Case-control Study of the Metabolic Syndrome and Metabolic Risk Factors for Endometrial Cancer
Menée au Canada, cette étude (515 cas et 962 témoins) évalue l'association entre le syndrome métabolique, divers facteurs de risque de nature métabolique et le risque de cancer de l'endomètre
Background: Metabolic syndrome may predict endometrial cancer risk better than diabetes, hypertension, dyslipidemia, dysglycemia or weight alone but few studies have examined this issue. Methods: We conducted a population-based case-control study in Alberta, Canada (2002-2006) that included 515 incident endometrial cancer cases and 962 frequency age-matched controls. Data were collected through in-person interviews, anthropometric measurements and 8-hour fasting bloods drawn either pre- or post-surgery. Bloods were analyzed using quantitative colorimetric or absorbance-based assays (ELISA) specific to metabolic syndrome markers. Metabolic syndrome was defined using harmonized guidelines requiring presence of ≥3 of the following risk factors: waist circumference ≥88cm, triglycerides ≥150mg/dL, HDL cholesterol <50mg/dL, treatment of previously diagnosed hypertension, and fasting blood glucose ≥100 mg/dL. Odds ratios (OR) and 95% confidence intervals (CI) for endometrial cancer risk with presence of metabolic syndrome and individual metabolic syndrome components were estimated using logistic regression analysis. Results: Metabolic syndrome was significantly more prevalent amongst cases (62%) than controls (38%). A statistically significant increased risk for endometrial cancer was observed for metabolic syndrome (OR=1.53, 95% CI 1.17-2.00) as well as for some of the individual components of metabolic syndrome including waist circumference ≥88cm (OR=1.57, 95% CI 1.18-2.08), hypertension (OR=1.57, 95% CI 1.18-2.09) and fasting blood glucose ≥100 mg/dL (OR=1.31, 95% CI 1.03-1.67). Some evidence for effect modification by menopausal status and body mass index was also found. Conclusions: Metabolic sydrome is clearly associated with increased endometrial cancer risk. Impact: Targeting the entire metabolic syndrome may optimize endometrial cancer risk reduction.