title: Metabolic syndrome and risks of colon and rectal cancer: the European prospective investigation into cancer and nutrition study.
abstract: Metabolic syndrome (MetS) is purportedly related to risk of developing colorectal cancer; however, the association of MetS, as defined according to recent international criteria, and colorectal cancer has not been yet evaluated. In particular, it remains unclear to what extent the MetS components individually account for such an association. We addressed these issues in a nested case-control study that included 1,093 incident cases matched (1:1) to controls by using incidence density sampling. Conditional logistic regression was used to estimate relative risks (RR) and 95% CIs. MetS was defined according to the criteria of the National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATPIII), the International Diabetes Federation (IDF), and the 2009 harmonized definition. Among individual components, abdominal obesity (RR = 1.51; 95% CI: 1.16-1.96) was associated with colon cancer, whereas abnormal glucose metabolism was associated with both colon (RR = 2.05; 95% CI: 1.57-2.68) and rectal cancer (RR = 2.07; 95% CI: 1.45-2.96). MetS, as defined by each of the definitions, was similarly associated with colon cancer (e.g., RR = 1.91; 95% CI: 1.47-2.42 for MetS by NCEP/ATPIII), whereas MetS by NCEP/ATPIII, but not IDF or harmonized definition, was associated with rectal cancer (RR = 1.45; 95% CI: 1.02-2.06). Overall, these associations were stronger in women than in men. However, the association between MetS and colorectal cancer was accounted for by abdominal obesity and abnormal glucose metabolism such that MetS did not provide risk information beyond these components (likelihood ratio test P = 0.10 for MetS by NCEP/ATPIII). These data suggest that simple assessment of abnormal glucose metabolism and/or abdominal obesity to identify individuals at colorectal cancer risk may have higher clinical utility than applying more complex MetS definitions.
authors.affiliation: Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany. krasimira.aleksandrova@dife.de
authors.forename: Krasimira
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authors.lastname: Aleksandrova
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authors.lastname: Rinaldi
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authors.lastname: Romieu
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authors.lastname: Romaguera
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authors.lastname: Overvad
authors.forename: Jane Nautrup
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authors.lastname: Olsen
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authors.forename: Marie-Christine
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authors.lastname: Boutron-Ruault
authors.forename: Françoise
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authors.lastname: Clavel-Chapelon
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authors.lastname: Morois
authors.forename: Giovanna
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authors.forename: Claudia
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authors.lastname: Agnoli
authors.forename: Salvatore
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authors.lastname: Panico
authors.forename: Rosario
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authors.lastname: Tumino
authors.forename: Paolo
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authors.lastname: Vineis
authors.forename: Rudolf
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authors.lastname: Kaaks
authors.forename: Annekatrin
authors.initials: A
authors.lastname: Lukanova
authors.forename: Antonia
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authors.lastname: Trichopoulou
authors.forename: Androniki
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authors.lastname: Naska
authors.forename: Christina
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authors.lastname: Bamia
authors.forename: Petra H
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authors.lastname: Peeters
authors.forename: Laudina
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authors.lastname: Rodríguez
authors.forename: Genevieve
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authors.lastname: Buckland
authors.forename: María-José
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authors.lastname: Sánchez
authors.forename: Miren
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authors.lastname: Dorronsoro
authors.forename: Jose-María
authors.initials: JM
authors.lastname: Huerta
authors.forename: Aurelio
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authors.lastname: Barricarte
authors.forename: Göran
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authors.lastname: Hallmans
authors.forename: Richard
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authors.lastname: Palmqvist
authors.forename: Kay-Tee
authors.initials: KT
authors.lastname: Khaw
authors.forename: Nicholas
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authors.lastname: Wareham
authors.forename: Naomi E
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authors.lastname: Allen
authors.forename: Konstantinos K
authors.initials: KK
authors.lastname: Tsilidis
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authors.lastname: Pischon
mesh_terms: D016022:Case-Control Studies; D003110:Colonic Neoplasms / Q000453:epidemiology / Q000209:etiology*; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications*; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D044465:White People