Metabolic syndrome, plasma lipid, lipoprotein and glucose levels, and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Item Type:	Article
Title:	Metabolic syndrome, plasma lipid, lipoprotein and glucose levels, and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)
Creators Name:	Cust, A.E. and Kaaks, R. and Friedenreich, C. and Bonnet, F. and Laville, M. and Tjonneland, A. and Olsen, A. and Overvad, K. and Jakobsen, M.U. and Chajes, V. and Clavel-Chapelon, F. and Boutron-Ruault, M.C. and Linseisen, J. and Lukanova, A. and Boeing, H. and Pischon, T. and Trichopoulou, A. and Christina, B. and Trichopoulos, D. and Palli, D. and Berrino, F. and Panico, S. and Tumino, R. and Sacerdote, C. and Gram, I.T. and Lund, E. and Quiros, J.R. and Travier, N. and Martinez-Garcia, C. and Larranaga, N. and Chirlaque, M.D. and Ardanaz, E. and Berglund, G. and Lundin, E. and Bueno-de-Mesquita, H.B. and van Duijnhoven, F.J.B. and Peeters, P.H.M. and Bingham, S. and Khaw, K.T. and Allen, N. and Key, T. and Ferrari, P. and Rinaldi, S. and Slimani, N. and Riboli, E.
Abstract:	To clarify the role of metabolic factors in endometrial carcinogenesis, we conducted a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), and examined the relation between prediagnostic plasma lipids, lipoproteins, and glucose, the metabolic syndrome (MetS; a cluster of metabolic factors) and endometrial cancer risk. Among pre- and postmenopausal women, 284 women developed endometrial cancer during follow-up. Using risk set sampling, 546 matched control subjects were selected. From conditional logistic regression models, high-density lipoprotein cholesterol (HDL-C) levels were inversely associated with risk body mass index (BMI)-adjusted relative risk (RR) for top versus bottom quartile 0.61 (95% confidence intervals (CI) 0.38-0.97), P(trend) = 0.02). Glucose levels were positively associated with risk (BMI-adjusted RR top versus bottom quartile 1.69 (95% CI 0.99-2.90), P(trend) = 0.03), which appeared stronger among postmenopausal women (BMI-adjusted RR top versus bottom tertile 2.61 (95% CI 1.46-4.66), P(trend) = 0.0006, P(heterogeneity) = 0.13) and never-users of exogenous hormones (P(heterogeneity) = 0.005 for oral contraceptive (OC) use and 0.05 for hormone replacement therapy-use). The associations of HDL-C and glucose with risk were no longer statistically significant after further adjustment for obesity-related hormones. Plasma total cholesterol, Low-density lipoprotein cholesterol (LDL-C), and triglycerides were not significantly related to overall risk. The presence of MetS was associated with risk (RR 2.12 (95% CI 1.51-2.97)), which increased with the number of MetS factors (P(trend) = 0.02). An increasing number of MetS factors other than waist circumference, however, was marginally significantly associated with risk only in women with waist circumference above the median (P(interaction) = 0.01). None of the associations differed significantly by fasting status. These findings suggest that metabolic abnormalities and obesity may act synergistically to increase endometrial cancer risk.
Keywords:	Adenocarcinoma, Blood Glucose, Case-Control Studies, Endometrial Neoplasms, Lipids, Lipoproteins, Metabolic Syndrome X, Nutritional Physiological Phenomena, Prospective Studies, Risk Factors
Source:	Endocrine-Related Cancer
ISSN:	1351-0088
Publisher:	HighWire Press
Volume:	14
Number:	3
Page Range:	755-767
Date:	1 September 2007
Official Publication:	https://doi.org/10.1677/ERC-07-0132
PubMed:	View item in PubMed

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