Background: The metabolic syndrome (MetSyn) is characterized by central obesity, impaired glucose tolerance, hypertension, hypertriglyceridemia and low‐density lipoprotein cholesterol, that may lead to cardiovascular disease and type 2 diabetes mellitus. This syndrome has also been associated with risk of colorectal neoplasia. Even though colon adenomas are the main precursor lesions for colorectal cancer, few studies have examined the relationship between MetSyn and adenomatous polyps. Thus, we aimed to determine the association between the MetSyn and adenomatous polyps in a population of adults in the United States.
Methods: In an ongoing screening colonoscopy‐based study, we have prospectively collected data (lifestyle risk factors and fasting blood samples) from 323 incident polyp cases (26.2%) and 910 (73.8%) controls at the University Hospitals of Cleveland; as part of the Case Transdisciplinary Research in Cancer and Energetics (TREC) Colon Polyps Study. Information on relevant covariates was collected through a computer‐assisted interview. Height, weight, waist and hip measurements, as well as blood collection was obtained just prior to their colonoscopy by a research nurse. The MetSyn was determined by the use of both the criteria of the American Heart Association/National Heart, Lung, and Blood institute (AHA/NHLBI) revised definition of the NCEP‐ATP III report and the criteria of the International Diabetes Federation (IDF). Descriptive statistics and unconditional logistic regression models were used to assess the association between the MetSyn and likelihood of being diagnosed with adenomatous polyps, with each of the two MetSyn definitions.
Results: Our study population included 469 women (38%) and 764 men (62%). The mean age of participants was 55.4±8.9 years, 473 (38%) of participants classified themselves as African American and 760 (62%) as Caucasian. For both criteria used, the prevalence of the MetSyn was higher in cases (NCEP‐ATPIII=48.3%, IDF=58.4%) than controls (NCEP‐ATPIII=41.2%, IDF=49.9%) (p<0.05). After adjusting for age, race, cigarette consumption, NSAID use and family history of colorectal cancer, persons with MetSyn according to the IDF criteria, were 41% more likely to have polyps (OR=1.41, 95% CI= 1.07–1.86, p=0.0140) as compared to those without the MetSyn. Analysis using the ATP‐III criteria showed that persons with MetSyn were 24% more likely to have polyps (OR=1.24, 95% CI=0.95–1.63), although this association was not statistically significant (p=0.1149).
Conclusions: The MetSyn appears to be an independent risk factor of polyps; particularly when the IDF criteria are used. These results suggest that patients with the MetSyn are potentially at increased risk for colorectal cancer. Thus, colorectal cancer screening should be emphasized in patients with the MetSyn, and individuals at high risk of colon cancer should be encouraged to reduce their MetSyn factors.
Citation Information: Cancer Prev Res 2010;3(1 Suppl):B112.