Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea.
J Gynecol Oncol. 2022 Jul;33(4):e35. doi: 10.3802/jgo.2022.33.e35. Epub 2022 Feb 16.
This study investigated the associations between obesity, metabolic syndrome (MetS), the combination of these two components as a metabolic obesity phenotype, and endometrial cancer risk in East Asian women.
A total of 6,097,686 cancer-free women aged 40-74 years who underwent the National Health Insurance Service health examination between 2009 and 2010 were included. Cancer incidence was identified using the healthcare utilization database. Associations between baseline obesity (body mass index <23 kg/m², 23-24.9 kg/m², ≥25 kg/m²), MetS, each component of MetS, MetS stratified by obesity status, combination of obesity and MetS, and endometrial cancer risk were investigated using hazard ratios (HRs).
Obesity, each component of MetS, and MetS increased the endometrial cancer risk. After these factors were mutually adjusted for, the association did not change. When stratified by obesity, MetS and MetS components were not associated with endometrial cancer in normal-weight or overweight women. However, in obese women, MetS and MetS components increased the risk of endometrial cancer (HR=1.29; 95% confidence interval [CI]=1.20-1.39). Compared with normal-weight women without MetS, endometrial cancer risk was not increased in normal-weight women with MetS. Overweight women showed an increased risk of endometrial cancer irrespective of the presence of MetS (HR=1.37 and 1.38, respectively). The HR of obese women with MetS was higher than that of obese women without MetS (HR=2.18 and 1.75).
The association between MetS and endometrial cancer was most prominent in obese women, suggesting that obese women with MetS would be more vulnerable to endometrial cancer.
本研究旨在探讨肥胖、代谢综合征（MetS）以及这两种因素组合（代谢肥胖表型）与东亚女性子宫内膜癌风险之间的关系。
共纳入 6097686 名年龄在 40-74 岁之间、于 2009 年至 2010 年期间接受国民健康保险服务健康检查的无癌症女性。通过医疗保健利用数据库确定癌症发病率。使用风险比（HRs）来研究基线肥胖（体重指数<23kg/m²、23-24.9kg/m²、≥25kg/m²）、MetS、MetS 的各个组成部分、根据肥胖状况分层的 MetS、肥胖与 MetS 的组合与子宫内膜癌风险之间的关系。
肥胖、MetS 的各个组成部分以及 MetS 均增加了子宫内膜癌的风险。在这些因素相互调整后，关联并未改变。按肥胖分层时，在正常体重或超重女性中，MetS 和 MetS 成分与子宫内膜癌无关。然而，在肥胖女性中，MetS 和 MetS 成分增加了子宫内膜癌的风险（HR=1.29；95%置信区间[CI]：1.20-1.39）。与无 MetS 的正常体重女性相比，正常体重伴有 MetS 的女性子宫内膜癌风险并未增加。超重女性无论是否存在 MetS，子宫内膜癌风险均增加（HR=1.37 和 1.38）。伴有 MetS 的肥胖女性的 HR 高于无 MetS 的肥胖女性（HR=2.18 和 1.75）。
MetS 与子宫内膜癌之间的关联在肥胖女性中最为显著，这表明伴有 MetS 的肥胖女性更容易患上子宫内膜癌。
