Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA.
Eur J Cancer Prev. 2012 Jul;21(4):326-32. doi: 10.1097/CEJ.0b013e32834dbc81.
The metabolic syndrome is associated with increased risk of diabetes and coronary heart disease. Although higher BMI and other related factors have been frequently associated with colorectal cancer, whether the metabolic syndrome is associated with the risk of colorectal cancer is unclear. We therefore assessed the association of the metabolic syndrome with the risk of colorectal cancer in a subsample of participants of the Women's Health Initiative who had repeated measurements of the components of the syndrome at baseline and during follow-up. Women with diabetes at baseline enrollment were excluded. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CI) at baseline and in time-dependent analyses. Among 4862 eligible women, 81 incident cases of colorectal cancer were identified over a median follow-up of 12 years. Presence of the metabolic syndrome at baseline was associated with increased risk of colorectal cancer (HR 2.15, 95% CI 1.30-3.53) and colon cancer (HR 2.28, 95% CI 1.31-3.98). These associations were largely explained by positive associations of serum glucose and systolic blood pressure with both outcomes. Time-dependent covariate analyses supported the baseline findings. Our results suggest that the positive association of the metabolic syndrome with risk of colorectal cancer is largely accounted for by serum glucose levels and systolic blood pressure. The biological mechanism underlying these associations remains to be clarified.
代谢综合征与糖尿病和冠心病风险增加相关。虽然较高的 BMI 和其他相关因素经常与结直肠癌相关，但代谢综合征是否与结直肠癌风险相关尚不清楚。因此，我们在 Women's Health Initiative 的参与者亚组中评估了代谢综合征与结直肠癌风险的关系，这些参与者在基线和随访期间对综合征的各个成分进行了重复测量。基线入组时患有糖尿病的女性被排除在外。Cox 比例风险模型用于估计基线和时间依赖性分析时的风险比（HR）和 95%置信区间（95%CI）。在 4862 名合格的女性中，12 年的中位随访期间发现了 81 例结直肠癌病例。基线时存在代谢综合征与结直肠癌（HR 2.15，95%CI 1.30-3.53）和结肠癌（HR 2.28，95%CI 1.31-3.98）的风险增加相关。这些关联主要归因于血清葡萄糖和收缩压与这两种结局的正相关。基于时间的协变量分析支持基线结果。我们的研究结果表明，代谢综合征与结直肠癌风险之间的正相关主要归因于血清葡萄糖水平和收缩压。这些关联背后的生物学机制仍有待阐明。
