Skip to main content

Advertisement

SpringerLink
Log in

Colorectal cancer association with metabolic syndrome and its components: a systematic review with meta-analysis

  • Meta-Analysis
  • Published:
Endocrine Aims and scope Submit manuscript

Abstract

We performed a systematic review and meta-analysis of the empirical evidence on the association of metabolic syndrome and its components with colorectal cancer incidence and mortality. A systematic literature search of multiple electronic databases was conducted and complemented by cross-referencing to identify studies published before 31 October 2012. Every included study was to report risk estimates with 95 % confidence intervals for the association between metabolic syndrome and colorectal cancer (incidence or mortality). Core items of identified studies were independently extracted by two reviewers, and results were summarized by standard methods of meta-analysis. We identified 17 studies, which reported on 49 data sets with 11,462 cancer cases. Metabolic syndrome was associated with an increased risk of colorectal cancer incidence and mortality in both men (RR: 1.33, 95 % CI 1.18–1.50, and 1.36, 1.25–1.48, respectively) and women (RR: 1.41, 1.18–1.70, and 1.16, 1.03–1.30, respectively). The risk estimates changed little depending on type of study (cohort vs non cohort), populations (US, Europe, Asia), cancer site (colon and rectum), or definition of the syndrome. The risk estimates for any single factor of the syndrome were significant for higher values of BMI/waist (RR: 1.19, 95 % CI 1.10–1.28), dysglycemia (RR: 1.29, 1.11–1.49), and higher blood pressure (RR: 1.09, 1.01–1.18). Dysglycemia and/or higher BMI/waist explained most of the risk associated with metabolic syndrome. Metabolic syndrome is associated with an increased risk of colorectal cancer incidence and mortality in both sexes. The risk conveyed by the full syndrome is not superior to the sum of its parts.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. American Cancer Society, Cancer facts & figures 2012 (American Cancer Society, Atlanta, 2012)

    Google Scholar 

  2. OECD. Health at a Glance 2011: OECD Indicators. OECD Publishing, http://dx.doi.org/10.1787/health_glance-2011-en. Accessed 27 Dec 2012

  3. WHO Europe. Early detection of common cancer: colorectal cancer 2012, http://www.euro.who.int/en/what-we-do/health-topics/noncommunicable-diseases/cancer/news/news/2012/2/early-detection-of-common-cancers. Accessed 27 Dec 2012

  4. K.G. Alberti KG, R.H. Eckel RH, S.M. Grundy SM, P.Z. Zimmet PZ, J.I. Cleeman, et al. International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; International Association for the Study of Obesity. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 120, 1640–1645 (2009)

  5. K. Esposito, P. Chiodini, A. Colao, A. Lenzi, D. Giugliano, Metabolic syndrome and risk of cancer: a systematic review and meta-analysis. Diabetes Care 35, 2402–2411 (2012)

    Article  PubMed  Google Scholar 

  6. R. Jinjuvadia, P. Lohia, C. Jinjuvadia, S. Montoya, S. Liangpunsakul, The association between metabolic syndrome and colorectal neoplasm: systemic review and meta-analysis. J Clin Gastroenterol 47, 33–44 (2013)

    Article  PubMed  Google Scholar 

  7. G. Wells, B. Shea, D. O’Connell, J. Peterson, V. Welch, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses, http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Accessed 27 Dec 2012

  8. A. Liberati, D.G. Altman, J. Tetzlaff, C. Mulrow, P.C. Gøtzsche et al., The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med 151, W65–W94 (2009)

    Article  PubMed  Google Scholar 

  9. S.L. Normand, Meta-analysis: formulating, evaluating, combining, and reporting. Stat Med 18, 321–329 (1999)

    Article  PubMed  CAS  Google Scholar 

  10. J.P. Higgins, S.G. Thompson, Quantifying heterogeneity in a meta-analysis. Stat Med 21, 1539–1558 (2002)

    Article  PubMed  Google Scholar 

  11. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 285, 2486–2497 (2001)

    Article  Google Scholar 

  12. H.C. van Houwelingen, L.R. Arends, T. Stijnen, Advanced methods in meta-analysis: multivariate approach and meta-regression. Stat Med 21, 589–624 (2002)

    Article  PubMed  Google Scholar 

  13. M. Egger, G. Davey Smith, M. Schneider, C. Minder, Bias in meta-analysis detected by a simple, graphical test. BMJ 315, 629–634 (1997)

    Article  PubMed  CAS  Google Scholar 

  14. M. Trevisan, J. Liu, P. Muti, G. Misciagna, A. Menotti et al., Markers of insulin resistance and colorectal cancer mortality. Cancer Epidemiol Biomarkers Prev 10, 937–941 (2001)

    PubMed  CAS  Google Scholar 

  15. L.A. Colangelo, S.M. Gapstur, P.H. Gann, A.R. Dyer, K. Liu, Colorectal cancer mortality and factors related to the insulin resistance syndrome. Cancer Epidemiol Biomarkers Prev 11, 385–391 (2002)

    PubMed  Google Scholar 

  16. R.L. AhmeL, K.H. Schmitz, K.E. Anderson, W.D. Rosamond, A.R. Folsom, The metabolic syndrome and risk of incident colorectal cancer. Cancer 107, 28–36 (2006)

    Article  Google Scholar 

  17. K. Bowers, D. Albanes, P. Limburg, P. Pietinen, P.R. Taylor et al., A prospective study of anthropometric and clinical measurements associated with insulin resistance syndrome and colorectal cancer in male smokers. Am J Epidemiol 164, 652–664 (2006)

    Article  PubMed  Google Scholar 

  18. T. Stürmer, J.E. Buring, I.-M. Le, J.M. Gaziano, R.J. Glynn, Metabolic abnormalities and risk for colorectal cancer in the Physicians’ Health Study. Cancer Epidemiol Biomarkers Prev 15, 2391–2397 (2006)

    Article  PubMed  Google Scholar 

  19. A. Russo, M. Autelitano, L. Bisanti, Metabolic syndrome and cancer risk. Eur J Cancer 44, 293–297 (2008)

    Article  PubMed  Google Scholar 

  20. T. Stocks, A. Lukanova, M. Johansson, S. Rinaldi, R. Palmqvist et al., Components of the metabolic syndrome and colorectal cancer risk; a prospective study. Int J Obes (Lond) 32, 304–314 (2008)

    Article  CAS  Google Scholar 

  21. N. Kontou, T. Psaltopoulou, N. Soupos, E. Polychronopoulos, D. Xinopoulos et al., Metabolic syndrome and colorectal cancer: the protective role of Mediterranean diet—a case–control study. Angiology 63, 390–396 (2012)

    Article  PubMed  Google Scholar 

  22. M. Inoue, M. Noda, N. Kurahashi, M. Iwasaki, S. Sasazuki et al., Impact of metabolic factors on subsequent cancer risk: results from a large-scale population-based cohort study in Japan. Eur J Cancer Prev 18, 240–247 (2009)

    Article  PubMed  Google Scholar 

  23. C.E. Matthews, X. Sui, M.J. LaMonte, S.A. Adams, J.R. Hébert et al., Metabolic syndrome and risk of death from cancers of the digestive system. Metabolism 59, 1231–1239 (2010)

    Article  PubMed  CAS  Google Scholar 

  24. T. Stocks, A. Lukanova, T. Bjørge, H. Ulmer, J. Manjer et al., Metabolic factors and the risk of colorectal cancer in 580,000 men and women in the Metabolic Syndrome and Cancer Project (Me-Can). Cancer 117, 2398–2407 (2011)

    Article  PubMed  Google Scholar 

  25. Z. Shen, S. Wang, Y. Ye, M. Yin, X. Yang et al., Clinical study on the correlation between metabolic syndrome and colorectal carcinoma. ANZ J Surg 80, 331–336 (2010)

    Article  PubMed  Google Scholar 

  26. C. Pelucchi, E. Negri, R. Talamini, F. Levi, A. Giacosa et al., Metabolic syndrome is associated with colorectal cancer in men. Eur J Cancer 46, 1866–1872 (2010)

    Article  PubMed  Google Scholar 

  27. K. Aleksandrova, H. Boeing, M. Jenab, H. Bas Bueno-de-Mesquita, E. Jansen et al., Metabolic syndrome and risks of colon and rectal cancer: the European Prospective Investigation into Cancer and Nutrition Study. Cancer Prev Res (Phila) 4, 1873–1883 (2011)

    Article  CAS  Google Scholar 

  28. G.C. Kabat, M.Y. Kim, U. Pete, M. Stefanick, L. Hou et al., A longitudinal study of the metabolic syndrome and risk of colorectal cancer in postmenopausal women. Eur J Cancer Prev 21, 326–332 (2012)

    Article  PubMed  CAS  Google Scholar 

  29. Y. Osaki, S.-I. Taniguchi, A. Tahara, M. Okamoto, T. Kishimoto, Metabolic syndrome and incidence of liver and breast cancers in Japan. Cancer Epidemiol 36, 141–147 (2012)

    Article  PubMed  Google Scholar 

  30. V. Ulaganathan, M. Kandiah, M.S. Zalilah, J.A. Faizal, H. Fijeraid et al., Colorectal cancer and its association with the metabolic syndrome: a Malaysian multi-centric case–control study. Asian J Cancer Prev 13, 3873–3877 (2012)

    Article  CAS  Google Scholar 

  31. S.D. Hursting, M.J. Hursting, Growth signals, inflammation, and vascular perturbations: mechanistic links between obesity, metabolic syndrome, and cancer. Arterioscler Thromb Vasc Biol 32, 1766–1770 (2012)

    Article  PubMed  CAS  Google Scholar 

  32. G. Ho, T. Wang, M.J. Gunter, H.D. Strickler, M. Cushman et al., Adipokines linking obesity with colorectal cancer risk in postmenopausal women. Cancer Res 72, 3029–3037 (2012)

    Article  PubMed  CAS  Google Scholar 

  33. X.F. Huang, J.Z. Chen, Obesity, the PI3K/Akt signal pathway and colon cancer. Obes Rev 10, 610–616 (2009)

    Article  PubMed  CAS  Google Scholar 

  34. A.A. Moghaddam, M. Woodward, R. Huxley, Obesity and risk of colorectal cancer: a meta-analysis of 31 studies with 70000 events. Cancer Epidemiol Biomarkers Prev 16, 2533–2547 (2007)

    Article  PubMed  Google Scholar 

  35. E. Giovannucci, D. Michaud, The role of obesity and related metabolic disturbances in cancers of the colon, prostate, and pancreas. Gastroenterology 132, 2208–2225 (2007)

    Article  PubMed  CAS  Google Scholar 

  36. T. Pischon, P.H. Lahmann, H. Boeing, C. Friedenreich, T. Norat et al., Body size and risk of colon and rectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC). J Natl Cancer Inst 98, 920–931 (2006)

    Article  PubMed  Google Scholar 

  37. J.Y. Park, P.N. Mitrou, R.H. Keogh, R.N. Luben, N.J. Wareham et al., Self-reported and measured anthropometric data and risk of colorectal cancer in the EPIC-Norfolk study. Intern J Obes 36, 107–118 (2012)

    Article  CAS  Google Scholar 

  38. S.C. Larsson, N. Orsini, A. Wolk, Diabetes mellitus and risk of colorectal cancer: a meta-analysis. J Natl Cancer Inst 97, 1679–1687 (2005)

    Article  PubMed  Google Scholar 

  39. H.U. Krämer, B. Schöttker, E. Raum, H. Brenner, Type 2 diabetes mellitus and colorectal cancer: meta-analysis on sex-specific differences. Eur J Cancer 48, 1269–1282 (2012)

    Article  PubMed  Google Scholar 

  40. S.H. Saydah, E.A. Platz, N. Rifai, M.N. Pollak, F.L. Brancati et al., Association of markers of insulin and glucose control with subsequent colorectal cancer risk. Cancer Epidemiol Biomarkers Prev 12, 412–418 (2003)

    PubMed  CAS  Google Scholar 

  41. M. Tsushima, A.M. Nomura, J. Lee, G.N. Stemmermann, Prospective study of the association of serum triglyceride and glucose with colorectal cancer. Dig Dis Sci 50, 499–505 (2005)

    Article  PubMed  Google Scholar 

  42. W. Borena, T. Stocks, H. Jonsson, S. Strohmaier, G. Nagel et al., Serum triglycerides and cancer risk in the metabolic syndrome and cancer (Me–Can) collaborative study. Cancer Causes Control 22, 291–299 (2011)

    Article  PubMed  Google Scholar 

  43. H. Ulmer, W. Borena, K. Rapp, J. Klenk, A. Strasak et al., Serum triglyceride concentrations and cancer risk in a large cohort study in Austria. Br J Cancer 101, 1202–1206 (2009)

    Article  PubMed  CAS  Google Scholar 

  44. F.J.B. van Duijnhoven, H.B. Bueno-De-Mesquita, M. Calligaro, M. Jenab, T. Pischon et al., Blood lipid and lipoprotein concentrations and colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition. Gut 60, 1094–1102 (2011)

    Article  PubMed  Google Scholar 

  45. N.M. Maruthur, S. Bolen, K. Gudzune, F.L. Brancati, J.M. Clark, Body mass index and colon cancer screening: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev 21, 737–746 (2012)

    Article  PubMed  Google Scholar 

  46. L. Li, H.L. Huang, X.Y. Zhang, Z.H. LV, Association of metabolic syndrome and colorectal cancer. Zhonghua Wei Chang Wai Ke Za Zhi 14, 848–851 (2011)

    Google Scholar 

  47. K. Aleksandrova, H. Boeing, M. Jenab, H.B. Bueno-de-Mesquita, E. Jansen et al., Total and high-molecular weight adiponectin and risk of colorectal cancer: the European Prospective Investigation into Cancer and Nutrition Study. Carcinogenesis 33, 1211–1218 (2012)

    Article  PubMed  Google Scholar 

  48. K. Esposito, D. Giugliano, Lifestyle and adiponectin level: four-year follow-up of controlled trials. Arch. Intern. Med. 170, 1270–1271 (2010)

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Cardio-thoracic and Respiratory Sciences, Second University of Naples, Naples, Italy

    Katherine Esposito

  2. Department of Medicine and Public Health, Second University of Naples, Naples, Italy

    Paolo Chiodini

  3. Department of Experimental Medicine, Second University of Naples, Naples, Italy

    Annalisa Capuano & Concetta Rafaniello

  4. Department of Geriatrics and Metabolic Diseases, Second University of Naples, Naples, Italy

    Giuseppe Bellastella, Maria Ida Maiorino & Dario Giugliano

  5. Department of Nutrition and Dietetics, Harokopio University, Athens, Greece

    Demosthenes B. Panagiotakos

  6. Division of Endocrinology, Diabetes, and Metabolic Diseases, Piazza L. Miraglia 2, 80138, Naples, Italy

    Katherine Esposito

Authors
  1. Katherine Esposito
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paolo Chiodini
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Annalisa Capuano
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Giuseppe Bellastella
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Maria Ida Maiorino
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Concetta Rafaniello
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Demosthenes B. Panagiotakos
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Dario Giugliano
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Katherine Esposito.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 350 kb)

Supplementary material 2 (DOCX 25 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Esposito, K., Chiodini, P., Capuano, A. et al. Colorectal cancer association with metabolic syndrome and its components: a systematic review with meta-analysis. Endocrine 44, 634–647 (2013). https://doi.org/10.1007/s12020-013-9939-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12020-013-9939-5

Keywords

Search

Navigation