Worsening metabolic syndrome associated with developing a variety of cancers

ByJosh Friedman

Fact checked byMindy Valcarcel, MS

Key takeaways:

Patients who had elevated, worsening metabolic syndrome had an increased likelihood of numerous cancer types.
Chronic inflammation also served as a factor in the development of various cancers.

Individuals with elevated and worsening metabolic syndrome had an increased risk for developing an array of cancer types compared with those who did not, according to results published in Cancer.

Those who also had chronic inflammation based on C-reactive protein levels had more risk for developing breast, endometrial, colorectal and liver cancers.

HRs for cancer risk for elevated-increasing MetS trajectory infographic — Data derived from Deng L, et al. *Cancer*. 2024;doi:10.1002/cncr.35235.

“This research suggests that proactive and continuous management of metabolic syndrome may serve as an essential strategy in preventing cancer,” Han-Ping Shi, MD, PhD, of Capital Medical University, Beijing, said in a press release.

Background and methodology

Individuals with metabolic syndrome (MetS) have increased risk for heart disease, stroke and type 2 diabetes, according to background information provided by researchers.

Recent studies indicate MetS also has associations with colon, liver and breast cancers, and various MetS conditions such as obesity, blood glucose levels and blood pressure have been linked to various cancer types as well.

However, “The severity of MetS can fluctuate over time, leading to transitions between metabolically healthy and unhealthy states,” researchers wrote. “This dynamic nature makes it challenging to assess the progression of MetS using a singular measurement.”

Researchers used the Kailuan study — a prospective cohort investigation in Tangshan, China, that includes 101,510 individuals — to conduct their own prospective cohort analysis.

Their patient population consisted of 44,115 participants (average age 49.26 years; 78.9% men), each of whom had three examinations between 2006 and 2010 with no cancer history.

Study investigators divided the population into four subsets according to MetS trajectory: low-stable (10.56%), moderate-low (40.84%), moderate-high (41.46%) and elevated-increasing (7.14%).

They calculated MetS scores using the sum of components for obesity, increased triglycerides, decreased high-density lipoprotein cholesterol, increased blood pressure and increased fasting plasma glucose.

Results and next steps

At a median follow-up of 9.4 years, the elevated-increasing cohort had an increased risk for overall cancer (HR = 1.27; 95% CI, 1.04-1.55) as well as breast (HR = 2.11; 95% CI, 1.04-4.34), endometrial (HR = 3.33; 95% CI, 1.16-6.77), kidney (HR = 4.52; 95% CI, 1.17-10.48), colorectal (HR = 2.54; 95% CI, 1.27-5.09) and liver (HR = 1.61; 95% CI, 1.09-4.57) cancers compared with the low-stable population.

The elevated-increasing population also had higher risk for overall, breast, endometrial, kidney and colorectal cancers compared with all other studied groups combined.

Participants in the elevated-increasing group with chronic inflammation (C-reactive protein 3 mg/L) had increased risk for breast, endometrial, colorectal and liver cancers, while those that did not had increased risk for kidney cancer.

“MetS and inflammation are closely associated,” researchers wrote. “Although in this study the presence of inflammation did not significantly modify the association between MetS and breast, uterine/uterine cervical, colorectal, or liver cancers, individuals with comorbid chronic inflammation were observed to have a higher risk of developing these types of tumors.

“We observed that subjects with concurrent chronic inflammation and persistently high MetS scores exhibited the highest risk [for] developing breast, endometrial, colon and liver cancer,” they added.

Study limitations included a lack of diversity among the patient population and “cancer-associated casual factors” in the Kailuan study, such as hepatitis C and dietary habits, according to researchers.

“Our study can guide future research into the biological mechanisms linking metabolic syndrome to cancer, potentially resulting in targeted treatments or preventive strategies,” Shi said in the release. “Formal evaluation of these interventions will be needed to determine if they are able to modulate cancer risk.”