Metabolic syndrome is a risk factor for colorectal adenoma and cancer: a study in a White population using the harmonized criteria

Abstract

Background: Metabolic syndrome (MetS) has been associated with colorectal adenomas and cancer. However, MetS definitions have changed over time, leading to a heterogeneity of patients included in previous studies and a substantial inextensibility of observations across time or eastern and western populations. Our aim was to evaluate the association of ‘harmonized’ criteria-defined MetS and its individual components with colorectal neoplasia and cancer in a western population. Methods: In this multicenter, cross-sectional study, we prospectively evaluated consecutive outpatients who underwent open-access colonoscopy over a 3-month period. MetS was diagnosed according to the 2009 ‘harmonized’ criteria. Results: Out of 5707 patients enrolled, we found 213 cancers (3.7%), 1614 polyps (28.3%), 240 nonpolypoid lesions (4.2%), 95 laterally spreading tumors (1.6%). Polyps presented histological low-grade dysplasia in 72.9% of samples, while in 9.8%, high-grade dysplasia or in situ carcinoma was present; dysplasia rates for nonpolypoid lesions were 66.2% (low-grade) and 2.9% (high-grade/ in situ carcinoma), while for laterally spreading tumors, 29.6% and 37%, respectively. Overall, MetS prevalence was 41.6%. MetS correlated with both adenomas [odds ratio (OR): 1.76, 95% confidence interval (CI) 1.54–2.00] and cancer (OR: 1.92, 95% CI 1.42–2.58). MetS was the only risk factor for such colonic lesions in subjects younger than 50 years. For all colonic neoplasia, we found MetS and not its individual components to be significantly associated. Conclusions: MetS is risk factor for cancer and adenoma in Whites, especially when younger than 50 years. MetS patients might be considered as a high-risk population also in colorectal cancer screening programs.

The association of Metabolic Syndrome and its Components with the Incidence and Survival of Colorectal Cancer: A Systematic Review and Meta-analysis

“…Basic information concerning the eligible studies are listed in Tables 1 and 2. From 2006 to 2019, a total of 10 prospective cohort studies [18-21, 25, 34-38], 6 case-control studies [39][40][41][42][43][44], one retrospective cohort study [22] and one cross-sectional study [45] were included in the meta-analysis of CRC incidence, and 8 prospective cohort studies [25][26][27][46][47][48][49], 2 retrospective cohort study [50,51] and 3 case-control studies [52][53][54] were included in the meta-analysis for CRC mortality. Thirteen studies were conducted in Asia [21,22,27,37,38,42,43,46,48,[50][51][52]54], eight were performed in Europe [20, 25, 34, 39-41, 44, 45], and the remaining studies were executed in the USA [18,19,26,35,36,47,49].…”

Germination Improves the Polyphenolic Profile and Functional Value of Mung Bean (Vigna radiata L.)

“…This added to a survival rate of 10% after 5 years [5], and a limited treatment success with surgery or with 5-fluorouracil (5FU) combined with other agents, such as irinotecan, capecitabine or oxaliplatin, and monoclonal antibodies such as cetuximab and bevacizumab [6], emphasize the need to develop new effective strategies with therapeutic action. In recent years, a new approach for the prevention of the disease has been developed, acting on factors that increase the risk of this pathology, such as obesity and diabetes [7]. In this context, diet modulation has been suggested as a way of prevention/management against this type of tumor [8], even in combination with other cancer drugs such as 5FU [9].…”

Evaluation of Metabolic Syndrome as A Risk Factor for Colorectal Cancer

“…Also, our results were consistent with Harlid et al, (19) who found no significant difference between cases and controls regarding weight, height and BMI. In the study conducted by Milano et al, (20) there was highly statistically significant differences between Positive and negative colonoscopy patients regarding Waist circum- ference and BMI (p<0.001). Also, Stocks et al, (21) found that, the use of BMI as a measure of obesity is hampered by the finding that BMI is not a specific measure of abdominal fat mass, which is linked to metabolic aberrations, such as insulin resistance (22).…”