Metabolic syndrome and risk of cancer in Chinese populations: a systematic review and meta-analysis in 57 260 individuals

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BackgroundThe prevalence of metabolic syndrome is increasing in China and globally. Studies show that metabolic syndrome is associated with risk of cancer, but this association in Chinese populations remains unclear. We performed a systematic review and meta-analysis to evaluate the association between metabolic syndrome and cancer in Chinese populations. MethodsWe searched Embase, MEDLINE, PubMed, and WanFang databases for studies up to April 5, 2018. We included research that met the following criteria: (1) they investigated the association between metabolic syndrome and risk of cancers; (2) they were case-control or cohort studies; (3) they were conducted in Chinese individuals aged 20 years and over; (4) they contained information on the numbers of cases and controls. We adopted random-effects models in the meta-analysis to estimate the relative risk (RR) and 95% CIs. We also performed subgroup analysis by sex and cancer types. FindingsWe analysed 36 datasets from 22 articles, including 7273 cases of cancer (2429 with metabolic syndrome) and 49 987 controls (11 440 with metabolic syndrome). Overall, the presence of metabolic syndrome was associated with increased risk of cancer by almost two times (RR=1·96; 95% CI 1·63–2·35). The association was stronger in females (RR=2·18; 95% CI 1·67–2·86) than in males (RR=1·12; 95% CI 0·57–2·22). In females, the presence of metabolic syndrome was associated with ovarian (RR=3·42; 95% CI 2·84–4·11), endometrial (RR=2·53; 95% CI 1·56–4·08), cervical (RR=2·39; 95% CI 1·72–3·32), and breast cancers (RR=1·61; 95% CI 1·27–2·05). We did not identify an association with prostate cancer in males (RR=0·93; 95% CI 0·43–2·03). InterpretationThis is the first systematic review of the association between metabolic syndrome and risk of cancer among Chinese populations. Our results indicate an increased risk of cancer for individuals with metabolic syndrome, especially females. Our findings also highlight the urgent need for preventive measures and therapeutic interventions of metabolic syndrome in female individuals because of the rapidly growing disease burden. FundingNo funding.