Harborg Sixten, Larsen Helene Borup, Elsgaard Stine, Borgquist Signe
Department of Oncology, Aarhus University Hospital/Aarhus University, Aarhus, Denmark.
Department of Clinical Epidemiology, Aarhus University Hospital/Aarhus University, Aarhus, Denmark.
J Intern Med. 2025 Mar;297(3):262-275. doi: 10.1111/joim.20052. Epub 2025 Jan 8.
This systematic review and meta-analysis assesses the association between metabolic syndrome and breast cancer (BC) outcomes in BC survivors.
Systematic searches were carried out in PubMed and Embase using variations of the search terms: breast neoplasms (population), metabolic syndrome (exposure), and survival (outcome). Metabolic syndrome was characterized according to the American Heart Association, which includes the presence of three out of five abnormal findings among the risk factors: high blood pressure, high triglycerides, low high-density lipoprotein, high fasting glucose, and central obesity. Data were obtained from observational studies and randomized controlled trials that utilized survival statistics and reported survival ratios to investigate how the presence of metabolic syndrome at the time of BC diagnosis is associated with BC outcomes. Study data were independently extracted by two authors, and effect sizes were pooled using random-effects models.
From the 1019 studies identified in the literature search, 17 were deemed eligible. These encompassed 42,135 BC survivors. The pooled estimates revealed that BC survivors who had metabolic syndrome at the time of their BC diagnosis experienced increased risk of recurrence (HR 1.69, 95% CI: 1.39-2.06), BC mortality (HR 1.83, 95% CI: 1.35-2.49), and shorter disease-free survival (HR 1.57, 95% CI: 1.36-1.81) compared to BC survivors without metabolic syndrome.
Among BC survivors, metabolic syndrome was associated with inferior BC outcomes. This necessitates the creation of clinical guidelines that include metabolic screening for BC survivors. Further research should identify effective interventions to reduce the prevalence of metabolic syndrome among BC survivors to improve metabolic health and BC outcomes.
本系统评价和荟萃分析评估了乳腺癌（BC）幸存者中代谢综合征与BC预后之间的关联。
在PubMed和Embase中进行系统检索，使用检索词的变体：乳腺肿瘤（研究对象）、代谢综合征（暴露因素）和生存（结局）。代谢综合征根据美国心脏协会的标准进行定义，其中包括在五个危险因素中出现三项异常结果：高血压、高甘油三酯、低高密度脂蛋白、高空腹血糖和中心性肥胖。数据来自观察性研究和随机对照试验，这些研究利用生存统计数据并报告生存率，以调查BC诊断时代谢综合征的存在与BC预后之间的关联。研究数据由两位作者独立提取，并使用随机效应模型汇总效应量。
在文献检索中确定的1019项研究中，17项被认为符合条件。这些研究涵盖了42135名BC幸存者。汇总估计显示，与无代谢综合征的BC幸存者相比，BC诊断时患有代谢综合征的BC幸存者复发风险增加（HR 1.69，95%CI：1.39 - 2.06）、BC死亡率增加（HR 1.83，95%CI：1.35 - 2.49），无病生存期缩短（HR 1.57，95%CI：1.36 - 1.81）。
在BC幸存者中，代谢综合征与较差的BC预后相关。这需要制定包括对BC幸存者进行代谢筛查的临床指南。进一步的研究应确定有效的干预措施，以降低BC幸存者中代谢综合征的患病率，从而改善代谢健康和BC预后。
