (IDF), and the 2009 harmonized definition. Among individual components, abdominal obesity (RR ¼ 1.51; 95% CI: 1.16-1.96) was associated with colon cancer, whereas abnormal glucose metabolism was associated with both colon (RR ¼ 2.05; 95% CI: 1.57-2.68) and rectal cancer (RR ¼ 2.07; 95% CI: 1.45-2.96). MetS, as defined by each of the definitions, was similarly associated with colon cancer (e.g., RR ¼ 1.91; 95% CI: 1.47-2.42 for MetS by NCEP/ATPIII), whereas MetS by NCEP/ATPIII, but not IDF or harmonized definition, was associated with rectal cancer (RR ¼ 1.45; 95% CI: 1.02-2.06). Overall, these associations were stronger in women than in men. However, the association between MetS and colorectal cancer was accounted for by abdominal obesity and abnormal glucose metabolism such that MetS did not provide risk information beyond these components (likelihood ratio test P ¼ 0.10 for MetS by NCEP/ ATPIII). These data suggest that simple assessment of abnormal glucose metabolism and/or abdominal obesity to identify individuals at colorectal cancer risk may have higher clinical utility than applying more complex MetS definitions.

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

“…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.…”

“…One study (1992) (38) , USA (2011) (17) , (32) , USA (43) , Japan (2010) (26) , Japan was conducted in the USA (38) , one in Sweden (42) , one in Korea (22) , two in Japan (25,43) , one in Finland (21) and two in European countries (4,34) (Table 1). Pooled data did not support the association between TC and CRC (RR = 0·95; 95 % CI 0·85, 1·06, P = 0·38).…”

“…Fourteen studies on TAG (eight cohort and six case-control studies) and risk of CRC were published between 1992 and 2012 and involved a total of 13 785 CRC cases (Table 1) (4,16,17,22,24,32,34,35,37,38,(40)(41)(42)(43) . Six studies were conducted in the USA (16,32,35,37,38,40) , one in Sweden (42) , one in Korea (22) , one in Austria (41) two in Japan (24,43) and three in European countries (4,17,34) (Table 1). The association of serum TAG with CRC risk was not observed (RR = 1·07; 95 % CI 0·99, 1·15; P = 0·10).…”

The metabolic syndrome as a risk factor for colorectal cancer

“…По разным исследованиям, риск развития КРР повышается c увеличением индекса массы тела (ИМТ) [18], увеличением окружности талии, сниже-нием уровня ЛПВП, повышением уровня глюкозы сы-воротки крови натощак [19]. Показано, что люди с МС и его отдельными компонентами также имеют более высокий риск развития колоректальных аденом, кото-рые более чем в 95% случаев являются предшествен-никами злокачественных новообразований толстой кишки [20,21].…”

“…Показано, что люди с МС и его отдельными компонентами также имеют более высокий риск развития колоректальных аденом, кото-рые более чем в 95% случаев являются предшествен-никами злокачественных новообразований толстой кишки [20,21]. Некоторые компоненты МС более тесно связаны с развитием рака ободочной кишки, чем с раком прямой кишки, также имеются различия в ассоциации МС и его компонентов со злокачествен-ными образованиями толстой кишки в зависимости от пола [19,22,23].…”