title: Metabolic syndrome and endometrial cancer: a meta-analysis.
abstract: We performed a systematic review and meta-analysis on the association of metabolic syndrome with endometrial cancer. A systematic literature search of electronic databases (Medline, ISI Web of Knowledge and Scopus) was conducted and complemented by cross-referencing to identify studies published before 31 January 2013. Core items of identified studies were independently extracted by two reviewers, and results were summarized by random effects meta-analysis. We identified six studies, which reported on 3,132 cancer cases. Metabolic syndrome was associated with an increased risk of endometrial cancer (RR: 1.89, 95 % CI 1.34-2.67, P < 0.001), with significant heterogeneity among studies (I (2) = 92 %, P < 0.001), but no indication for publication bias in the Egger's test (P = 0.240). A sensitivity analysis omitting two studies produced no heterogeneity (I (2) = 0 %) and attenuated the association (RR: 1.39, 1.31-1.48, P < 0.001). The risk estimates for any single factor of the syndrome were 2.21 (P < 0.001) for higher values of body mass index and/or waist, 1.81 (P = 0.044) for hyperglycemia, 1.81 (P = 0.024) for higher blood pressure values, and 1.17 (P < 0.001) for high triglyceride levels; there was no significant association with low HDL-cholesterol. Metabolic syndrome is associated with an increased risk of endometrial cancer; among the components of the syndrome, obesity/high waist is that more strongly associated with endometrial cancer.
authors: Division of Endocrinology, Diabetes, and Metabolic Diseases, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples, Piazza L. Miraglia 2, 80138, Naples, Italy, katherine.esposito@unina2.it.
authors: Katherine
authors: K
authors: Esposito
authors: Paolo
authors: P
authors: Chiodini
authors: Annalisa
authors: A
authors: Capuano
authors: Giuseppe
authors: G
authors: Bellastella
authors: Maria Ida
authors: MI
authors: Maiorino
authors: Dario
authors: D
authors: Giugliano
mesh_terms: D016022:Case-Control Studies; D015331:Cohort Studies; D016889:Endometrial Neoplasms / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology*; D012307:Risk Factors
references: Ann Oncol. 2011 Apr;22(4):884-889
references: 20937645
references: Int J Mol Epidemiol Genet. 2012;3(2):122-33
references: 22724049
references: Cancer Epidemiol Biomarkers Prev. 1994 Oct-Nov;3(7):575-81
references: 7827588
references: Ann Oncol. 2010 May;21 Suppl 5:v41-5
references: 20555100
references: J Clin Endocrinol Metab. 1981 Jul;53(1):192-9
references: 7240376
references: Am J Obstet Gynecol. 2011 Dec;205(6):518-25
references: 21802066
references: Diabetologia. 2007 Jul;50(7):1365-74
references: 17476474
references: Cancer Epidemiol Biomarkers Prev. 2011 Nov;20(11):2384-95
references: 21921255
references: Stat Med. 2002 Feb 28;21(4):589-624
references: 11836738
references: Int J Cancer. 2004 Jan 10;108(2):262-8
references: 14639613
references: Metab Syndr Relat Disord. 2007 Dec;5(4):291-6
references: 18370798
references: Am J Epidemiol. 2013 Apr 15;177(8):787-99
references: 23492765
references: Ann Chir Gynaecol Suppl. 1994;208:20-4
references: 8092764
references: Control Clin Trials. 1986 Sep;7(3):177-88
references: 3802833
references: Annu Rev Med. 2010;61:301-16
references: 19824817
references: Stat Med. 2002 Jun 15;21(11):1539-58
references: 12111919
references: Int J Cancer. 2009 Jun 15;124(12):2938-41
references: 19267407
references: Hypertension. 1999 Aug;34(2):320-5
references: 10454461
references: Cancer Epidemiol Biomarkers Prev. 2001 Jun;10(6):611-6
references: 11401910
references: Eur J Cancer. 2008 Jan;44(2):293-7
references: 18055193
references: Cancer Causes Control. 2000 Feb;11(2):185-92
references: 10710204
references: Endocr Relat Cancer. 2007 Sep;14(3):755-67
references: 17914105
references: Int J Cancer. 2003 May 10;104(6):669-76
references: 12640672
references: Int J Gynecol Cancer. 2013 Feb;23(2):294-303
references: 23287960
references: Diabetes Care. 2012 Nov;35(11):2402-11
references: 23093685
references: Cancer Epidemiol Biomarkers Prev. 2008 Apr;17(4):921-9
references: 18398032
references: Lancet. 2008 Feb 16;371(9612):569-78
references: 18280327
references: J Clin Endocrinol Metab. 2003 Oct;88(10):4904-10
references: 14557472
references: J Diabetes Complications. 2010 Sep-Oct;24(5):345-53
references: 20656522
references: Gynecol Oncol. 2010 Apr;117(1):41-6
references: 20096921
references: Ann Intern Med. 2009 Aug 18;151(4):W65-94
references: 19622512
references: Circulation. 2009 Oct 20;120(16):1640-5
references: 19805654
references: Eur J Endocrinol. 2003 Jan;148(1):147-55
references: 12534368
references: Int J Cancer. 2007 Jun 15;120(12):2656-64
references: 17285578
references: Eur J Cancer Clin Oncol. 1989 Oct;25(10):1451-6
references: 2591436
references: Cancer Causes Control. 2000 Sep;11(8):707-11
references: 11065007
references: BMJ. 1998 Jan 3;316(7124):61-6
references: 9451274
references: Eur J Oncol Nurs. 2009 Apr;13(2):122-7
references: 19332387
references: Am J Epidemiol. 1998 Aug 1;148(3):234-40
references: 9690359
references: Cancer Epidemiol Biomarkers Prev. 2002 Dec;11(12):1531-43
references: 12496040
references: Metab Syndr Relat Disord. 2011 Feb;9(1):1-12
references: 20973675
references: BMJ. 2007 Dec 1;335(7630):1134
references: 17986716
references: Circulation. 2005 Oct 25;112(17):2735-52
references: 16157765
references: Am J Epidemiol. 2010 Apr 15;171(8):892-902
references: 20219764