Department of Population Health Research, Division of Cancer Care, Alberta Health Services-Cancer Care Tom Baker Cancer Centre, 1331-29 Street N.W. Calgary, Alberta T2N 4N2, Canada.
Cancer Epidemiol Biomarkers Prev. 2011 Nov;20(11):2384-95. doi: 10.1158/1055-9965.EPI-11-0715. Epub 2011 Sep 15.
Metabolic syndrome may predict endometrial cancer risk better than diabetes, hypertension, dyslipidemia, dysglycemia, or weight alone, but few studies have examined this issue.
We conducted a population-based case-control study in Alberta, Canada (2002-2006) that included 515 incident endometrial cancer cases and 962 frequency age-matched controls. Data were collected through in-person interviews, anthropometric measurements, and 8-hour fasting bloods drawn either pre- or postsurgery. Bloods were analyzed using quantitative colorimetric or absorbance-based assays (ELISA), specific to metabolic syndrome markers. Metabolic syndrome was defined using harmonized guidelines requiring presence of ≥ 3 of the following risk factors: waist circumference ≥ 88 cm, triglycerides ≥ 150 mg/dL, high-density lipoprotein cholesterol <50 mg/dL, treatment of previously diagnosed hypertension, and fasting blood glucose ≥ 100 mg/dL. OR and 95% CIs for endometrial cancer risk with presence of metabolic syndrome and individual metabolic syndrome components were estimated using logistic regression analysis.
Metabolic syndrome was significantly more prevalent among cases (62%) than controls (38%). A statistically significant increased risk for endometrial cancer was observed for metabolic syndrome (OR = 1.53; 95% CI: 1.17-2.00), as well as for some of the individual components of metabolic syndrome including waist circumference ≥ 88 cm (OR = 1.57; 95% CI: 1.18-2.08), hypertension (OR = 1.57; 95% CI: 1.18-2.09), and fasting blood glucose ≥ 100 mg/dL (OR = 1.31; 95% CI: 1.03-1.67). Some evidence for effect modification by menopausal status and body mass index was also found.
Metabolic syndrome is clearly associated with increased endometrial cancer risk.
Targeting the entire metabolic syndrome may optimize endometrial cancer risk reduction.
代谢综合征可能比糖尿病、高血压、血脂异常、血糖异常或体重本身更能预测子宫内膜癌的风险，但很少有研究对此问题进行探讨。
我们在加拿大艾伯塔省进行了一项基于人群的病例对照研究（2002-2006 年），其中包括 515 例新发子宫内膜癌病例和 962 例按年龄频数匹配的对照。数据通过面对面访谈、人体测量和 8 小时禁食血样收集获得，血样采集时间在术前或术后。采用定量比色或吸光度测定法（ELISA）分析血液，针对代谢综合征标志物进行检测。代谢综合征采用经过协调的指南进行定义，需要满足以下≥3 种危险因素：腰围≥88cm、甘油三酯≥150mg/dL、高密度脂蛋白胆固醇<50mg/dL、已确诊的高血压治疗以及空腹血糖≥100mg/dL。采用 logistic 回归分析估计存在代谢综合征和个别代谢综合征成分与子宫内膜癌风险的比值比（OR）和 95%置信区间（CI）。
病例组（62%）代谢综合征的患病率明显高于对照组（38%）。代谢综合征与子宫内膜癌风险显著增加相关（OR=1.53；95%CI：1.17-2.00），以及代谢综合征的一些个别成分，包括腰围≥88cm（OR=1.57；95%CI：1.18-2.08）、高血压（OR=1.57；95%CI：1.18-2.09）和空腹血糖≥100mg/dL（OR=1.31；95%CI：1.03-1.67）。还发现绝经状态和体重指数存在一定的效应修饰作用。
代谢综合征与子宫内膜癌风险增加明显相关。
针对整个代谢综合征可能会优化子宫内膜癌的风险降低。
