Division of Cancer Epidemiology and Genetics, Nutritional Epidemiology Branch, National Cancer Institute, Rockville, MD 20892-7344, USA.
Metabolism. 2010 Aug;59(8):1231-9. doi: 10.1016/j.metabol.2009.11.019. Epub 2010 Jan 4.
We tested the hypothesis that risk of early mortality from cancers of the digestive system will be greater in men with, compared with men without, the metabolic syndrome (MetS). Participants were 33,230 men who were seen at the Cooper Clinic in Dallas, TX, and followed for 14.4 (SD = 7.0) years. Metabolic syndrome was defined as having at least 3 of the following risk factors: abdominal obesity, fasting hypertriglyceridemia, low high-density lipoprotein cholesterol, high blood pressure, or high fasting glucose level or diabetes. Metabolic syndrome was associated with higher mortality (hazard ratio [HR] = 1.90 [95% confidence interval = 1.42-2.55]), and there was a graded positive association for the addition of more syndrome components (P < .01). Adjustment for cardiorespiratory fitness attenuated the risk estimates by 20% to 30%, but they remained significant after this adjustment. Evaluation of the independent contribution of each of the syndrome components revealed that both abdominal obesity (HR = 1.89 [1.36-2.62]) and high glucose (HR = 1.38 [1.02-1.87]) were independently associated with cancer mortality. Our results support the hypothesis that metabolic syndrome is positively associated with mortality from cancers of the digestive system. Interventions that reduce abnormalities associated with the syndrome could reduce risk of premature death from these cancers.
我们检验了这样一个假设,即与没有代谢综合征(MetS)的男性相比,患有代谢综合征的男性死于消化系统癌症的早期死亡风险更大。参与者为 33230 名在德克萨斯州达拉斯的库珀诊所就诊的男性,随访时间为 14.4 年(SD=7.0)。代谢综合征的定义为至少有以下 3 种危险因素:腹部肥胖、空腹高甘油三酯血症、低高密度脂蛋白胆固醇、高血压或高空腹血糖水平或糖尿病。代谢综合征与更高的死亡率相关(风险比 [HR]=1.90[95%置信区间=1.42-2.55]),并且随着更多综合征成分的加入,存在着正分级关联(P<0.01)。调整心肺适能后,风险估计值降低了 20%至 30%,但在进行此调整后,风险仍然显著。对每个综合征成分的独立贡献进行评估后发现,腹部肥胖(HR=1.89[1.36-2.62])和高血糖(HR=1.38[1.02-1.87])都与癌症死亡率独立相关。我们的研究结果支持这样一个假设,即代谢综合征与消化系统癌症的死亡率呈正相关。减少与该综合征相关的异常的干预措施可能会降低这些癌症导致的过早死亡的风险。