title: Metabolic syndrome and leptin are associated with adverse pathological features in male colorectal cancer patients.
abstract: OBJECTIVE
  Metabolic syndrome (MetS) describes a clustering of factors including central obesity, hypertension and raised plasma glucose, triglycerides and high-density lipoprotein (HDL) cholesterol. Central obesity is associated with a risk for colorectal cancer, but the impact of MetS on colorectal cancer biology and outcomes is unclear.
  
  
  METHODS
  A prospective observational study of colorectal cancer patients was carried out in an Irish population. Patients underwent metabolic and anthropometric assessment before treatment, including measurement of serum hormones and adipokines and CT measurement of visceral fat. MetS was defined according to the International Diabetes Federation definition(3) .
  
  
  RESULTS
  One-hundred and thirty consecutive colorectal cancer patients (66 men and 64 women) were recruited. MetS was diagnosed in 38% patients compared with the population norms reported at 21%(21) . Male patients had a significantly greater visceral fat area compared with female patients. MetS was associated with node-positive disease (P = 0.026), percentage nodal involvement (P = 0.033) and extramural vascular invasion (P = 0.049) in male patients but no significant association was observed in female patients. HDL cholesterol was also significantly associated with a more advanced pathological stage (P = 0.014) and node-positive disease (P = 0.028). Leptin was associated with nodal status (P = 0.036), microvascular invasion (P = 0.054), advanced pathological stage (P = 0.046) and more advanced Dukes stage (P = 0.042).
  
  
  CONCLUSIONS
  We report a high prevalence of MetS and visceral obesity in a colorectal cancer population. MetS and plasma leptin are associated with a more aggressive tumour phenotype in male patients only.
authors.affiliation: Department of Clinical Nutrition, St James's Hospital and Trinity College Dublin, Ireland. healyl2@tcd.ie
authors.forename: L A
authors.initials: LA
authors.lastname: Healy
authors.forename: J M
authors.initials: JM
authors.lastname: Howard
authors.forename: A M
authors.initials: AM
authors.lastname: Ryan
authors.forename: P
authors.initials: P
authors.lastname: Beddy
authors.forename: B
authors.initials: B
authors.lastname: Mehigan
authors.forename: R
authors.initials: R
authors.lastname: Stephens
authors.forename: J V
authors.initials: JV
authors.lastname: Reynolds
mesh_terms: D000368:Aged; D001794:Blood Pressure; D001823:Body Composition; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002277:Carcinoma / Q000097:blood / Q000150:complications* / Q000556:secondary*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015179:Colorectal Neoplasms / Q000097:blood / Q000150:complications* / Q000473:pathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007333:Insulin Resistance; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging; D020738:Leptin / Q000097:blood*; D008207:Lymphatic Metastasis; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D009361:Neoplasm Invasiveness; D011446:Prospective Studies; D011859:Radiography; D012737:Sex Factors; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
chemical_list: D002097:C-Reactive Protein; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; D020738:Leptin; D014280:Triglycerides; C517652:hemoglobin A1c protein, human