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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; Tjonneland, Anne; Olsen, Anja; Overvad, Kim; Jakobsen, Marianne Uhre and Chajes, Veronique, et al. (2007) In Endocrine-Related Cancer 14(3). p.755-767
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 (FR) for top versus bottom... (More)
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 (FR) for top versus bottom quartile 0.61 (95% confidence intervals (CI) 0.38-0.97), P-trend= 0.02). Glucose levels were positively associated with risk (BMI-adjusted RR top versus bottom quartile 1.69 (95% Cl 0.99-2.90), P-trend, = 0.03), which appeared stronger among postmenopausal women (BMI-adjusted RR top versus bottom tertile 2.61 (95% Cl 1.46-4.66), P-trend=0.0006, P-heterogeneity=0.13) and never-users of exogenous hormones (P-heterogeneity=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 (P-trend=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 (P-interaction=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. (Less)
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Endocrine-Related Cancer
volume
14
issue
3
pages
755 - 767
publisher
Society for Endocrinology
external identifiers
  • wos:000250482800019
  • scopus:35948940140
ISSN
1479-6821
DOI
10.1677/ERC-07-0132
language
English
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yes
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e2b88f39-ed53-4dc3-a4e9-28a49792982e (old id 654069)
date added to LUP
2007-12-06 11:40:09
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2017-08-13 03:35:51
@article{e2b88f39-ed53-4dc3-a4e9-28a49792982e,
  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 (FR) for top versus bottom quartile 0.61 (95% confidence intervals (CI) 0.38-0.97), P-trend= 0.02). Glucose levels were positively associated with risk (BMI-adjusted RR top versus bottom quartile 1.69 (95% Cl 0.99-2.90), P-trend, = 0.03), which appeared stronger among postmenopausal women (BMI-adjusted RR top versus bottom tertile 2.61 (95% Cl 1.46-4.66), P-trend=0.0006, P-heterogeneity=0.13) and never-users of exogenous hormones (P-heterogeneity=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 (P-trend=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 (P-interaction=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.},
  author       = {Cust, Anne E. and Kaaks, Rudolf and Friedenreich, Christine and Bonnet, Fabrice and Laville, Martine and Tjonneland, Anne and Olsen, Anja and Overvad, Kim and Jakobsen, Marianne Uhre and Chajes, Veronique and Clavel-Chapelon, Frangoise and Boutron-Ruault, Marie-Christine and Linseisen, Jakob and Lukanova, Annekatrin and Boeing, Heiner and Pischon, Tobias and Trichopoulou, Antonia and Christina, Bamia and Trichopoulos, Dimitrios and Palli, Domenico and Berrino, Franco and Panico, Salvatore and Tumino, Rosario and Sacerdote, Carlotta and Gram, Inger Torhild and Lund, Eiliv and Quiros, J. R. and Travier, Nomie and Garcia, Carmen Martinez and Larranaga, Nerea and Chirlaque, Maria-Dolores and Ardanaz, Eva and Berglund, Göran and Lundin, Eva and Bueno-De-Mesquita, H. Bas and Franzel, J. B. van Duijnhoven and Peeters, Petra H. M. and Bingham, Sheila and Khaw, Kay-Tee and Allen, Naomi and Key, Tim and Ferrari, Pietro and Rinaldi, Sabina and Slimani, Nadia and Riboli, Elio},
  issn         = {1479-6821},
  language     = {eng},
  number       = {3},
  pages        = {755--767},
  publisher    = {Society for Endocrinology},
  series       = {Endocrine-Related Cancer},
  title        = {Metabolic syndrome, plasma lipid, lipoprotein and glucose levels, and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)},
  url          = {http://dx.doi.org/10.1677/ERC-07-0132},
  volume       = {14},
  year         = {2007},
}