Rheumatology Section, Department of Medicine, University of Verona, Verona, Italy.
Division of cardiac rehabilitation, San Pancrazio Hospital, Arco di Trento, Trento, Italy.
Arthritis Res Ther. 2021 Mar 19;23(1):89. doi: 10.1186/s13075-021-02465-3.
Several studies on community populations found that metabolic syndrome (MetS) is associated with higher risk for total incident cancer with a predisposition for specific types of cancer. These findings have never been analyzed in patients with chronic inflammatory rheumatic and musculoskeletal diseases (RMD). We assessed prevalence/incidence and factors related to the development of cancer in a large cohort of these patients and evaluate whether MetS and its components were associated with cancer independent of traditional markers of inflammation.
Between March 2014 and April 2016, 474 patients with RMD involved in a cardiovascular primary prevention program were consecutively recruited into this ambispective (combination of retrospective/prospective) study. They underwent clinical, laboratory, and echocardiographic evaluations. MetS was diagnosed according to the ATPIII criteria.
Duration of follow-up was 42 [18-60] months. Patients with a diagnosis of cancer (made before recruitment or during follow-up) were 46 (9.7%). Cancer was diagnosed in 22/76 patients (29%) with MetS and in 24/398 patients (6%, p < 0.001) without MetS; nearly two thirds of malignancies belonged to those traditionally related to MetS. MetS was the strongest cancer risk factor. Cancer was positively associated with the number of MetS components identified in each patient. Beyond MetS, cancer was associated to older age and increased inflammatory disease activity; this information allowed to build a simple performance indicator highly sensitive for cancer development.
In light of our results, an increasingly accurate assessment of MetS would be required in patients with RMD as potential measure of clinical outcomes including the risk of cancer.
几项针对社区人群的研究发现，代谢综合征（MetS）与总癌症发病率升高相关，且与特定类型的癌症发病倾向相关。这些发现从未在患有慢性炎症性风湿和肌肉骨骼疾病（RMD）的患者中进行过分析。我们评估了大量此类患者癌症的患病率/发病率和相关因素，并评估 MetS 及其成分是否与癌症相关，而与炎症的传统标志物无关。
2014 年 3 月至 2016 年 4 月，474 名参与心血管一级预防计划的 RMD 患者连续入组本前瞻性（回顾性/前瞻性组合）研究。他们接受了临床、实验室和超声心动图评估。根据 ATPIII 标准诊断 MetS。
随访时间为 42 [18-60] 个月。诊断为癌症（在招募前或随访期间确诊）的患者为 46 例（9.7%）。在患有 MetS 的 76 名患者中有 22 例（29%）和在没有 MetS 的 398 名患者中有 24 例（6%）诊断出癌症（p<0.001）；恶性肿瘤中近三分之二属于传统上与 MetS 相关的肿瘤。MetS 是最强的癌症危险因素。癌症与每位患者中确定的 MetS 成分数量呈正相关。除 MetS 外，癌症与年龄较大和炎症性疾病活动增加相关；这些信息可以构建一个简单的性能指标，对癌症的发生具有高度敏感性。
根据我们的结果，需要对 RMD 患者进行更准确的 MetS 评估，作为包括癌症风险在内的临床结果的潜在衡量标准。
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