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Poor metabolic health linked to CRC risk in normal-weight, postmenopausal women
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Postmenopausal women of normal weight with metabolically unhealthy phenotypes had an increased risk for colorectal cancer in a large prospective study, leading researchers to conclude that even normal-weight women should be evaluated for metabolic health.
“Our finding that normal-weight U.S. women who are metabolically unhealthy have an increased risk of colorectal cancer compared with those who are metabolically healthy highlights how important it is for women to be aware of their metabolic health status, which can be assessed using standard clinical tests,” Xiaoyun Liang, MD, of the Beijing Normal University in China, said in a press release.
Liang and colleagues identified 5,068 postmenopausal women with BMI between 18.5 and 25 kg/m2 within the Women’s Health Initiative cohort, and compared the risk for colorectal cancer between metabolically healthy and unhealthy phenotypes.
Metabolic phenotype was defined based on the Adult Treatment Panel-III criteria, except for waist circumference. Metabolically unhealthy phenotype was thus defined by the presence of at least two of the following factors: elevated triglycerides, low HDL cholesterol, elevated blood pressure and elevating fasting glucose.
Overall, 33.7% met criteria for a metabolically unhealthy phenotype, and after a mean follow-up period of 14.3 years, colorectal cancer occurred in 64 of the 3,358 metabolically healthy women compared with 50 of the 1,710 metabolically unhealthy women.
Multivariable Cox proportional hazards regression showed that among these normal-weight women, a metabolically unhealthy phenotype was associated with a 49% higher risk for colorectal cancer compared with a metabolically healthy phenotype (HR = 1.49; 95% CI, 1.02-2.18).
A sensitivity analysis also showed that women with metabolic syndrome had more than a twofold higher risk for both colorectal cancer (HR = 2.14; 95% CI, 1.38-3.32) and colon cancer (HR = 2.42; 95% CI, 1.48-3.95) compared with metabolically healthy women.
The researchers acknowledged that study limitations included the inability to account for changes in BMI since enrollment and a lack of men and younger women in the cohort. “Colorectal cancer is the third most commonly diagnosed cancer for women in the United States,” Liang said in the press release. “Recognition that normal-weight women who are metabolically unhealthy may have an increased risk for colorectal cancer could result in more timely use of preventive interventions and reduce the burden of this deadly disease.” – by Adam Leitenberger
Disclosures: The researchers report no relevant financial disclosures.
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