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

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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., Kaaks, R., Friedenreich, C., Bonnet, F., Laville, M., Tjonneland, A., Olsen, A., Overvad, K., Jakobsen, M.U., Chajes, V., Clavel-Chapelon, F., Boutron-Ruault, M.C., Linseisen, J., Lukanova, A., Boeing, H., Pischon, T., Trichopoulou, A., Christina, B., Trichopoulos, D., Palli, D., Berrino, F., Panico, S., Tumino, R., Sacerdote, C., Gram, I.T., Lund, E., Quiros, J.R., Travier, N., Martinez-Garcia, C., Larranaga, N., Chirlaque, M.D., Ardanaz, E., Berglund, G., Lundin, E., Bueno-de-Mesquita, H.B., van Duijnhoven, F.J.B., Peeters, P.H.M., Bingham, S., Khaw, K.T., Allen, N., Key, T., Ferrari, P., Rinaldi, S., 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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