The association of Metabolic Syndrome and its Components with the Incidence and Survival of Colorectal Cancer: A Systematic Review and Meta-analysis

Abstract

Background: This meta-analysis was aimed to quantitatively assess the associations of metabolic syndrome (MetS) and its components with colorectal cancer (CRC). Methods: PubMed, EMBASE and Web of Science databases were systematically searched for eligible studies. A total of 18 studies for CRC incidence and 12 studies for CRC mortality were identified. Results: MetS was associated with an increased risk of CRC incidence and mortality in male (RR: 1.28, 95 % CI 1.16-1.39, and 1.24, 1.18-1.31, respectively) and correlated with an increased risk of CRC incidence in female (RR: 1.21, 1.13-1.30), but not with CRC mortality in female. MetS increased the risk of cancer-specific mortality (RR: 1.72, 1.03-2.42), but not overall mortality. The risk estimates of CRC incidence changed little depending on age, sex, cancer site, the type of studies, ethnicity, publication year, or definition of MetS. As for CRC mortality, further stratified analyses indicated statistical significance in studies with assessing cancer-specific survival outcome, in male, a cohort design, ethnicity of non-Chinese or with definition of MetS as ≥ 3 metabolic abnormalities. Obesity and hyperglycemia are risk factors of CRC incidence in both male and female. Only dysglycemia is the risk factor for CRC mortality. Conclusions: MetS is associated with an increased risk of CRC incidence and cancer-specific mortality, but not overall mortality. In addition, MetS may increase the CRC mortality in male rather than in female. However, since most of the studies on CRC mortality were conducted in Chinese, further studies are needed to clarify this connection.

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

“…MetS was identified as a risk factor for CRC development in a Women's Health Initiative cohort, a prospective cohort study in China, and the Metabolic Syndrome and Cancer Project 8,11,22 . Moreover, a recent meta‐analysis concluded that the positive association between MetS and the risk of CRC was supported by current evidence 19 . In contrast, nonsignificant associations were found in the Physicians' Health Study and a cohort study in Japan 13,14 .…”

“…Furthermore, many studies have demonstrated that the individual components of MetS are related to an increased CRC risk 15‐18 . Although the findings have been inconsistent, significant positive associations with obesity and diabetes, but not the other components, have been observed 9,11,19 . Notably, most previous studies conducted in Europe and the United States used different definitions for MetS.…”

Glycemic Variability Within 1 Year Following Surgery for Stage II–III Colon Cancer

“…Individuals with T2D lose the ability to maintain a therapeutic range of blood glucose (American Diabetes Association, 2021). Unregulated blood glucose, an essential component for cellular metabolism, contributes to metabolic syndrome, which can increase the risk of colorectal cancer (Han et al, 2021). Numerous studies have investigated the association between T2D and cancer following the seminal epidemiological study by Giovannucci et al (2010) that identified an increased risk for cancer among individuals with T2D.…”

Effects of a Diet Based on Foods from Symbiotic Agriculture on the Gut Microbiota of Subjects at Risk for Metabolic Syndrome

“…Subjects with untreated MS can easily develop cardiovascular and cerebrovascular disease, with an increased risk of mortality [ 4 ]. Moreover, several epidemiological and clinical studies support the hypothesis that MS may also be an important etiologic factor for the development and progression of certain types of cancer and for overall cancer mortality [ 5 , 6 , 7 , 8 , 9 ].…”