Colorectal Cancer Association with Metabolic Syndrome and Its Components: a Systematic Review with Meta-analysis

Overview

Journal Endocrine

Specialty Endocrinology

Date 2013 Apr 3

PMID 23546613

Citations 95

Authors

Katherine Esposito

Paolo Chiodini

Annalisa Capuano

Giuseppe Bellastella

Maria Ida Maiorino

Concetta Rafaniello

Demosthenes B Panagiotakos

Dario Giugliano

Affiliations

Soon will be listed here.

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.

Citing Articles

Examining associations of digestive system cancer with hypertension and diabetes using network analysis in older patients.

Hashimoto H, Nojiri S, Takeda T, Urasaki W, Nishizaki Y, Nagahara A Sci Rep. 2025; 15(1):6458.

PMID: 39987328 PMC: 11846871. DOI: 10.1038/s41598-025-90734-5.

Fracture Risk Assessment in Metabolic Syndrome in Terms of Secondary Osteoporosis Potential. A Narrative Review.

Armutcu F, McCloskey E Calcif Tissue Int. 2025; 116(1):41.

PMID: 39979438 PMC: 11842537. DOI: 10.1007/s00223-025-01341-5.

Association of "a body shape index" with the risk of developing colorectal cancer in U.S. patients with metabolic syndrome: evidence from the NHANES 1999-2018.

Kurexi A, Peng J, Yao J, Wang L, Wang Q BMC Gastroenterol. 2024; 24(1):447.

PMID: 39627686 PMC: 11613469. DOI: 10.1186/s12876-024-03537-9.

Triglyceride-glucose index (TyG index) is associated with a higher risk of colorectal adenoma and multiple adenomas in asymptomatic subjects.

Zhu Z, Lam T, Tang R, Wong S, Lui R, Ng S PLoS One. 2024; 19(11):e0310526.

PMID: 39509387 PMC: 11542827. DOI: 10.1371/journal.pone.0310526.

Mass Spectrometry Proteomics Characterization of Plasma Biomarkers for Colorectal Cancer Associated With Inflammation.

Urbiola-Salvador V, Jablonska A, Miroszewska D, Kamysz W, Duzowska K, Drezek-Chyla K Biomark Insights. 2024; 19:11772719241257739.

PMID: 38911905 PMC: 11191626. DOI: 10.1177/11772719241257739.

References

Higgins J, Thompson S . Quantifying heterogeneity in a meta-analysis. Stat Med. 2002; 21(11):1539-58. DOI: 10.1002/sim.1186. View

Huang X, Chen J . Obesity, the PI3K/Akt signal pathway and colon cancer. Obes Rev. 2009; 10(6):610-6. DOI: 10.1111/j.1467-789X.2009.00607.x. View

Borena W, Stocks T, Jonsson H, Strohmaier S, Nagel G, Bjorge T . Serum triglycerides and cancer risk in the metabolic syndrome and cancer (Me-Can) collaborative study. Cancer Causes Control. 2010; 22(2):291-9. DOI: 10.1007/s10552-010-9697-0. View

Matthews C, Sui X, LaMonte M, Adams S, Hebert J, Blair S . Metabolic syndrome and risk of death from cancers of the digestive system. Metabolism. 2010; 59(8):1231-9. PMC: 2891079. DOI: 10.1016/j.metabol.2009.11.019. View

Esposito K, Chiodini P, Colao A, Lenzi A, Giugliano D . Metabolic syndrome and risk of cancer: a systematic review and meta-analysis. Diabetes Care. 2012; 35(11):2402-11. PMC: 3476894. DOI: 10.2337/dc12-0336. View

Pischon T, Lahmann P, Boeing H, Friedenreich C, Norat T, Tjonneland A . Body size and risk of colon and rectal cancer in the European Prospective Investigation Into Cancer and Nutrition (EPIC). J Natl Cancer Inst. 2006; 98(13):920-31. DOI: 10.1093/jnci/djj246. View

Colangelo L, Gapstur S, Gann P, Dyer A, Liu K . Colorectal cancer mortality and factors related to the insulin resistance syndrome. Cancer Epidemiol Biomarkers Prev. 2002; 11(4):385-91. View

Egger M, Davey Smith G, Schneider M, Minder C . Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997; 315(7109):629-34. PMC: 2127453. DOI: 10.1136/bmj.315.7109.629. View

Stocks T, Lukanova A, Bjorge T, Ulmer H, Manjer J, Almquist M . Metabolic factors and the risk of colorectal cancer in 580,000 men and women in the metabolic syndrome and cancer project (Me-Can). Cancer. 2013; 117(11):2398-407. DOI: 10.1002/cncr.25772. View

10.

Hursting S, Hursting M . Growth signals, inflammation, and vascular perturbations: mechanistic links between obesity, metabolic syndrome, and cancer. Arterioscler Thromb Vasc Biol. 2012; 32(8):1766-70. DOI: 10.1161/ATVBAHA.111.241927. View

11.

Jinjuvadia R, Lohia P, Jinjuvadia C, Montoya S, Liangpunsakul S . The association between metabolic syndrome and colorectal neoplasm: systemic review and meta-analysis. J Clin Gastroenterol. 2012; 47(1):33-44. PMC: 3518571. DOI: 10.1097/MCG.0b013e3182688c15. View

12.

Kabat G, Kim M, Peters U, Stefanick M, Hou L, Wactawski-Wende J . A longitudinal study of the metabolic syndrome and risk of colorectal cancer in postmenopausal women. Eur J Cancer Prev. 2011; 21(4):326-32. PMC: 5759970. DOI: 10.1097/CEJ.0b013e32834dbc81. View

13.

Esposito K, Giugliano D . Lifestyle and adiponectin level: four-year follow-up of controlled trials. Arch Intern Med. 2010; 170(14):1270-1. DOI: 10.1001/archinternmed.2010.246. View

14.

van Houwelingen H, Arends L, Stijnen T . Advanced methods in meta-analysis: multivariate approach and meta-regression. Stat Med. 2002; 21(4):589-624. DOI: 10.1002/sim.1040. View

15.

Giovannucci E, Michaud D . The role of obesity and related metabolic disturbances in cancers of the colon, prostate, and pancreas. Gastroenterology. 2007; 132(6):2208-25. DOI: 10.1053/j.gastro.2007.03.050. View

16.

Shen Z, Wang S, Ye Y, Yin M, Yang X, Jiang K . Clinical study on the correlation between metabolic syndrome and colorectal carcinoma. ANZ J Surg. 2010; 80(5):331-6. DOI: 10.1111/j.1445-2197.2009.05084.x. View

17.

Aleksandrova K, Boeing H, Jenab M, Bueno-de-Mesquita H, Jansen E, van Duijnhoven F . Metabolic syndrome and risks of colon and rectal cancer: the European prospective investigation into cancer and nutrition study. Cancer Prev Res (Phila). 2011; 4(11):1873-83. DOI: 10.1158/1940-6207.CAPR-11-0218. View

18.

Park J, Mitrou P, Keogh R, Luben R, Wareham N, Khaw K . Self-reported and measured anthropometric data and risk of colorectal cancer in the EPIC-Norfolk study. Int J Obes (Lond). 2011; 36(1):107-18. DOI: 10.1038/ijo.2011.61. View

19.

Kontou N, Psaltopoulou T, Soupos N, Polychronopoulos E, Xinopoulos D, Linos A . Metabolic syndrome and colorectal cancer: the protective role of Mediterranean diet--a case-control study. Angiology. 2012; 63(5):390-6. DOI: 10.1177/0003319711421164. View

20.

Aleksandrova K, Boeing H, Jenab M, Bueno-de-Mesquita H, Jansen E, van Duijnhoven F . Total and high-molecular weight adiponectin and risk of colorectal cancer: the European Prospective Investigation into Cancer and Nutrition Study. Carcinogenesis. 2012; 33(6):1211-8. PMC: 3388489. DOI: 10.1093/carcin/bgs133. View