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Metabolic Syndrome Linked With Higher Risk of Endometrial Cancer Regardless of Being Overweight or Obese

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Key Points

  • Women with metabolic syndrome have an increased risk of endometrial cancer, regardless of whether they are overweight or obese.
  • Each distinct metabolic syndrome (including excessive weight, high blood pressure, high triglycerides, and impaired fasting glucose) was individually associated with increased risk for endometrial cancer, and the risk was similar across endometrial cancer subtypes.
  • Strategies to reduce the prevalence of metabolic syndrome factors, such as weight loss and exercise, might have a favorable effect on endometrial cancer incidence.

A large population-based analysis of women 65 and older in the United States diagnosed with endometrial cancer has found that women with metabolic syndrome—characterized by low HDL cholesterol, hypertension, high triglycerides, and elevated waist circumference—have an increased risk of endometrial cancer. The additional risk was independent of being overweight or obese, according to the study results. The study by Trabert et al is published in Cancer Epidemiology, Biomarkers & Prevention.

Study Methodology

Using the SEER-Medicare Linked Database, the researchers analyzed data from 16,323 women diagnosed with endometrial cancer between 1993 and 2007 and 100,751 women without endometrial cancer. In addition, the researchers created metabolic syndrome variables on the basis of two definitions.

The first, as suggested by the U.S. National Cholesterol Education Program Adult Treatment Panel III (NCEP-III), was defined as the presence of at least three of the following conditions: central adiposity/elevated waist circumference, hypertension, high triglycerides, low HDL cholesterol, and impaired fasting glucose. The second, as described by the International Diabetes Federation (IDF), was defined as the presence of central adiposity/elevated waist circumference plus any two of the other factors: impaired fasting glucose—including type II diabetes—hypertension, low HDL cholesterol, and high triglycerides.

Study Findings

The researchers found that a diagnosis of metabolic syndrome was associated with an increased endometrial cancer risk of 39% based on the NCEP-III metabolic syndrome definition, and 103% based on the IDF definition. After taking into account whether a woman was overweight/obese, the associations with increased risk of endometrial cancer were 21% and 17% for the two metabolic syndrome definitions, respectively.

The researchers also found that each distinct metabolic syndrome condition they could evaluate within the database, including excessive weight, high blood pressure, high triglycerides, and impaired fasting glucose, was individually associated with increased risk for endometrial cancer and that the risk was similar across endometrial cancer subtypes.

“We found that a diagnosis of metabolic syndrome was associated with higher risk of endometrial cancer, and that metabolic syndrome appeared to increase risk regardless of whether the woman was considered obese,” Britton Trabert, PhD, an investigator in the Division of Cancer Epidemiology and Genetics of the National Cancer Institute and the lead author of the study, said in a statement.

Although the study was not designed to evaluate the potential impact of preventing metabolic syndrome on endometrial cancer risk, strategies to reduce the prevalence of metabolic syndrome factors, such as weight loss and exercise, “might have a favorable effect on endometrial cancer incidence,” concluded the researchers.

Dr. Trabert is the corresponding author of the Cancer Epidemiology, Biomarkers & Prevention article.

The study was funded by the National Cancer Institute Intramural Research Program. The authors reported no conflicts of interest.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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