Metabolic syndrome, plasma lipid, lipoprotein and glucose levels, and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Anne E. Cust, Rudolf Kaaks, Christine Friedenreich, Fabrice Bonnet, Martine Laville, Anne Tjønneland, Anja Olsen, Kim Overvad, Marianne Uhre Jakobsen, Véronique Chajès, Françoise Clavel-Chapelon, Marie Christine Boutron-Ruault, Jakob Linseisen, Annekatrin Lukanova, Heiner Boeing, Tobias Pischon, Antonia Trichopoulou, Bamia Christina, Dimitrios Trichopoulos, Domenico PalliFranco Berrino, Salvatore Panico, Rosario Tumino, Carlotta Sacerdote, Inger Torhild Gram, Eiliv Lund, J. R. Quirós, Noémie Travier, Carmen Martínez-García, Nerea Larrañaga, María Dolores Chirlaque, Eva Ardanaz, Göran Berglund, Eva Lundin, H. Bas Bueno-De-Mesquita, Fränzel J B Van Duijnhoven, Petra H M Peeters, Sheila Bingham, Kay Tee Khaw, Naomi Allen, Tim Key, Pietro Ferrari, Sabina Rinaldi, Nadia Slimani, Eho Riboli

Research output: Contribution to journalArticle

Abstract

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 (RR) for top versus bottom quartile 0.61 (95% confidence intervals (CI) 0.38-0.97), Ptrend = 0.02). Glucose levels were positively associated with risk (BMI-adjusted RR top versus bottom quartile 1.69 (95% CI 0.99-2.90), Ptrend = 0.03), which appeared stronger among postmenopausal women (BMI-adjusted RR top versus bottom fertile 2.61 (95% CI 1.46-4.66), Ptrend = 0.0006, Pheterogeneity = 0.13) and never-users of exogenous hormones (Pheterogeneity = 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 (Ptrend = 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 (Pinteraction = 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.

Original languageEnglish
Pages (from-to)755-767
Number of pages13
JournalEndocrine-Related Cancer
Volume14
Issue number3
DOIs
Publication statusPublished - Sep 2007

Fingerprint

Endometrial Neoplasms
Lipoproteins
Lipids
Glucose
Neoplasms
Confidence Intervals
Body Mass Index
Waist Circumference
HDL Cholesterol
Obesity
Logistic Models
Hormones
Hormone Replacement Therapy
Oral Contraceptives
LDL Cholesterol
Case-Control Studies
Fasting
Carcinogenesis
Cholesterol

ASJC Scopus subject areas

  • Endocrinology
  • Oncology
  • Cancer Research
  • Endocrinology, Diabetes and Metabolism

Cite this

Metabolic syndrome, plasma lipid, lipoprotein and glucose levels, and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). / Cust, Anne E.; Kaaks, Rudolf; Friedenreich, Christine; Bonnet, Fabrice; Laville, Martine; Tjønneland, Anne; Olsen, Anja; Overvad, Kim; Jakobsen, Marianne Uhre; Chajès, Véronique; Clavel-Chapelon, Françoise; Boutron-Ruault, Marie Christine; Linseisen, Jakob; Lukanova, Annekatrin; Boeing, Heiner; Pischon, Tobias; Trichopoulou, Antonia; Christina, Bamia; Trichopoulos, Dimitrios; Palli, Domenico; Berrino, Franco; Panico, Salvatore; Tumino, Rosario; Sacerdote, Carlotta; Gram, Inger Torhild; Lund, Eiliv; Quirós, J. R.; Travier, Noémie; Martínez-García, Carmen; Larrañaga, Nerea; Chirlaque, María Dolores; Ardanaz, Eva; Berglund, Göran; Lundin, Eva; Bueno-De-Mesquita, H. Bas; Van Duijnhoven, Fränzel J B; Peeters, Petra H M; Bingham, Sheila; Khaw, Kay Tee; Allen, Naomi; Key, Tim; Ferrari, Pietro; Rinaldi, Sabina; Slimani, Nadia; Riboli, Eho.

In: Endocrine-Related Cancer, Vol. 14, No. 3, 09.2007, p. 755-767.

Research output: Contribution to journalArticle

Cust, AE, Kaaks, R, Friedenreich, C, Bonnet, F, Laville, M, Tjønneland, A, Olsen, A, Overvad, K, Jakobsen, MU, Chajès, V, Clavel-Chapelon, F, Boutron-Ruault, MC, Linseisen, J, Lukanova, A, Boeing, H, Pischon, T, Trichopoulou, A, Christina, B, Trichopoulos, D, Palli, D, Berrino, F, Panico, S, Tumino, R, Sacerdote, C, Gram, IT, Lund, E, Quirós, JR, Travier, N, Martínez-García, C, Larrañaga, N, Chirlaque, MD, Ardanaz, E, Berglund, G, Lundin, E, Bueno-De-Mesquita, HB, Van Duijnhoven, FJB, Peeters, PHM, Bingham, S, Khaw, KT, Allen, N, Key, T, Ferrari, P, Rinaldi, S, Slimani, N & Riboli, E 2007, 'Metabolic syndrome, plasma lipid, lipoprotein and glucose levels, and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)', Endocrine-Related Cancer, vol. 14, no. 3, pp. 755-767. https://doi.org/10.1677/ERC-07-0132
Cust, Anne E. ; Kaaks, Rudolf ; Friedenreich, Christine ; Bonnet, Fabrice ; Laville, Martine ; Tjønneland, Anne ; Olsen, Anja ; Overvad, Kim ; Jakobsen, Marianne Uhre ; Chajès, Véronique ; Clavel-Chapelon, Françoise ; Boutron-Ruault, Marie Christine ; Linseisen, Jakob ; Lukanova, Annekatrin ; Boeing, Heiner ; Pischon, Tobias ; Trichopoulou, Antonia ; Christina, Bamia ; Trichopoulos, Dimitrios ; Palli, Domenico ; Berrino, Franco ; Panico, Salvatore ; Tumino, Rosario ; Sacerdote, Carlotta ; Gram, Inger Torhild ; Lund, Eiliv ; Quirós, J. R. ; Travier, Noémie ; Martínez-García, Carmen ; Larrañaga, Nerea ; Chirlaque, María Dolores ; Ardanaz, Eva ; Berglund, Göran ; Lundin, Eva ; Bueno-De-Mesquita, H. Bas ; Van Duijnhoven, Fränzel J B ; Peeters, Petra H M ; Bingham, Sheila ; Khaw, Kay Tee ; Allen, Naomi ; Key, Tim ; Ferrari, Pietro ; Rinaldi, Sabina ; Slimani, Nadia ; Riboli, Eho. / Metabolic syndrome, plasma lipid, lipoprotein and glucose levels, and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). In: Endocrine-Related Cancer. 2007 ; Vol. 14, No. 3. pp. 755-767.
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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 - Tjønneland, Anne

AU - Olsen, Anja

AU - Overvad, Kim

AU - Jakobsen, Marianne Uhre

AU - Chajès, Véronique

AU - Clavel-Chapelon, Françoise

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 - Quirós, J. R.

AU - Travier, Noémie

AU - Martínez-García, Carmen

AU - Larrañaga, Nerea

AU - Chirlaque, María Dolores

AU - Ardanaz, Eva

AU - Berglund, Göran

AU - Lundin, Eva

AU - Bueno-De-Mesquita, H. Bas

AU - Van Duijnhoven, Fränzel J B

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, Eho

PY - 2007/9

Y1 - 2007/9

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 (RR) for top versus bottom quartile 0.61 (95% confidence intervals (CI) 0.38-0.97), Ptrend = 0.02). Glucose levels were positively associated with risk (BMI-adjusted RR top versus bottom quartile 1.69 (95% CI 0.99-2.90), Ptrend = 0.03), which appeared stronger among postmenopausal women (BMI-adjusted RR top versus bottom fertile 2.61 (95% CI 1.46-4.66), Ptrend = 0.0006, Pheterogeneity = 0.13) and never-users of exogenous hormones (Pheterogeneity = 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 (Ptrend = 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 (Pinteraction = 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 (RR) for top versus bottom quartile 0.61 (95% confidence intervals (CI) 0.38-0.97), Ptrend = 0.02). Glucose levels were positively associated with risk (BMI-adjusted RR top versus bottom quartile 1.69 (95% CI 0.99-2.90), Ptrend = 0.03), which appeared stronger among postmenopausal women (BMI-adjusted RR top versus bottom fertile 2.61 (95% CI 1.46-4.66), Ptrend = 0.0006, Pheterogeneity = 0.13) and never-users of exogenous hormones (Pheterogeneity = 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 (Ptrend = 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 (Pinteraction = 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.

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