Abstract
BackgroundRecent studies have proved metabolic syndrome (MetS) was linked to cancer risks. However, few data has examined the relationship between MetS and epithelial ovarian cancer (EOC).MethodsWe conducted a population-based case-control study in Tianjin Medical University Cancer Institute and Hospital, China (2010–2015) that enrolled 573 EOC patients and 1146 matched controls. Data were collected through in-person interviews, anthropometric measurement, and 8-h fasting bloods drawn. MetS was estimated by Chinese Diabetes Society (CDS) definition requiring presence of ≥3 of the following risk factors: 1) body mass index (BMI) ≥25.0 kg/m2,2) fasting plasma glucose ≥6.1 mmol/L or 2-h plasma glucose ≥ 7.8 mmol/L, 3) systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg, 4) triglyceride (TG) ≥1.70 mmol/L or high-density lipoprotein cholesterol (HDL-C) < 1.0 mmol/L. Statistics were completed using chi-square tests and logistic regression analysis. The survival analysis was conducted by the Kaplan-Meier method and Cox proportional hazard regression models.ResultsMetS was significantly more prevalent among EOC (25.13%) than controls (6.89%). A statistically significant increase risk for EOC was observed for MetS (multivariable-adjusted OR = 3.187; 95% CI: 2.135–4.756). MetS was significantly associated with histological grade (P < 0.001), FIGO stage (P = 0.003), and lymph node (LN) status (P = 0.002) of EOC. In binary logistic regression analysis, the presence of MetS predicts the risk of advanced FIGO stage (OR = 2.155, 95% CI: 1.327–3.498, P = 0.002), lower differentiation (OR = 2.472, 95% CI: 1.164–5.250, P = 0.019), and LN metastasis (OR = 2.590, 95% CI: 1.089–6.160, P = 0.031) of EOC. Moreover, MetS is the independent factor for the evaluation of PFS and OS of EOC patients (both of them P < 0.001) in Cox proportional hazard model.ConclusionMetS is obviously related to increased EOC risk. EOC patients with MetS in Chinese population were found to have statistically significant tumor advanced stage, low differentiation, LN metastasis and poor prognosis.
Highlights
Recent studies have proved metabolic syndrome (MetS) was linked to cancer risks
In age-adjusted binary logistic regression analysis, the presence of MetS predicts the risk of advanced International federation of gynecology and obstetrics (FIGO) stage (OR = 2.155, 95% CI: 1.327–3.498, P = 0.002), lower differentiation (OR = 2.472, 95% CI: 1.164–5.250, P = 0.019), and lymph node (LN) metastasis (OR = 2.590, 95% CI: 1.089–6.160, P = 0.031) of epithelial ovarian cancer (EOC) patients (Table 5)
MetS was originally recognized as a cluster of risk factors that better predicted cardiovascular disease and diabetes incidence, than simple Body mass index (BMI) or obesity measures [15] since it was firstly proposed by Reavan in 1988 [16] and the accepted criteria for clinical identification of the components of MetS has been promulgated by NCPATPIII [17] and WHO as well as IDF [13], and the American Association of Clinical Endocrinologists (AACE) [18]
Summary
Recent studies have proved metabolic syndrome (MetS) was linked to cancer risks. Few data has examined the relationship between MetS and epithelial ovarian cancer (EOC). 95% of ovarian cancers are of epithelial origin. Epithelial ovarian cancer (EOC) was the leading killer among women with gynecologic cancers. In 2015, there were 22,280 estimated new diagnoses of ovarian cancer and 14,240 deaths from the disease [1]. Statistic revealed the morbidity and mortality of ovarian cancer were rising obviously [2]. Scientists do not reach a consensus about the prevalence of ovarian cancer because of oncologic diseases have multiple causes.
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