title: Case-control study of metabolic syndrome and ovarian cancer in Chinese population.
abstract: BACKGROUND
  Recent studies have proved metabolic syndrome (MetS) was linked to cancer risks. However, few data has examined the relationship between MetS and epithelial ovarian cancer (EOC).
  
  
  METHODS
  We conducted a population-based case-control study in Tianjin Medical University Cancer Institute and Hospital, China (2010-2015) that enrolled 573 EOC patients and 1146 matched controls. Data were collected through in-person interviews, anthropometric measurement, and 8-h fasting bloods drawn. MetS was estimated by Chinese Diabetes Society (CDS) definition requiring presence of ≥3 of the following risk factors: 1) body mass index (BMI) ≥25.0 kg/m2,2) fasting plasma glucose ≥6.1 mmol/L or 2-h plasma glucose ≥ 7.8 mmol/L, 3) systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg, 4) triglyceride (TG) ≥1.70 mmol/L or high-density lipoprotein cholesterol (HDL-C) < 1.0 mmol/L. Statistics were completed using chi-square tests and logistic regression analysis. The survival analysis was conducted by the Kaplan-Meier method and Cox proportional hazard regression models.
  
  
  RESULTS
  MetS was significantly more prevalent among EOC (25.13%) than controls (6.89%). A statistically significant increase risk for EOC was observed for MetS (multivariable-adjusted OR = 3.187; 95% CI: 2.135-4.756). MetS was significantly associated with histological grade (P < 0.001), FIGO stage (P = 0.003), and lymph node (LN) status (P = 0.002) of EOC. In binary logistic regression analysis, the presence of MetS predicts the risk of advanced FIGO stage (OR = 2.155, 95% CI: 1.327-3.498,P= 0.002), lower differentiation (OR = 2.472, 95% CI: 1.164-5.250,P= 0.019), and LN metastasis (OR = 2.590, 95% CI: 1.089-6.160,P= 0.031) of EOC. Moreover, MetS is the independent factor for the evaluation of PFS and OS of EOC patients (both of themP < 0.001) in Cox proportional hazard model.
  
  
  CONCLUSIONS
  MetS is obviously related to increased EOC risk. EOC patients with MetS in Chinese population were found to have statistically significant tumor advanced stage, low differentiation, LN metastasis and poor prognosis.
authors.affiliation: Department of Gynecologic Oncology, Tianjin Medical University Cancer Institute and Hospital, Huanhuxi Road, Hexi District, Tianjin, 300060 China.|Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060 China.|National Clinical Research Centre of Cancer, Tianjin, 300060 China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Gynecologic Oncology, Tianjin Medical University Cancer Institute and Hospital, Huanhuxi Road, Hexi District, Tianjin, 300060 China.|Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060 China.|National Clinical Research Centre of Cancer, Tianjin, 300060 China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Gynecologic Oncology, Tianjin Medical University Cancer Institute and Hospital, Huanhuxi Road, Hexi District, Tianjin, 300060 China.
authors.forename: Wenxin
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Gynecologic Oncology, Tianjin Medical University Cancer Institute and Hospital, Huanhuxi Road, Hexi District, Tianjin, 300060 China.
authors.forename: Ke
authors.initials: K
authors.lastname: Wang
keywords: Diabetes; Hypertension; Metabolic syndrome; Ovarian cancer