Department of Epidemiology, Istituto di Ricerche Farmacologiche 'Mario Negri', Milan.
Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, Aviano.
Ann Oncol. 2011 Apr;22(4):884-889. doi: 10.1093/annonc/mdq464. Epub 2010 Oct 11.
Various studies reported direct associations between endometrial cancer risk and individual components of the metabolic syndrome (MetS), i.e. obesity, diabetes, hypertension, and dyslipidemia, but only a few epidemiological studies considered the association with MetS overall.
We analyzed data from a case-control study including 454 women with incident endometrial cancer and 798 controls admitted to the same hospitals as cases for acute conditions. Different definitions of MetS were considered, including a combination of self-reported history of diabetes, drug-treated hypertension, drug-treated hyperlipidemia, and various measures of (central) obesity. Odds ratios (ORs) were computed from unconditional logistic regression models, adjusted for major confounding factors.
The multivariate ORs of endometrial cancer were 2.18 for type 2 diabetes, 1.77 for hypertension, 1.20 for hyperlipidemia, between 1.62 and 2.23 for various definitions of central obesity, and 3.83 for women with a body mass index (BMI) >30 kg/m(2). The risk of endometrial cancer was significantly increased for subjects with MetS, the ORs ranging between 1.67 and 2.77 when waist circumference was included in MetS definition, and 8.40 when BMI was considered instead.
This study indicates a direct association between various MetS components, besides overweight, with the risk of endometrial cancer.
多项研究报告称,子宫内膜癌风险与代谢综合征(MetS)的各个组成部分(即肥胖、糖尿病、高血压和血脂异常)之间存在直接关联,但只有少数流行病学研究考虑了整体代谢综合征与子宫内膜癌之间的关联。
我们分析了一项病例对照研究的数据,该研究纳入了 454 名新发子宫内膜癌患者和 798 名因急性疾病入住与病例相同医院的对照者。我们考虑了不同的代谢综合征定义,包括糖尿病、药物治疗的高血压、药物治疗的血脂异常和(中心)肥胖的各种测量指标的组合。采用非条件逻辑回归模型计算比值比(OR),并根据主要混杂因素进行调整。
多变量 OR 表明 2 型糖尿病患者患子宫内膜癌的风险为 2.18,高血压患者为 1.77,血脂异常患者为 1.20,各种中心性肥胖定义的患者为 1.62-2.23,BMI>30 kg/m²的患者为 3.83。患有代谢综合征的患者子宫内膜癌风险显著增加,当腰围纳入代谢综合征定义时,OR 值在 1.67 和 2.77 之间,而当 BMI 被视为代谢综合征的指标时,OR 值为 8.40。
本研究表明,除超重外,代谢综合征的各种组成部分与子宫内膜癌的风险之间存在直接关联。