TY - JOUR
T1 - The metabolic syndrome and cancer
T2 - Is the metabolic syndrome useful forpredicting 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.
N1 - Funding Information:
Funding: this work is funded by a National Health and Medical Research Council (NHMRC grant APP1002663), Australian Government Department of Health. The work is supported, in part, by the Victorian Operational Infrastructure Scheme. JLH is supported by a Monash University Australian Postgraduate Award and a Baker IDI Bright Sparks scholarship, JES is supported by National Health and Medical Research Council Senior Research Fellowship (ID 526609), DJM is supported by a Victorian Cancer Agency Public Health Fellowship. Funding sources for individual studies can be found in baseline papers listed in the reference list.
Publisher Copyright:
© 2015 Elsevier Masson SAS.
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 thesum 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 completedata on the MetS to national cancer registries and used Cox proportional hazards models to estimate associations of the MetS, the number ofpositive MetS components, and each of the five MetS components separately with the risk for overall, colorectal, prostate and breast cancer. Hazardratios (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 betweenthe 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) foroverall, 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, andthese associations appear to be driven, largely, by elevated WC and BP. We also demonstrate that the MetS is only a moderate discriminator ofcancer 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 thesum 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 completedata on the MetS to national cancer registries and used Cox proportional hazards models to estimate associations of the MetS, the number ofpositive MetS components, and each of the five MetS components separately with the risk for overall, colorectal, prostate and breast cancer. Hazardratios (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 betweenthe 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) foroverall, 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, andthese associations appear to be driven, largely, by elevated WC and BP. We also demonstrate that the MetS is only a moderate discriminator ofcancer risk.
KW - Cancer
KW - Epidemiology
KW - Metabolic syndrome
KW - Prediction
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U2 - 10.1016/j.diabet.2015.04.006
DO - 10.1016/j.diabet.2015.04.006
M3 - Article
C2 - 26037090
AN - SCOPUS:84930027355
SN - 1262-3636
VL - 41
SP - 463
EP - 469
JO - Diabetes and Metabolism
JF - Diabetes and Metabolism
IS - 6
ER -