title: Metabolic syndrome and the risk of urothelial carcinoma of the bladder: a case-control study.
abstract: BACKGROUND
  The Metabolic syndrome (MetS) is an emerging condition worldwide, consistently associated with an increased risk of several cancers. Some information exists on urothelial carcinoma of the bladder (UCB) and MetS. This study aims at further evaluating the association between the MetS and UCB.
  
  
  METHODS
  Between 2003 and 2014 in Italy, we conducted a hospital-based case-control study, enrolling 690 incident UCB patients and 665 cancer-free matched patients. The MetS was defined as the presence of at least three of the four selected indicators: abdominal obesity, hypercholesterolemia, hypertension, and diabetes. Odds ratios (ORs) and corresponding 95 % confidence intervals (CIs) for MetS and its components were estimated through multiple logistic regression models, adjusting for potential confounders.
  
  
  RESULTS
  Patients with MetS were at a 2-fold higher risk of UCB (95 % CI:1.38-3.19), compared to those without the MetS. In particular, ORs for bladder cancer were 2.20 (95 % CI:1.42-3.38) for diabetes, 0.88 (95 % CI: 0.66-1.17) for hypertension, 1.16 (95 % CI: 0.80-1.67) for hypercholesterolemia, and 1.63 (95 % CI:1.22-2.19) for abdominal obesity. No heterogeneity in risks emerged across strata of sex, age, education, geographical area, and smoking habits. Overall, 8.1 % (95 % CI: 3.9-12.4 %) of UCB cases were attributable to the MetS.
  
  
  CONCLUSIONS
  This study supports a positive association between the MetS and bladder cancer risk.
authors.affiliation: Unit of Epidemiology, Istituto Tumori "Fondazione Pascale IRCCS", Via Mariano Semmola, 1 - 80131, Naples, Italy. m.montella@istitutotumori.na.it.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Montella
authors.affiliation: Unit of Epidemiology and Biostatistics, CRO Aviano National Cancer Institute, via F. Gallini, 2 - 33081, Aviano, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Di Maso
authors.affiliation: Unit of Epidemiology, Istituto Tumori "Fondazione Pascale IRCCS", Via Mariano Semmola, 1 - 80131, Naples, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Crispo
authors.affiliation: Unit of Epidemiology, Istituto Tumori "Fondazione Pascale IRCCS", Via Mariano Semmola, 1 - 80131, Naples, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Grimaldi
authors.affiliation: Department of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", via La Masa, 19 - 20156, Milan, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Bosetti
authors.affiliation: Department of Medical Statistics, Biometry and Bioinformatics, Fondazione IRCCS Istituto Nazionale Tumori, via A. Vanzetti, 5 - 20133, Milan, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Turati
authors.affiliation: Unit of Epidemiology, Istituto Tumori "Fondazione Pascale IRCCS", Via Mariano Semmola, 1 - 80131, Naples, Italy.
authors.forename: Aldo
authors.initials: A
authors.lastname: Giudice
authors.affiliation: Laboratory of Translational Oncology & Functional Genomics, Department of Biomedical and Biotechnological Sciences, University of Catania, via Androne, 83 - 95124, Catania, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Libra
authors.affiliation: Unit of Epidemiology and Biostatistics, CRO Aviano National Cancer Institute, via F. Gallini, 2 - 33081, Aviano, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Serraino
authors.affiliation: Department of Clinical Sciences and Community Health, Università degli Studi di Milano, via A. Vanzetti, 5 - 20133, Milan, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: La Vecchia
authors.affiliation: Department of Urology and Gynecology, Istituto Tumori "Fondazione Pascale IRCCS", Via Mariano Semmola, 1 - 80131, Naples, Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: Tambaro
authors.affiliation: Division of Medicine Laboratory and Clinical Pathology, Istituto Tumori "Fondazione Pascale IRCCS", Via Mariano Semmola, 1 - 80131, Naples, Italy.
authors.forename: Ernesta
authors.initials: E
authors.lastname: Cavalcanti
authors.affiliation: Istituto Tumori "Fondazione Pascale IRCCS", Cappella dei Cangiani, 1 - 80131, Naples, Italy.
authors.forename: Gennaro
authors.initials: G
authors.lastname: Ciliberto
authors.affiliation: Unit of Epidemiology and Biostatistics, CRO Aviano National Cancer Institute, via F. Gallini, 2 - 33081, Aviano, Italy.
authors.forename: Jerry
authors.initials: J
authors.lastname: Polesel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology / Q000473:pathology; D007558:Italy; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications / Q000453:epidemiology; D012307:Risk Factors; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology* / Q000209:etiology* / Q000473:pathology