title: Metabolic syndrome is associated with increased breast cancer risk: a systematic review with meta-analysis.
abstract: Background. Although individual metabolic risk factors are reported to be associated with breast cancer risk, controversy surrounds risk of breast cancer from metabolic syndrome (MS). We report the first systematic review and meta-analysis of the association between MS and breast cancer risk in all adult females. Methods. Studies were retrieved by searching four electronic reference databases [PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and ProQuest through June 30, 2012] and cross-referencing retrieved articles. Eligible for inclusion were longitudinal studies reporting associations between MS and breast cancer risk among females aged 18 years and older. Relative risks and 95% confidence intervals were calculated for each study and pooled using random-effects models. Publication bias was assessed quantitatively (Trim and Fill) and qualitatively (funnel plots). Heterogeneity was examined using Q and I (2) statistics. Results. Representing nine independent cohorts and 97,277 adult females, eight studies met the inclusion criteria. A modest, positive association was observed between MS and breast cancer risk (RR: 1.47, 95% CI, 1.15-1.87; z = 3.13; p = 0.002; Q = 26.28, p = 0.001; I (2) = 69.55%). No publication bias was observed. Conclusions. MS is associated with increased breast cancer risk in adult women.
authors: Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV 26506, USA.
authors: Ruchi
authors: R
authors: Bhandari
authors: Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, WV 26506, USA.
authors: George A
authors: GA
authors: Kelley
authors: National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
authors: Tara A
authors: TA
authors: Hartley
authors: Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV 26506, USA.
authors: Ian R H
authors: IR
authors: Rockett
references: Gac Sanit. 2009 Mar-Apr;23(2):158
references: 19249134
references: Rev Endocr Metab Disord. 2014 Jun;15(2):157-67
references: 24019064
references: J Surg Res. 2004 Feb;116(2):337-49
references: 15013374
references: Eur J Cancer. 2008 Jan;44(2):293-7
references: 18055193
references: Cancer Epidemiol Biomarkers Prev. 2010 Jul;19(7):1737-45
references: 20615887
references: Stat Med. 2002 Jun 15;21(11):1539-58
references: 12111919
references: Ann Oncol. 1995 Mar;6(3):245-8
references: 7612489
references: Curr Drug Targets. 2010 Sep;11(9):1133-46
references: 20545607
references: Int J Cancer. 2011 Oct 1;129(7):1699-707
references: 21105041
references: J Hypertens. 2000 Mar;18(3):249-54
references: 10726709
references: Cancer Epidemiol Biomarkers Prev. 2005 Jan;14 (1):33-40
references: 15668473
references: Cancer Causes Control. 2009 Sep;20(7):1055-60
references: 19184472
references: Int J Cancer. 1997 May 2;71(3):360-3
references: 9139868
references: Obes Rev. 2004 Aug;5(3):153-65
references: 15245384
references: Maturitas. 2005 May 16;51(1):83-97
references: 15883113
references: JAMA. 1997 Nov 5;278(17):1407-11
references: 9355998
references: Eur J Cancer Prev. 2001 Feb;10(1):33-42
references: 11263589
references: Int J Nurs Stud. 2010 Aug;47(8):994-1000
references: 20129610
references: Best Pract Res Clin Endocrinol Metab. 2008 Aug;22(4):625-38
references: 18971123
references: Diabetes Nutr Metab. 2004 Oct;17(5):290-5
references: 16295051
references: Aliment Pharmacol Ther. 2005 Nov;22 Suppl 2:40-3
references: 16225471
references: Acta Oncol. 1988;27(1):31-7
references: 3365352
references: Mol Carcinog. 2011 Aug;50(8):643-51
references: 21574190
references: Metabolism. 2011 Oct;60(10):1372-8
references: 21550085
references: Circulation. 2004 Jan 27;109(3):433-8
references: 14744958
references: Circulation. 2002 Dec 17;106(25):3143-421
references: 12485966
references: Control Clin Trials. 1986 Sep;7(3):177-88
references: 3802833
references: Am J Epidemiol. 2000 Sep 15;152(6):514-27
references: 10997541
references: Prev Med. 1997 Jan-Feb;26(1):144-53
references: 9010910
references: Arch Gynecol Obstet. 2011 Nov;284(5):1271-6
references: 21249376
references: J Natl Cancer Inst. 2011 Feb 2;103(3):273-8
references: 21163903
references: Asian Pac J Cancer Prev. 2011;12(4):1061-5
references: 21790252
references: Horm Metab Res. 2003 Feb;35(2):92-6
references: 12734788
references: Biometrics. 2000 Jun;56(2):455-63
references: 10877304
references: Hypertension. 1999 Aug;34(2):320-5
references: 10454461
references: Clin Oncol (R Coll Radiol). 2010 May;22(4):281-8
references: 20189371
references: Expert Rev Mol Diagn. 2010 May;10(4):509-19
references: 20465505
references: Cancer Epidemiol Biomarkers Prev. 2009 Jul;18(7):2046-53
references: 19567502
references: Int J Cancer. 2007 Aug 15;121(4):856-62
references: 17397032
references: Nutr Metab Cardiovasc Dis. 2010 Jan;20(1):41-8
references: 19361966
references: J Endocrinol Invest. 2013 Feb;36(2):132-9
references: 23481613
references: Melanoma Res. 2011 Dec;21(6):541-6
references: 21946019
references: Lancet. 2005 Sep 24-30;366(9491):1059-62
references: 16182882
references: Am J Epidemiol. 1999 Feb 15;149(4):339-46
references: 10025476
references: Ann Epidemiol. 2005 Mar;15(3):202-6
references: 15723765
references: Diabetes Care. 1997 Apr;20(4):645-9
references: 9096996
references: Diabetes Care. 2003 Jun;26(6):1752-8
references: 12766105
references: JAMA. 2005 Jan 12;293(2):194-202
references: 15644546
references: Am J Pathol. 2011 Jan;178(1):402-12
references: 21224077
references: Metabolism. 2003 Jun;52(6):724-30
references: 12800098
references: Eur J Epidemiol. 2009;24(6):281-8
references: 19357973
references: Arterioscler Thromb Vasc Biol. 2008 Apr;28(4):629-36
references: 18174459
references: J Cancer Res Clin Oncol. 1998;124(3-4):186-90
references: 9619745
references: Obes Res. 2005 Aug;13(8):1476-84
references: 16129731
references: Asian Pac J Cancer Prev. 2012;13(1):139-46
references: 22502657
references: Am J Epidemiol. 2002 Aug 15;156(4):349-52
references: 12181105
references: Breast Cancer Res Treat. 2010 Jun;121(2):479-83
references: 19851862
references: Mol Carcinog. 2008 Feb;47(2):157-63
references: 17620310
references: Eur J Cancer Prev. 2009 Jun;18(3):240-7
references: 19491612
references: Epidemiology. 1995 Mar;6(2):137-41
references: 7742399
references: Maturitas. 2008 May 20;60(1):19-30
references: 18485631
references: Eur J Cancer. 2011 Jan;47(1):33-43
references: 20889333
references: J Hum Hypertens. 2006 Oct;20(10):727-32
references: 16885996
references: Am J Clin Nutr. 2007 Sep;86(3):s823-35
references: 18265476
references: Obes Rev. 2003 Aug;4(3):157-73
references: 12916817
references: J Clin Epidemiol. 1995 Jan;48(1):159-63
references: 7853041
references: Endocrine. 2013 Dec;44(3):634-47
references: 23546613
references: Circulation. 2005 Oct 25;112(17):2735-52
references: 16157765
references: Menopause. 2013 Dec;20(12):1301-9
references: 23571527
references: Int J Cancer. 2006 Jun 1;118(11):2832-9
references: 16385576
references: Breast J. 2006 Sep-Oct;12(5):462-6
references: 16958966
references: Am J Epidemiol. 1992 Jan 15;135(2):153-68
references: 1536132
references: Cancer Epidemiol. 2012 Apr;36(2):141-7
references: 21890443
references: Breast Cancer Res. 2011 Mar 30;13(2):R34
references: 21450081
references: Best Pract Res Clin Obstet Gynaecol. 2010 Feb;24(1):19-27
references: 19264556
references: Metabolism. 1998 Jan;47(1):70-4
references: 9440480
references: Cancer Epidemiol. 2010 Oct;34(5):580-6
references: 20579950
references: J Clin Endocrinol Metab. 1988 Sep;67(3):460-4
references: 2842359
references: Anticancer Res. 2010 May;30(5):1863-8
references: 20592393
references: Cancer. 1987 Dec 15;60(12):3065-70
references: 3677028
references: J Natl Cancer Inst. 1997 Sep 17;89(18):1360-5
references: 9308706
references: Chang Gung Med J. 2011 Jan-Feb;34(1):1-22
references: 21392470
references: Cancer Causes Control. 2002 Oct;13(8):741-51
references: 12420953
references: Int J Cancer. 1974 Aug 15;14(2):153-60
references: 4378317
references: Am J Obstet Gynecol. 2006 Jan;194(1):100-4
references: 16389017
references: Ann Oncol. 2011 Dec;22(12):2687-92
references: 21415236
references: Diabetes. 1996 Jul;45(7):984-7
references: 8666153
references: Eur Rev Med Pharmacol Sci. 2002 Mar-Jun;6(2-3):55-9
references: 12708611
references: Endocr Rev. 2007 Dec;28(7):763-77
references: 17981890
references: Psychol Bull. 1968 Oct;70(4):213-20
references: 19673146
references: Diabetes Care. 2012 Nov;35(11):2402-11
references: 23093685
references: Int J Cancer. 2006 Jul 1;119(1):236-8
references: 16450399
references: J Cancer Res Clin Oncol. 1996;122(12):745-9
references: 8954172
references: Diabetes. 1988 Dec;37(12):1595-607
references: 3056758
references: Br J Cancer. 2012 Oct 23;107(9):1608-17
references: 22996614
references: Milbank Mem Fund Q. 1955 Apr;33(2):121-36
references: 14369727
references: Bioessays. 2007 Oct;29(10):1029-38
references: 17876797
references: J Natl Cancer Inst. 2004 Aug 4;96(15):1152-60
references: 15292387
references: Endocr Relat Cancer. 2007 Jun;14(2):189-206
references: 17639037
references: Nutr Cancer. 2003;45(1):1-16
references: 12791499
references: Diabetes Care. 2010 Jul;33(7):1674-85
references: 20587728
references: Acta Diabetol. 2002 Sep;39(3):105-10
references: 12357293
references: Obes Rev. 2007 Sep;8(5):395-408
references: 17716297
references: Cancer Biol Ther. 2010 Dec 15;10(12):1240-3
references: 20935521
references: Proc Nutr Soc. 2012 Feb;71(1):181-9
references: 22051112
references: Int J Cancer. 1988 Oct 15;42(4):489-94
references: 3170022