Clustering of metabolic risk factors and cancer risk: a Self-Organizing Map approach

Abstract

Background: We examined the synergistic effects of multiple metabolic risk factors (MRFs) and cancer risk among Iranian adults. Methods: Among 8593 (3929 men) participants aged ≥30 years, the Self-organizing map (SOM) was applied to clustering of four MRFs including high fasting plasma glucose (HFPG), high total cholesterol (HTC), high systolic blood pressure (HSBP) and high body mass index (HBMI). The Cox proportional hazards model was used to investigate the association between clusters with cancer incidence during a median of 14.0 years. Results: About 32 and 40% of men and women, respectively, had three or four MRFs. We identified seven clusters of MRFs in both men and women. In both genders, MRFs were clustered in those with older age. Further, inverse associations were found between smoking in men and education level in women and clustering of MRFs. In men, a cluster with 100% HSBP and HBMI had the highest risk for overall cancer. While, among women, a cluster with 100% HFPG and 93% HBMI yielded the highest risk for cancer. The risk was decreased when HBMI accompanied by HTC. Conclusions: Clustering patterns may reflect underlying link between MRFs and cancer and could potentially facilitate tailored health promotion interventions.