Original Article

International Journal of Obesity (2008) 32, 304–314; doi:10.1038/sj.ijo.0803713; published online 18 September 2007

Components of the metabolic syndrome and colorectal cancer risk; a prospective study

T Stocks1, A Lukanova2,3, M Johansson1, S Rinaldi4, R Palmqvist5, G Hallmans6, R Kaaks2 and P Stattin1

  1. 1Department of Surgical and Perioperative sciences, Urology and Andrology, Umeå University Hospital, Umeå, Sweden
  2. 2Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
  3. 3Department of Obstetrics and Gynecology, New York University School of Medicine, New York, USA
  4. 4Nutrition and Hormones group International Agency for Research on Cancer, Lyon, France
  5. 5Department of Medical Biosciences, Pathology, Umeå University Hospital, Umeå, Sweden
  6. 6Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University Hospital, Umeå, Sweden

Correspondence: T Stocks, Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University Hospital, 901 85 Umeå, Sweden. E-mail: tanja.stocks@urologi.umu.se

Received 7 May 2007; Revised 11 July 2007; Accepted 20 July 2007; Published online 18 September 2007.

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Abstract

Objective:

 

To examine the relation of well-known factors of the metabolic syndrome (MetS) as well as related circulating factors, with risk of colorectal cancer.

Methods:

 

We performed a case control study of 306 colorectal cancer cases and 595 matched controls nested in the Northern Sweden Health and Disease Cohort. Levels of C-peptide, glycated haemoglobin (HbA1c), leptin and adiponectin were measured in cryopreserved samples. Body mass index (BMI), systolic and diastolic blood pressure and fasting and post-load plasma glucose, had been measured in a subcohort. Conditional logistic regression was used to calculate odds ratios (OR) of disease, including risk assessments for the MetS factors: obesity (BMI>30 kg m-2), hypertension (blood pressure greater than or equal to140/90 mmHg or use of anti-hypertensive drugs) and hyperglycaemia (fasting glucose greater than or equal to6.1 mmol l-1 or post-load glucose in capillary plasma greater than or equal to8.9 mmol l-1).

Results:

 

None of the studied variables were significantly associated with risk across quartiles. Presence of obesity, hypertension and hyperglycaemia significantly increased the risk of colorectal cancer; OR for three vs null factors was 2.57 (95% Confidence Interval [CI] 1.20–5.52; P trend=0.0021), as compared to a 30 to 70% increased risk for the factors in single. Similarly, top decile levels of C-peptide, HbA1c and leptin/adiponectin ratio were associated with an increased risk; ORs for top vs deciles 1–9 were 1.56 (95% CI 0.93–2.62; P=0.090), 1.83 (95% CI 1.00–3.36; P=0.051) and 1.50 (95% CI 0.83–2.71; P=0.18), respectively.

Conclusions:

 

Our study support the view that components of the MetS increase risk of colorectal cancer, and further suggests that only very high levels of metabolic factors confer an increased risk.

Keywords:

colorectal neoplasms, insulin resistance, blood glucose, C-peptide, leptin

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