The metabolic syndrome and cancer: Is the metabolic syndrome useful for predicting cancer risk above and beyond its individual components?

J. Harding, M. Sooriyakumaran, K. J. Anstey, R. Adams, B. Balkau, T. Briffa, T. M E Davis, W. A. Davis, A. Dobson, G. G. Giles, J. Grant, M. Knuiman, M. Luszcz, P. Mitchell, J. A. Pasco, C. Reid, D. Simmons, L. Simons, A. Tonkin, M. WoodwardJ. E. Shaw, D. J. Magliano

Research output: Contribution to journalArticle

Abstract

Aims: The metabolic syndrome (MetS) is a risk factor for cancer. However, it is not known if the MetS confers a greater cancer risk than the sum of its individual components, which components drive the association, or if the MetS predicts future cancer risk. Materials and methods: We linked 20,648 participants from the Australian and New Zealand Diabetes and Cancer Collaboration with complete data on the MetS to national cancer registries and used Cox proportional hazards models to estimate associations of the MetS, the number of positive MetS components, and each of the five MetS components separately with the risk for overall, colorectal, prostate and breast cancer. Hazard ratios (HR) and 95% confidence intervals (95%CI) are reported. We assessed predictive ability of the MetS using Harrell's c-statistic. Results: The MetS was inversely associated with prostate cancer (HR 0.85; 95% CI 0.72-0.99). We found no evidence of an association between the MetS overall, colorectal and breast cancers. For those with five positive MetS components the HR was 1.12 (1.02-1.48) and 2.07 (1.26-3.39) for overall, and colorectal cancer, respectively, compared with those with zero positive MetS components. Greater waist circumference (WC) (1.38; 1.13-1.70) and elevated blood pressure (1.29; 1.01-1.64) were associated with colorectal cancer. Elevated WC and triglycerides were (inversely) associated with prostate cancer. MetS models were only poor to moderate discriminators for all cancer outcomes. Conclusions: We show that the MetS is (inversely) associated with prostate cancer, but is not associated with overall, colorectal or breast cancer. Although, persons with five positive components of the MetS are at a 1.2 and 2.1 increased risk for overall and colorectal cancer, respectively, and these associations appear to be driven, largely, by elevated WC and BP. We also demonstrate that the MetS is only a moderate discriminator of cancer risk.

Original languageEnglish (US)
JournalDiabetes and Metabolism
DOIs
StateAccepted/In press - Feb 19 2015
Externally publishedYes

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Neoplasms
Colorectal Neoplasms
Prostatic Neoplasms
Waist Circumference
Breast Neoplasms
New Zealand
Proportional Hazards Models
Registries
Triglycerides
Confidence Intervals
Blood Pressure

Keywords

  • Cancer
  • Epidemiology
  • Metabolic syndrome
  • Prediction

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

The metabolic syndrome and cancer : Is the metabolic syndrome useful for predicting cancer risk above and beyond its individual components? / Harding, J.; Sooriyakumaran, M.; Anstey, K. J.; Adams, R.; Balkau, B.; Briffa, T.; Davis, T. M E; Davis, W. A.; Dobson, A.; Giles, G. G.; Grant, J.; Knuiman, M.; Luszcz, M.; Mitchell, P.; Pasco, J. A.; Reid, C.; Simmons, D.; Simons, L.; Tonkin, A.; Woodward, M.; Shaw, J. E.; Magliano, D. J.

In: Diabetes and Metabolism, 19.02.2015.

Research output: Contribution to journalArticle

Harding, J, Sooriyakumaran, M, Anstey, KJ, Adams, R, Balkau, B, Briffa, T, Davis, TME, Davis, WA, Dobson, A, Giles, GG, Grant, J, Knuiman, M, Luszcz, M, Mitchell, P, Pasco, JA, Reid, C, Simmons, D, Simons, L, Tonkin, A, Woodward, M, Shaw, JE & Magliano, DJ 2015, 'The metabolic syndrome and cancer: Is the metabolic syndrome useful for predicting cancer risk above and beyond its individual components?', Diabetes and Metabolism. https://doi.org/10.1016/j.diabet.2015.04.006
Harding, J. ; Sooriyakumaran, M. ; Anstey, K. J. ; Adams, R. ; Balkau, B. ; Briffa, T. ; Davis, T. M E ; Davis, W. A. ; Dobson, A. ; Giles, G. G. ; Grant, J. ; Knuiman, M. ; Luszcz, M. ; Mitchell, P. ; Pasco, J. A. ; Reid, C. ; Simmons, D. ; Simons, L. ; Tonkin, A. ; Woodward, M. ; Shaw, J. E. ; Magliano, D. J. / The metabolic syndrome and cancer : Is the metabolic syndrome useful for predicting cancer risk above and beyond its individual components?. In: Diabetes and Metabolism. 2015.
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abstract = "Aims: The metabolic syndrome (MetS) is a risk factor for cancer. However, it is not known if the MetS confers a greater cancer risk than the sum of its individual components, which components drive the association, or if the MetS predicts future cancer risk. Materials and methods: We linked 20,648 participants from the Australian and New Zealand Diabetes and Cancer Collaboration with complete data on the MetS to national cancer registries and used Cox proportional hazards models to estimate associations of the MetS, the number of positive MetS components, and each of the five MetS components separately with the risk for overall, colorectal, prostate and breast cancer. Hazard ratios (HR) and 95{\%} confidence intervals (95{\%}CI) are reported. We assessed predictive ability of the MetS using Harrell's c-statistic. Results: The MetS was inversely associated with prostate cancer (HR 0.85; 95{\%} CI 0.72-0.99). We found no evidence of an association between the MetS overall, colorectal and breast cancers. For those with five positive MetS components the HR was 1.12 (1.02-1.48) and 2.07 (1.26-3.39) for overall, and colorectal cancer, respectively, compared with those with zero positive MetS components. Greater waist circumference (WC) (1.38; 1.13-1.70) and elevated blood pressure (1.29; 1.01-1.64) were associated with colorectal cancer. Elevated WC and triglycerides were (inversely) associated with prostate cancer. MetS models were only poor to moderate discriminators for all cancer outcomes. Conclusions: We show that the MetS is (inversely) associated with prostate cancer, but is not associated with overall, colorectal or breast cancer. Although, persons with five positive components of the MetS are at a 1.2 and 2.1 increased risk for overall and colorectal cancer, respectively, and these associations appear to be driven, largely, by elevated WC and BP. We also demonstrate that the MetS is only a moderate discriminator of cancer risk.",
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T1 - The metabolic syndrome and cancer

T2 - Is the metabolic syndrome useful for predicting cancer risk above and beyond its individual components?

AU - Harding, J.

AU - Sooriyakumaran, M.

AU - Anstey, K. J.

AU - Adams, R.

AU - Balkau, B.

AU - Briffa, T.

AU - Davis, T. M E

AU - Davis, W. A.

AU - Dobson, A.

AU - Giles, G. G.

AU - Grant, J.

AU - Knuiman, M.

AU - Luszcz, M.

AU - Mitchell, P.

AU - Pasco, J. A.

AU - Reid, C.

AU - Simmons, D.

AU - Simons, L.

AU - Tonkin, A.

AU - Woodward, M.

AU - Shaw, J. E.

AU - Magliano, D. J.

PY - 2015/2/19

Y1 - 2015/2/19

N2 - Aims: The metabolic syndrome (MetS) is a risk factor for cancer. However, it is not known if the MetS confers a greater cancer risk than the sum of its individual components, which components drive the association, or if the MetS predicts future cancer risk. Materials and methods: We linked 20,648 participants from the Australian and New Zealand Diabetes and Cancer Collaboration with complete data on the MetS to national cancer registries and used Cox proportional hazards models to estimate associations of the MetS, the number of positive MetS components, and each of the five MetS components separately with the risk for overall, colorectal, prostate and breast cancer. Hazard ratios (HR) and 95% confidence intervals (95%CI) are reported. We assessed predictive ability of the MetS using Harrell's c-statistic. Results: The MetS was inversely associated with prostate cancer (HR 0.85; 95% CI 0.72-0.99). We found no evidence of an association between the MetS overall, colorectal and breast cancers. For those with five positive MetS components the HR was 1.12 (1.02-1.48) and 2.07 (1.26-3.39) for overall, and colorectal cancer, respectively, compared with those with zero positive MetS components. Greater waist circumference (WC) (1.38; 1.13-1.70) and elevated blood pressure (1.29; 1.01-1.64) were associated with colorectal cancer. Elevated WC and triglycerides were (inversely) associated with prostate cancer. MetS models were only poor to moderate discriminators for all cancer outcomes. Conclusions: We show that the MetS is (inversely) associated with prostate cancer, but is not associated with overall, colorectal or breast cancer. Although, persons with five positive components of the MetS are at a 1.2 and 2.1 increased risk for overall and colorectal cancer, respectively, and these associations appear to be driven, largely, by elevated WC and BP. We also demonstrate that the MetS is only a moderate discriminator of cancer risk.

AB - Aims: The metabolic syndrome (MetS) is a risk factor for cancer. However, it is not known if the MetS confers a greater cancer risk than the sum of its individual components, which components drive the association, or if the MetS predicts future cancer risk. Materials and methods: We linked 20,648 participants from the Australian and New Zealand Diabetes and Cancer Collaboration with complete data on the MetS to national cancer registries and used Cox proportional hazards models to estimate associations of the MetS, the number of positive MetS components, and each of the five MetS components separately with the risk for overall, colorectal, prostate and breast cancer. Hazard ratios (HR) and 95% confidence intervals (95%CI) are reported. We assessed predictive ability of the MetS using Harrell's c-statistic. Results: The MetS was inversely associated with prostate cancer (HR 0.85; 95% CI 0.72-0.99). We found no evidence of an association between the MetS overall, colorectal and breast cancers. For those with five positive MetS components the HR was 1.12 (1.02-1.48) and 2.07 (1.26-3.39) for overall, and colorectal cancer, respectively, compared with those with zero positive MetS components. Greater waist circumference (WC) (1.38; 1.13-1.70) and elevated blood pressure (1.29; 1.01-1.64) were associated with colorectal cancer. Elevated WC and triglycerides were (inversely) associated with prostate cancer. MetS models were only poor to moderate discriminators for all cancer outcomes. Conclusions: We show that the MetS is (inversely) associated with prostate cancer, but is not associated with overall, colorectal or breast cancer. Although, persons with five positive components of the MetS are at a 1.2 and 2.1 increased risk for overall and colorectal cancer, respectively, and these associations appear to be driven, largely, by elevated WC and BP. We also demonstrate that the MetS is only a moderate discriminator of cancer risk.

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KW - Epidemiology

KW - Metabolic syndrome

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