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 language | English |
|---|---|
| Pages (from-to) | 755-767 |
| Number of pages | 13 |
| Journal | Endocrine-Related Cancer |
| Volume | 14 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Sep 2007 |
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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 journal › Article
}
TY - JOUR
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.
UR - http://www.scopus.com/inward/record.url?scp=35948940140&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=35948940140&partnerID=8YFLogxK
U2 - 10.1677/ERC-07-0132
DO - 10.1677/ERC-07-0132
M3 - Article
C2 - 17914105
AN - SCOPUS:35948940140
VL - 14
SP - 755
EP - 767
JO - Endocrine-Related Cancer
JF - Endocrine-Related Cancer
SN - 1351-0088
IS - 3
ER -