TY - JOUR
T1 - Metabolic syndrome, plasma lipid, lipoprotein and glucose levels, and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)
AU - Cust, Anne E.
AU - Kaaks, Rudolf
AU - Friedenreich, Christine
AU - Bonnet, Fabrice
AU - Laville, Martine
AU - Tjonneland, Anne
AU - Olsen, Anja
AU - Overvad, Kim
AU - Jakobsen, Marianne Uhre
AU - Chajes, Veronique
AU - Clavel-Chapelon, Frangoise
AU - Boutron-Ruault, Marie-Christine
AU - Linseisen, Jakob
AU - Lukanova, Annekatrin
AU - Boeing, Heiner
AU - Pischon, Tobias
AU - Trichopoulou, Antonia
AU - Christina, Bamia
AU - Trichopoulos, Dimitrios
AU - Palli, Domenico
AU - Berrino, Franco
AU - Panico, Salvatore
AU - Tumino, Rosario
AU - Sacerdote, Carlotta
AU - Gram, Inger Torhild
AU - Lund, Eiliv
AU - Quiros, J. R.
AU - Travier, Nomie
AU - Garcia, Carmen Martinez
AU - Larranaga, Nerea
AU - Chirlaque, Maria-Dolores
AU - Ardanaz, Eva
AU - Berglund, Goran
AU - Lundin, Eva
AU - Bueno-De-Mesquita, H. Bas
AU - Franzel, J. B. van Duijnhoven
AU - Peeters, Petra H. M.
AU - Bingham, Sheila
AU - Khaw, Kay-Tee
AU - Allen, Naomi
AU - Key, Tim
AU - Ferrari, Pietro
AU - Rinaldi, Sabina
AU - Slimani, Nadia
AU - Riboli, Elio
PY - 2007
Y1 - 2007
N2 - 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 (FR) 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% Cl 0.99-2.90), P-trend, = 0.03), which appeared stronger among postmenopausal women (BMI-adjusted RR top versus bottom tertile 2.61 (95% Cl 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.
AB - 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 (FR) 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% Cl 0.99-2.90), P-trend, = 0.03), which appeared stronger among postmenopausal women (BMI-adjusted RR top versus bottom tertile 2.61 (95% Cl 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.
U2 - 10.1677/ERC-07-0132
DO - 10.1677/ERC-07-0132
M3 - Journal article
SN - 1351-0088
VL - 14
SP - 755
EP - 767
JO - Endocrine - Related Cancer
JF - Endocrine - Related Cancer
IS - 3
ER -