Metabolic syndrome and total cancer mortality in the Third National Health and Nutrition Examination Survey
Open accessAbstract
Purpose Although metabolic syndrome incidence has substantially increased during the last few decades, it largely remains unclear whether this metabolic disorder is associated with total cancer mortality. The present study was carried out to investigate this important question.Methods A total of 687 cancer deaths were identified from 14,916 participants in the third National Health and Nutrition Examination Survey by linking them to the National Death Index database through December 31, 2006. Cox proportional hazards regression was performed to calculate hazard ratios (HR) and 95% confidence intervals (CI) for total cancer mortality in relation to metabolic syndrome and its individual components.Results After adjustment for confounders, a diagnosis of metabolic syndrome was associated with 33% elevated total cancer mortality. Compared with individuals without metabolic syndrome, those with 3, 4 and 5 abnormal components had HRs (95% CIs) of 1.28 (1.03-1.59), 1.24 (0.96-1.60), and 1.87 (1.34-2.63), respectively (p-trend = 0.0003). Systolic blood pressure and serum glucose were associated with an increased risk of death from total cancer [HR (95% CI) for highest vs. lowest quartiles: 1.67 (1.19-2.33), p-trend = 0.002 and 1.34 (1.04-1.74), p-trend = 0.003, respectively]. Overall null results were obtained for lung cancer mortality. The effects of metabolic syndrome and its components on non-lung cancer mortality were generally similar to, but somewhat larger than, those for total cancer mortality.Conclusion Our study is among the first to reveal that metabolic syndrome is associated with increased total cancer mortality.
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Metabolic syndrome is associated with a 33% elevated total cancer mortality.
“Metabolic syndrome is associated with a 33% elevated total cancer mortality (184).”
From Metabolic Flexibility as an Adaptation to Energy Resources and Requirements in Health and Disease (2018) · cites this paper as [184]
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Cites
Jemal, A., Bray, F., Ferlay, J., Ward, E., & Forman, D. (2011) · CA A Cancer Journal for Clinicians · doi:10.3322/caac.20107 · Cited by 54,708 · see citing works
Global cancer statistics, 2012
Torre, L. A., Bray, F., Siegel, R. L., Ferlay, J., Lortet‐Tieulent, J., & Jemal, A. (2015) · CA A Cancer Journal for Clinicians · doi:10.3322/caac.21262 · Cited by 26,858 · see citing works
Alberti, K. G. M. M., Eckel, R. H., Grundy, S. M., Zimmet, P. Z., Cleeman, J. I., Donato, K. A., Fruchart, J.-C., James, W. P. T., Loria, C. M., & Smith, S. C. (2009) · Circulation · doi:10.1161/circulationaha.109.192644 · Cited by 14,860 · see citing works
Siegel, R. L., Miller, K. D., & Jemal, A. (2015) · CA A Cancer Journal for Clinicians · doi:10.3322/caac.21254 · Cited by 11,854 · see citing works
Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. Adults
Calle, E. E., Rodriguez, C., Walker-Thurmond, K., & Thun, M. J. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa021423 · Cited by 7,696 · see citing works
Finucane, M. M., Stevens, G. A., Cowan, M. J., Danaei, G., Lin, J. K., Paciorek, C. J., Singh, G. M., Gutierrez, H. R., Lu, Y., Bahalim, A. N., et al. (2011) · The Lancet · doi:10.1016/s0140-6736(10)62037-5 · Cited by 4,050 · see citing works
Purposeful selection of variables in logistic regression
Bursac, Z., Gauss, C. H., Williams, D. K., & Hosmer, D. W. (2008) · Source Code for Biology and Medicine · doi:10.1186/1751-0473-3-17 · Cited by 4,035 · see citing works
Park, Y.-W., Zhu, S., Palaniappan, L., Heshka, S., Carnethon, M. R., & Heymsfield, S. B. (2003) · Archives of Internal Medicine · doi:10.1001/archinte.163.4.427 · Cited by 2,074 · see citing works
Service, P. H. (1994) · PubMed · Cited by 740 · see citing works
American Society of Clinical Oncology Position Statement on Obesity and Cancer
Ligibel, J. A., Alfano, C. M., Courneya, K. S., Demark‐Wahnefried, W., Burger, R. A., Chlebowski, R. T., Fabian, C. J., Gucalp, A., Hershman, D. L., Hudson, M. M., et al. (2014) · Journal of Clinical Oncology · doi:10.1200/jco.2014.58.4680 · Cited by 528 · see citing works
Visceral obesity, metabolic syndrome, insulin resistance and cancer
Doyle, S. L., Donohoe, C. L., Lysaght, J., & Reynolds, J. V. (2011) · Proceedings of The Nutrition Society · doi:10.1017/s002966511100320x · Cited by 307 · see citing works
The Role of Obesity in Cancer Survival and Recurrence
Demark‐Wahnefried, W., Platz, E. A., Ligibel, J. A., Blair, C. K., Courneya, K. S., Meyerhardt, J. A., Ganz, P. A., Rock, C. L., Schmitz, K. H., Wadden, T. A., et al. (2012) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-12-0485 · Cited by 295 · see citing works
Stocks, T., Hemelrijck, M. V., Manjer, J., Bjørge, T., Ulmer, H., Hallmans, G., Lindkvist, B., Selmer, R. M., Nagel, G., Tretli, S., et al. (2012) · Hypertension · doi:10.1161/hypertensionaha.111.189258 · Cited by 286 · see citing works
Effect of obesity and other lifestyle factors on mortality in women with breast cancer
Maso, L. D., Zucchetto, A., Talamini, R., Serraino, D., Stocco, C. F., Vercelli, M., Falcini, F., Franceschi, S., & for Prospective Analysis of Case‐control studies on Environmental factors and health (PACE) study group (2008) · International Journal of Cancer · doi:10.1002/ijc.23747 · Cited by 239 · see citing works
Colorectal cancer mortality and factors related to the insulin resistance syndrome.
Colangelo, L. A., Gapstur, S. M., Gann, P. H., Dyer, A. R., & Liu, K. (2002) · PubMed · Cited by 236 · see citing works
Waist circumference and waist/hip ratio in relation to all-cause mortality, cancer and sleep apnea
Seidell, J. C. (2009) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2009.71 · Cited by 231 · see citing works
Is there an association between hypertension and cancer mortality?
Grossman, E., Messerli, F. H., Boyko, V., & Goldbourt, U. (2002) · The American Journal of Medicine · doi:10.1016/s0002-9343(02)01049-5 · Cited by 209 · see citing works
Cancer, obesity, diabetes, and antidiabetic drugs: is the fog clearing?
Klil-Drori, A. J., Azoulay, L., & Pollak, M. (2016) · Nature Reviews Clinical Oncology · doi:10.1038/nrclinonc.2016.120 · Cited by 207 · see citing works
Impact of the Obesity Epidemic on Cancer
Goodwin, P. J., & Stambolic, V. (2014) · Annual Review of Medicine · doi:10.1146/annurev-med-051613-012328 · Cited by 204 · see citing works
Esposito, K., Chiodini, P., Capuano, A., Bellastella, G., Maiorino, M. I., Rafaniello, C., Panagiotakos, D. B., & Giugliano, D. (2013) · Endocrine · doi:10.1007/s12020-013-9939-5 · Cited by 197 · see citing works
Prevalence of metabolic syndrome and gender differences
Beigh, S. H., & Jain, S. (2012) · Bioinformation · doi:10.6026/97320630008613 · Cited by 195 · see citing works
Markers of insulin resistance and colorectal cancer mortality.
Trevisan, M., Liu, J., Muti, P. C., Misciagna, G., Menotti, A., & Fucci, F. (2001) · PubMed · Cited by 189 · see citing works
Metabolic Syndrome and Breast Cancer in the Me-Can (Metabolic Syndrome and Cancer) Project
Bjørge, T., Lukanova, A., Jönsson, H., Tretli, S., Ulmer, H., Manjer, J., Stocks, T., Selmer, R. M., Nagel, G., Almquist, M., et al. (2010) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-10-0230 · Cited by 183 · see citing works
Hypertension, serum lipids and cancer risk: A review of epidemiological evidence
Radišauskas, R., Kuzmickienė, I., Milinavičienė, E., et al. (2016) · Medicina · doi:10.1016/j.medici.2016.03.002 · Cited by 168 · see citing works
Epidemiology of the metabolic syndrome in the USA
McCullough, A. J. (2010) · Journal of Digestive Diseases · doi:10.1111/j.1751-2980.2010.00469.x · Cited by 146 · see citing works
Gallagher, E. J., & LeRoith, D. (2013) · Diabetes Care · doi:10.2337/dcs13-2001 · Cited by 145 · see citing works
Metabolic profile, physical activity, and mortality in breast cancer patients
Emaus, A., Veierød, M. B., Tretli, S., Finstad, S. E., Selmer, R. M., Furberg, A.-S., Bernstein, L., Schlichting, E., & Thune, I. (2009) · Breast Cancer Research and Treatment · doi:10.1007/s10549-009-0603-y · Cited by 142 · see citing works
Metabolic syndrome and postmenopausal breast cancer
Esposito, K., Chiodini, P., Capuano, A., Bellastella, G., Maiorino, M. I., Rafaniello, C., & Giugliano, D. (2013) · Menopause The Journal of The North American Menopause Society · doi:10.1097/gme.0b013e31828ce95d · Cited by 140 · see citing works
Growth Signals, Inflammation, and Vascular Perturbations
Hursting, S. D., & Hursting, M. J. (2012) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/atvbaha.111.241927 · Cited by 132 · see citing works
Batty, G. D., Shipley, M. J., Marmot, M. G., & Smith, G. D. (2004) · Cancer Causes & Control · doi:10.1007/s10552-004-1050-z · Cited by 131 · see citing works
Metabolic syndrome and risk of cancer mortality in men
Jaggers, J. R., Sui, X., Hooker, S. P., LaMonte, M. J., Matthews, C. E., Hand, G. A., & Blair, S. N. (2009) · European Journal of Cancer · doi:10.1016/j.ejca.2009.01.031 · Cited by 117 · see citing works
Perseghin, G., Calori, G., Lattuada, G., Ragogna, F., Dugnani, E., Garancini, M. P., Crosignani, P., Villa, M., Bosi, E., Ruotolo, G., et al. (2012) · Acta Diabetologica · doi:10.1007/s00592-011-0361-2 · Cited by 110 · see citing works
Nago, N., Ishikawa, S., Goto, T., et al. (2010) · Journal of Epidemiology · doi:10.2188/jea.je20100065 · Cited by 106 · see citing works
Conceptualizing overdiagnosis in cancer screening
Marcus, P. M., Prorok, P. C., Miller, A. B., DeVoto, E. J., & Kramer, B. S. (2015) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djv014 · Cited by 90 · see citing works
Insulin and IGFs in Obesity-Related Breast Cancer
Belardi, V., Gallagher, E. J., Novosyadlyy, R., & LeRoith, D. (2013) · Journal of Mammary Gland Biology and Neoplasia · doi:10.1007/s10911-013-9303-7 · Cited by 89 · see citing works
Obesity and breast cancer: role of inflammation and aromatase
Simpson, E. R., & Brown, K. A. (2013) · Journal of Molecular Endocrinology · doi:10.1530/jme-13-0217 · Cited by 88 · see citing works
Diabetes and cancer, common threads and missing links
Hua, F., Yu, J., & Hu, Z. (2016) · Cancer Letters · doi:10.1016/j.canlet.2016.02.006 · Cited by 79 · see citing works
Grundmark, B., Garmo, H., Loda, M. F., et al. (2010) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-10-0112 · Cited by 78 · see citing works
Xiang, Y., Xiong, H., Cui, Z.-L., et al. (2013) · Journal of Experimental & Clinical Cancer Research · doi:10.1186/1756-9966-32-9 · Cited by 76 · see citing works
Younossi, Z. M., Zheng, L., Stepanova, M., Venkatesan, C., & Mir, H. M. (2013) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.12265 · Cited by 75 · see citing works
Obesity and Mortality from Cancer
Adami, H., & Trichopoulos, D. (2003) · New England Journal of Medicine · doi:10.1056/nejmp030029 · Cited by 75 · see citing works
Obesity: Focus on all-cause mortality and cancer
Teucher, B., Rohrmann, S., & Kaaks, R. (2009) · Maturitas · doi:10.1016/j.maturitas.2009.11.018 · Cited by 74 · see citing works
Metabolic syndrome and cancer-related mortality among Korean men and women
Lee, J. S., Cho, S., & Park, H. S. (2009) · Annals of Oncology · doi:10.1093/annonc/mdp344 · Cited by 59 · see citing works
Gołąbek, T., Bukowczan, J., Chłosta, P. L., Powroźnik, J., Dobruch, J. T., & Borówka, A. (2013) · Urologia Internationalis · doi:10.1159/000351325 · Cited by 57 · see citing works
Insulin–Insulin-Like Growth Factor Axis and Colon Cancer
Sridhar, S. S., & Goodwin, P. J. (2008) · Journal of Clinical Oncology · doi:10.1200/jco.2008.19.8937 · Cited by 56 · see citing works
Metabolic syndrome and risk of death from cancers of the digestive system
Matthews, C. E., Sui, X., LaMonte, M. J., Adams, S. A., Hébert, J. R., & Blair, S. N. (2010) · Metabolism · doi:10.1016/j.metabol.2009.11.019 · Cited by 53 · see citing works
Blood pressure and site-specific cancer mortality: evidence from the original Whitehall study
Batty, G. D., Shipley, M. J., Marmot, M. G., & Smith, G. D. (2003) · British Journal of Cancer · doi:10.1038/sj.bjc.6601255 · Cited by 50 · see citing works
Parekh, N., Lin, Y., Hayes, R. B., Albu, J., & Lu‐Yao, G. L. (2010) · Cancer Causes & Control · doi:10.1007/s10552-009-9492-y · Cited by 41 · see citing works
Effect of Elevated Basal Insulin on Cancer Incidence and Mortality in Cancer Incident Patients
Dankner, R. S., Shanik, M. H., Keinan‐Boker, L., Cohen, C., & Chetrit, A. (2012) · Diabetes Care · doi:10.2337/dc11-1513 · Cited by 40 · see citing works
Impact of body mass index on breast cancer in accordance with the life-stage of women
Suzuki, R., Saji, S., & Toi, M. (2012) · Frontiers in Oncology · doi:10.3389/fonc.2012.00123 · Cited by 33 · see citing works
Metabolic Profile of Breast Cancer in a Population of Women in Southern Spain
López‐Sáez, J. B., Martinez-Rubio, J. A., Alvarez, M. M., et al. (2008) · The Open Clinical Cancer Journal · doi:10.2174/1874189400802010001 · Cited by 16 · see citing works
Inflammation and cancer: Partners in crime
Hoenerhoff, M. J. (2015) · The Veterinary Journal · doi:10.1016/j.tvjl.2015.07.007 · Cited by 6 · see citing works
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Metabolic Flexibility as an Adaptation to Energy Resources and Requirements in Health and Disease
Smith, R. L., Soeters, M. R., Wüst, R. C. I., & Houtkooper, R. H. (2018) · Endocrine Reviews · doi:10.1210/er.2017-00211 · Cited by 787 · see citing works
- Authors
- Gathirua-Mwangi, W. G., Monahan, P. O., Murage, M. J., & Zhang, J.
- Affiliations
- Indiana University Health (US)
- Indiana University Indianapolis (US)
- Corresponding author
- Zhang, Jianjun
- Venue
- Cancer Causes & Control
- Published
- 2017-01-17
- Volume
- 28
- Issue
- 2
- Pages
- 127-136
- ISSN
- 0957-5243 (ISSN-L)
- 1573-7225
- PMC
- PMC5308139
- OpenAlex
- W2572585796
- Cited by
- 52
- References
- 52
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 4 · 2023: 7 · 2022: 7 · 2021: 7 · 2020: 6 · 2019: 6 · 2018: 8 · 2017: 2
- FWCI
- 2.65
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cancer Causes & Control (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- IUScholarWorks (Indiana University) (submittedVersion)
- Purdue University Indianapolis (Indiana University) (submittedVersion)
- Funders
- National Cancer Institute (R25 CA117865-07S1, K05CA175048, 3R01CA196243-02S1)
- Topics
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
- Keywords
- metabolic syndrome, cancer mortality, systolic blood pressure, serum glucose, metabolic syndrome components, lung cancer mortality, NHANES
- MeSH terms
- Adult, Aged, Blood Glucose, Blood Pressure, Female, Humans, Male, Middle Aged, Neoplasms, Nutrition Surveys, Risk Factors, Triglycerides, Incidence, Databases, Factual, Metabolic Syndrome, Waist Circumference, Young Adult
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