Gathirua-Mwangi Wambui G, Monahan Patrick O, Murage Mwangi J, Zhang Jianjun
Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, 1050 Wishard Boulevard, RG5118, Indianapolis, IN, 46202, USA.
Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN, USA.
Cancer Causes Control. 2017 Feb;28(2):127-136. doi: 10.1007/s10552-016-0843-1. Epub 2017 Jan 17.
Although metabolic syndrome incidence has substantially increased during the last few decades, it largely remains unclear whether this metabolic disorder is associated with total cancer mortality. The present study was carried out to investigate this important question.
A total of 687 cancer deaths were identified from 14,916 participants in the third National Health and Nutrition Examination Survey by linking them to the National Death Index database through December 31, 2006. Cox proportional hazards regression was performed to calculate hazard ratios (HR) and 95% confidence intervals (CI) for total cancer mortality in relation to metabolic syndrome and its individual components.
After adjustment for confounders, a diagnosis of metabolic syndrome was associated with 33% elevated total cancer mortality. Compared with individuals without metabolic syndrome, those with 3, 4 and 5 abnormal components had HRs (95% CIs) of 1.28 (1.03-1.59), 1.24 (0.96-1.60), and 1.87 (1.34-2.63), respectively (p-trend = 0.0003). Systolic blood pressure and serum glucose were associated with an increased risk of death from total cancer [HR (95% CI) for highest vs. lowest quartiles: 1.67 (1.19-2.33), p-trend = 0.002 and 1.34 (1.04-1.74), p-trend = 0.003, respectively]. Overall null results were obtained for lung cancer mortality. The effects of metabolic syndrome and its components on non-lung cancer mortality were generally similar to, but somewhat larger than, those for total cancer mortality.
Our study is among the first to reveal that metabolic syndrome is associated with increased total cancer mortality.
尽管在过去几十年中代谢综合征的发病率大幅上升，但这种代谢紊乱是否与癌症总死亡率相关在很大程度上仍不清楚。本研究旨在调查这一重要问题。
通过将第三次全国健康和营养检查调查的14916名参与者与截至2006年12月31日的国家死亡指数数据库进行关联，共确定了687例癌症死亡病例。采用Cox比例风险回归分析来计算代谢综合征及其各个组分与癌症总死亡率相关的风险比（HR）和95%置信区间（CI）。
在对混杂因素进行校正后，代谢综合征诊断与癌症总死亡率升高33%相关。与无代谢综合征的个体相比，有3个、4个和5个异常组分的个体的HR（95%CI）分别为1.28（1.03 - 1.59）、1.24（0.96 - 1.60）和1.87（1.34 - 2.63）（P趋势 = 0.0003）。收缩压和血清葡萄糖与癌症总死亡风险增加相关[最高四分位数与最低四分位数相比的HR（95%CI）：分别为1.67（1.19 - 2.33），P趋势 = 0.002和1.34（1.04 - 1.74），P趋势 = 0.003]。肺癌死亡率总体上未得出显著结果。代谢综合征及其组分对非肺癌死亡率的影响通常与癌症总死亡率相似，但略大。
我们的研究是首批揭示代谢综合征与癌症总死亡率增加相关的研究之一。
