The association between metabolic abnormality and endometrial cancer: A large case-control study in China

Abstract

Objectives. To investigate the association between insulin-resistance-related conditions (comprising the metabolic syndrome) and endometrial cancer risk in Chinese women. Methods. We conducted a large case-control study including 942 endometrial cancers and 1721 controls on a Chinese population. The relative endometrial cancer risks from various factors were calculated by the х 2 test. Menopausal status and BMI were applied as potential confounders to analyze the joint effects with other factors. Results. We found that overweight/obesity, hypertension, diabetes mellitus and glucose metabolic disturbance were all associated with endometrial cancer risk. Effective medication on diabetes can significantly decrease cancer risk (uncontrolled diabetes: RR = 5.563, 95% CI = 2.406–12.859, p < 0.001; controlled diabetes: RR = 1.331, 95% CI = 0.529–3.352, p > 0.05) as compared with normal controls. Serum lipids were also found to be linked to endometrial cancer risk: positive correlations were present with total serum cholesterol, triglycerides, low-density lipoprotein cholesterol and dyslipidaemia, while a negative correlation was found with high-density lipoprotein cholesterol. We also observed an elevated risk for type I endometrial cancer (OR = 1.839, 95% CI = 1.539–2.197, p < 0.001) in women with BMI ≥ 24.58 versus those with BMI < 24.58, but not for type II cancer (OR = 1.092, 95% CI = 0.969–1.231, p > 0.05). Conclusions. Our findings support the hypothesis that metabolic abnormalities or insulin resistance may promote the initiation and progression of endometrial cancer. The effective treatment of type 2 diabetes might contribute to endometrial cancer prevention.