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Components of the metabolic syndrome and colorectal cancer risk; a prospective study

Abstract

Objective:

To examine the relation of well-known factors of the metabolic syndrome (MetS) as well as related circulating factors, with risk of colorectal cancer.

Methods:

We performed a case control study of 306 colorectal cancer cases and 595 matched controls nested in the Northern Sweden Health and Disease Cohort. Levels of C-peptide, glycated haemoglobin (HbA1c), leptin and adiponectin were measured in cryopreserved samples. Body mass index (BMI), systolic and diastolic blood pressure and fasting and post-load plasma glucose, had been measured in a subcohort. Conditional logistic regression was used to calculate odds ratios (OR) of disease, including risk assessments for the MetS factors: obesity (BMI>30 kg m−2), hypertension (blood pressure 140/90 mmHg or use of anti-hypertensive drugs) and hyperglycaemia (fasting glucose 6.1 mmol l−1 or post-load glucose in capillary plasma 8.9 mmol l−1).

Results:

None of the studied variables were significantly associated with risk across quartiles. Presence of obesity, hypertension and hyperglycaemia significantly increased the risk of colorectal cancer; OR for three vs null factors was 2.57 (95% Confidence Interval [CI] 1.20–5.52; Ptrend=0.0021), as compared to a 30 to 70% increased risk for the factors in single. Similarly, top decile levels of C-peptide, HbA1c and leptin/adiponectin ratio were associated with an increased risk; ORs for top vs deciles 1–9 were 1.56 (95% CI 0.93–2.62; P=0.090), 1.83 (95% CI 1.00–3.36; P=0.051) and 1.50 (95% CI 0.83–2.71; P=0.18), respectively.

Conclusions:

Our study support the view that components of the MetS increase risk of colorectal cancer, and further suggests that only very high levels of metabolic factors confer an increased risk.

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Acknowledgements

We thank Åsa Ågren, project data base manager at the Medical Biobank, Umeå University Hospital, Sweden, for co-ordinating our data, John Hutilainen, data base executing officer at the Medical Biobank, Umeå University Hospital, Sweden, for managing and completing the study file, Ove Björ, statistician at the Oncological center, Umeå University Hospital, Sweden, for input regarding statistical analyses, and Priscilia Amouval and David Achiantre, laboratory technicians at the International Agency for Research on Cancer, Lyon, France, for analysing plasma hormone levels. This study was funded by the World Cancer Research Fund, International Grant 2002/30, the Swedish Cancer Society 04–0417, and by the Västerbotten County Council.

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Correspondence to T Stocks.

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Stocks, T., Lukanova, A., Johansson, M. et al. Components of the metabolic syndrome and colorectal cancer risk; a prospective study. Int J Obes 32, 304–314 (2008). https://doi.org/10.1038/sj.ijo.0803713

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