Metabolic syndrome and endometrial cancer: a meta-analysis

Abstract

We performed a systematic review and meta-analysis on the association of metabolic syndrome with endometrial cancer. A systematic literature search of electronic databases (Medline, ISI Web of Knowledge and Scopus) was conducted and complemented by cross-referencing to identify studies published before 31 January 2013. Core items of identified studies were independently extracted by two reviewers, and results were summarized by random effects meta-analysis. We identified six studies, which reported on 3,132 cancer cases. Metabolic syndrome was associated with an increased risk of endometrial cancer (RR: 1.89, 95 % CI 1.34-2.67, P < 0.001), with significant heterogeneity among studies (I (2) = 92 %, P < 0.001), but no indication for publication bias in the Egger's test (P = 0.240). A sensitivity analysis omitting two studies produced no heterogeneity (I (2) = 0 %) and attenuated the association (RR: 1.39, 1.31-1.48, P < 0.001). The risk estimates for any single factor of the syndrome were 2.21 (P < 0.001) for higher values of body mass index and/or waist, 1.81 (P = 0.044) for hyperglycemia, 1.81 (P = 0.024) for higher blood pressure values, and 1.17 (P < 0.001) for high triglyceride levels; there was no significant association with low HDL-cholesterol. Metabolic syndrome is associated with an increased risk of endometrial cancer; among the components of the syndrome, obesity/high waist is that more strongly associated with endometrial cancer.

Insulin resistance and endometrial cancer risk: A systematic review and meta-analysis

“…Our findings are in concurrence with experimental studies demonstrating the involvement of insulin in the development of malignant endometrial histological features and anchorage-independent growth [57]. A recent metaanalysis of six studies reported a significant increased risk of EC in women with metabolic syndrome (relative risk: 1.89, 95% CI 1.34e2.67) [58]. However, metabolic syndrome does not include a direct insulin estimate.…”

Fatores preditivos para a ocorrência de pólipos endometriais em mulheres na pós-menopausa

“…Na análise do risco para pólipos endometriais, apresentaram maiores chances de desenvolvimento do pólipo as pacientes com IMC≥25 kg/m 2 , glicose ≥100 mg/dL e que apresentavam dislipidemia, diabetes e SM. Estudos epidemiológicos têm relatado associações de risco para o desenvolvimento do câncer endometrial com os componentes individuais da SM, incluindo obesidade, diabetes e hipertensão, com possível associação também com os pólipos endometriais [13][14][15] . Contudo, outras investigações têm demonstrado que, embora hipertensão, diabetes e obesidade sejam variáveis significativamente associadas aos pólipos endometriais, estas perdem significância quando são realizados estudos de regressão logística multivariada ajustada para a idade 6,9 .…”

“…RI e distúrbios do metabolismo de carboidratos são comuns em mulheres com doenças endometriais 12 . Dos componentes envolvidos na SM, a obesidade abdominal pode ser considerada como o elemento-chave no desenvolvimento da neoplasia endometrial, porém parece haver também significância nessa associação com hiperglicemia, hipertrigliceridemia e hipertensão arterial 15 . As mulheres com pólipo endometrial tiveram mais filhos quando comparadas ao Grupo Controle (média de 3,8 versus 2,8 filhos).…”

“…Resistência à insulina e distúrbios do metabolismo de carboidratos são comuns em mulheres com doenças endometriais 12 . Estudos epidemiológicos têm relatado associações de risco de desenvolvimento do câncer endometrial com os componentes individuais da SM, com destaque para obesidade, hiperglicemia, hipertensão arterial e aumento nos níveis de triglicérides, o que poderia também associar a SM aos pólipos endometriais; porém, esse envolvimento permanece incerto [13][14][15] . A prevalência dos pólipos endometriais na pós-menopausa é bastante significativa, sendo causa comum de sangramento uterino anormal, o que ocasiona recorrentes discussões quanto à sua diferenciação com a neoplasia do endométrio.…”

Epidemiology: Disease Associations and Modulators of HDL-Related Biomarkers

“…Special interest has been recently focused on HDL in cancer patients. Several epidemiological studies have shown that low HDL-C level may be a risk and/or prognostic factor of biliary tract cancers (Andreotti et al 2008), prostate cancer (Mondul et al 2011;Kotani et al 2013), colon cancer (van Duijnhoven et al 2011), breast cancer (Furberg et al 2005, Melvin et al 2012) and gastric cancer (Tamura et al 2012), but not that of endometrial cancer (Cust et al 2007;Esposito et al 2014) or rectal cancer (van Duijnhoven et al 2011). Confounding factors related to obesity and metabolic syndrome may be more strongly associated with the latter cancer types (Kotani et al 2013).…”