title: Prospective cohort study of metabolic risk factors and gastric adenocarcinoma risk in the Metabolic Syndrome and Cancer Project (Me-Can).
abstract: OBJECTIVE
  Little is known about the association between the metabolic syndrome (MetS) and the risk of gastric adenocarcinoma. The aim of this study was to investigate whether metabolic risk factors, together or combined, were associated with the risk of gastric adenocarcinoma.
  
  
  METHODS
  The Metabolic Syndrome and Cancer Project (Me-Can) is a pooling of prospective cohorts in Austria, Norway, and Sweden with information on blood pressure, lipids, glucose, and BMI available in 578,700 individuals. Cox proportional hazards analysis was used to calculate hazard ratio (HR) of gastric adenocarcinoma using metabolic risk factors categorized into quintiles and transformed into z-scores (with mean = 0 and SD = 1). The standardized sum of all z-scores created a composite MetS score.
  
  
  RESULTS
  In total, 1,210 incident cases of gastric adenocarcinoma were identified. Glucose was significantly associated with the risk of gastric adenocarcinoma [calibrated HR 1.58 (1.14-2.20) per one unit increment in z-score] in women. There was a statistically significant association between triglycerides and risk of gastric adenocarcinoma per mmol increment in triglycerides [HR 1.20 (1.06-1.36) per mmol] but not for the adjusted z-score in women. There were no significant association between any metabolic factors and gastric cancer among men. The composite MetS score was associated with the risk of gastric adenocarcinoma in women [HR 1.18 (1.00-1.38) per one unit increment in z-score] but not in men.
  
  
  CONCLUSIONS
  Glucose and high levels of the composite MetS score were associated with an increased risk of gastric adenocarcinoma in women but not in men.
authors.affiliation: Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. bjorn.lindkvist@vgregion.se
authors.forename: Björn
authors.initials: B
authors.lastname: Lindkvist
authors.forename: Martin
authors.initials: M
authors.lastname: Almquist
authors.forename: Tone
authors.initials: T
authors.lastname: Bjørge
authors.forename: Tanja
authors.initials: T
authors.lastname: Stocks
authors.forename: Wegene
authors.initials: W
authors.lastname: Borena
authors.forename: Dorthe
authors.initials: D
authors.lastname: Johansen
authors.forename: Göran
authors.initials: G
authors.lastname: Hallmans
authors.forename: Anders
authors.initials: A
authors.lastname: Engeland
authors.forename: Gabriele
authors.initials: G
authors.lastname: Nagel
authors.forename: Håkan
authors.initials: H
authors.lastname: Jonsson
authors.forename: Randi
authors.initials: R
authors.lastname: Selmer
authors.forename: Guenter
authors.initials: G
authors.lastname: Diem
authors.forename: Christel
authors.initials: C
authors.lastname: Häggström
authors.forename: Steinar
authors.initials: S
authors.lastname: Tretli
authors.forename: Pär
authors.initials: P
authors.lastname: Stattin
authors.forename: Jonas
authors.initials: J
authors.lastname: Manjer
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000209:etiology*; D000328:Adult; D000368:Aged; D001317:Austria / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D015201:Meta-Analysis as Topic; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000209:etiology; D009664:Norway / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000209:etiology*; D013548:Sweden / Q000453:epidemiology