Components of the metabolic syndrome and colorectal cancer risk; a prospective study.
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 (BMI>30 kg m(-2)), hypertension (blood pressure > or =140/90 mmHg or use of anti-hypertensive drugs) and hyperglycaemia (fasting glucose > or =6.1 mmol l(-1) or post-load glucose in capillary plasma > or =8.9 mmol l(-1)).


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)=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=0.090), 1.83 (95% CI 1.00-3.36; P=0.051) and 1.50 (95% CI 0.83-2.71; P=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.
Stocks
T
T
Department of Surgical and Perioperative sciences, Urology and Andrology, Umeå University Hospital, Umeå, Sweden. tanja.stocks@urologi.umu.se
Lukanova
A
A
Johansson
M
M
Rinaldi
S
S
Palmqvist
R
R
Hallmans
G
G
Kaaks
R
R
Stattin
P
P
D052242:Adiponectin / Q000097:blood; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000097:blood; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000378:metabolism; D004812:Epidemiologic Methods; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000378:metabolism; D006973:Hypertension / Q000453:epidemiology; D020738:Leptin / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000378:metabolism; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology
D052242:Adiponectin; D001786:Blood Glucose; D002096:C-Peptide; D006442:Glycated Hemoglobin; D020738:Leptin