title: Metabolic syndrome and colorectal neoplasms: An ominous association.
abstract: OBJECTIVE
  To evaluate the association of metabolic syndrome (MS) and colorectal cancer and adenomas in a Western country, where the incidence of MS is over 27%.
  
  
  METHODS
  This was a prospective study between March 2013 and March 2014. MS was diagnosed according to the National Cholesterol Education Program-ATP III. Demographic characteristics, anthropometric measurements, metabolic risk factors, and colonoscopic pathologic findings were assessed in patients with MS (group 1) who underwent routine colonoscopy at our department. This data was compared with consecutive patients without metabolic syndrome (group 2), with no differences regarding sex and age. Patients with incomplete colonoscopy, family history, or past history of colorectal neoplasm were excluded. Informed consent was obtained and the ethics committee approved this study. Statistical analysis was performed using Student's t-test and χ(2) test, with a P value ≤ 0.05 being considered statistically significant.
  
  
  RESULTS
  Of 258 patients, 129 had MS; 51% males; mean-age 67.1 years (50-87). Among the MS group, 94% had high blood pressure, 91% had increased waist circumference, 60% had diabetes, 55% had low high-density lipoprotein cholesterol level, 50% had increased triglyceride level, and 54% were obese [body mass index (BMI) 30 kg/m(2)]. 51% presented 4 criteria of MS. MS was associated with increased prevalence of adenomas (43% vs 25%, P = 0.004) and colorectal cancer (13% vs 5%, P = 0.027), compared with patients without MS. MS was also positively associated with multiple (≥ 3) adenomas (35% vs 9%, P = 0.024) and sessile adenomas (69% vs 53%, P = 0.05). No difference existed between location (P = 0.086), grade of dysplasia (P = 0.196), or size (P = 0.841) of adenomas. In addition, no difference was found between BMI (P = 0.078), smoking (P = 0.146), alcohol consumption (P = 0.231), and the presence of adenomas.
  
  
  CONCLUSIONS
  MS is positively associated with adenomas and colorectal cancer. However, there is not enough information in western European countries to justify screening in patients with MS. To our knowledge, no previous study has evaluated this association in Portuguese patients.
authors.affiliation: Daniel Trabulo, Suzane Ribeiro, Cláudio Martins, Cristina Teixeira, Cláudia Cardoso, João Mangualde, Ricardo Freire, Élia Gamito, Ana L Alves, Fátima Augusto, Ana P Oliveira, Isabelle Cremers, Gastroenterology Department, Hospital de São Bernardo, Centro Hospitalar de Setúbal, 2910-446 Setúbal, Portugal.
authors.forename: Daniel
authors.initials: D
authors.lastname: Trabulo
authors.affiliation: Daniel Trabulo, Suzane Ribeiro, Cláudio Martins, Cristina Teixeira, Cláudia Cardoso, João Mangualde, Ricardo Freire, Élia Gamito, Ana L Alves, Fátima Augusto, Ana P Oliveira, Isabelle Cremers, Gastroenterology Department, Hospital de São Bernardo, Centro Hospitalar de Setúbal, 2910-446 Setúbal, Portugal.
authors.forename: Suzane
authors.initials: S
authors.lastname: Ribeiro
authors.affiliation: Daniel Trabulo, Suzane Ribeiro, Cláudio Martins, Cristina Teixeira, Cláudia Cardoso, João Mangualde, Ricardo Freire, Élia Gamito, Ana L Alves, Fátima Augusto, Ana P Oliveira, Isabelle Cremers, Gastroenterology Department, Hospital de São Bernardo, Centro Hospitalar de Setúbal, 2910-446 Setúbal, Portugal.
authors.forename: Cláudio
authors.initials: C
authors.lastname: Martins
authors.affiliation: Daniel Trabulo, Suzane Ribeiro, Cláudio Martins, Cristina Teixeira, Cláudia Cardoso, João Mangualde, Ricardo Freire, Élia Gamito, Ana L Alves, Fátima Augusto, Ana P Oliveira, Isabelle Cremers, Gastroenterology Department, Hospital de São Bernardo, Centro Hospitalar de Setúbal, 2910-446 Setúbal, Portugal.
authors.forename: Cristina
authors.initials: C
authors.lastname: Teixeira
authors.affiliation: Daniel Trabulo, Suzane Ribeiro, Cláudio Martins, Cristina Teixeira, Cláudia Cardoso, João Mangualde, Ricardo Freire, Élia Gamito, Ana L Alves, Fátima Augusto, Ana P Oliveira, Isabelle Cremers, Gastroenterology Department, Hospital de São Bernardo, Centro Hospitalar de Setúbal, 2910-446 Setúbal, Portugal.
authors.forename: Cláudia
authors.initials: C
authors.lastname: Cardoso
authors.affiliation: Daniel Trabulo, Suzane Ribeiro, Cláudio Martins, Cristina Teixeira, Cláudia Cardoso, João Mangualde, Ricardo Freire, Élia Gamito, Ana L Alves, Fátima Augusto, Ana P Oliveira, Isabelle Cremers, Gastroenterology Department, Hospital de São Bernardo, Centro Hospitalar de Setúbal, 2910-446 Setúbal, Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Mangualde
authors.affiliation: Daniel Trabulo, Suzane Ribeiro, Cláudio Martins, Cristina Teixeira, Cláudia Cardoso, João Mangualde, Ricardo Freire, Élia Gamito, Ana L Alves, Fátima Augusto, Ana P Oliveira, Isabelle Cremers, Gastroenterology Department, Hospital de São Bernardo, Centro Hospitalar de Setúbal, 2910-446 Setúbal, Portugal.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Freire
authors.affiliation: Daniel Trabulo, Suzane Ribeiro, Cláudio Martins, Cristina Teixeira, Cláudia Cardoso, João Mangualde, Ricardo Freire, Élia Gamito, Ana L Alves, Fátima Augusto, Ana P Oliveira, Isabelle Cremers, Gastroenterology Department, Hospital de São Bernardo, Centro Hospitalar de Setúbal, 2910-446 Setúbal, Portugal.
authors.forename: Élia
authors.initials: É
authors.lastname: Gamito
authors.affiliation: Daniel Trabulo, Suzane Ribeiro, Cláudio Martins, Cristina Teixeira, Cláudia Cardoso, João Mangualde, Ricardo Freire, Élia Gamito, Ana L Alves, Fátima Augusto, Ana P Oliveira, Isabelle Cremers, Gastroenterology Department, Hospital de São Bernardo, Centro Hospitalar de Setúbal, 2910-446 Setúbal, Portugal.
authors.forename: Ana L
authors.initials: AL
authors.lastname: Alves
authors.affiliation: Daniel Trabulo, Suzane Ribeiro, Cláudio Martins, Cristina Teixeira, Cláudia Cardoso, João Mangualde, Ricardo Freire, Élia Gamito, Ana L Alves, Fátima Augusto, Ana P Oliveira, Isabelle Cremers, Gastroenterology Department, Hospital de São Bernardo, Centro Hospitalar de Setúbal, 2910-446 Setúbal, Portugal.
authors.forename: Fátima
authors.initials: F
authors.lastname: Augusto
authors.affiliation: Daniel Trabulo, Suzane Ribeiro, Cláudio Martins, Cristina Teixeira, Cláudia Cardoso, João Mangualde, Ricardo Freire, Élia Gamito, Ana L Alves, Fátima Augusto, Ana P Oliveira, Isabelle Cremers, Gastroenterology Department, Hospital de São Bernardo, Centro Hospitalar de Setúbal, 2910-446 Setúbal, Portugal.
authors.forename: Ana P
authors.initials: AP
authors.lastname: Oliveira
authors.affiliation: Daniel Trabulo, Suzane Ribeiro, Cláudio Martins, Cristina Teixeira, Cláudia Cardoso, João Mangualde, Ricardo Freire, Élia Gamito, Ana L Alves, Fátima Augusto, Ana P Oliveira, Isabelle Cremers, Gastroenterology Department, Hospital de São Bernardo, Centro Hospitalar de Setúbal, 2910-446 Setúbal, Portugal.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Cremers
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000453:epidemiology*; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology; D011174:Portugal / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D013997:Time Factors
keywords: Colorectal adenomas; Colorectal cancer; Metabolic syndrome; Obesity; Western countries