Study on the Relevance of Metabolic Syndrome and Incidence of Gastric Cancer in Korea
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Sample
- (1)
- Cases below the age of 30.
- (2)
- Cases with missing values among metabolic syndrome checkup items (fasting blood sugar, systolic and diastolic blood pressure, TG, HDL, waist circumference).
- (3)
- Cases with a history of cardiovascular or cerebrovascular diseases and cancer; beneficiaries for cancer (C00-97), cardiovascular/cerebrovascular diseases (ischemic heart disease I20-25, cardiac failure I50 or I42), cerebrovascular disease (I60-69), atrial fibrillation (I48), and circulatory system disease (I00-99).
2.2. Measurements
2.2.1. Dependent Variable: Gastric Cancer
2.2.2. Independent Variable: Metabolic Syndrome
2.2.3. Adjusted Variables: Sex, Age, Health Behavior, Family History, Laboratory Findings
2.3. Statistical Analysis
2.4. Ethical Consideration
3. Results
3.1. Cumulative Incidence Rate of Gastric Cancer
3.2. Risk of Gastric Cancer Following the Progression of Metabolic Syndrome
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Alberti, K.G.; Eckel, R.H.; Grundy, S.M.; Zimmet, P.Z.; Cleeman, J.I.; Donato, K.A.; Fruchart, J.C.; James, W.P.; Loria, C.M.; Smith, S.C., Jr.; et al. Harmonizing the metabolic syndrome: A joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009, 120, 1640–1645. [Google Scholar] [CrossRef]
- Lin, Y.; Ness-Jensen, E.; Hveem, K.; Lagergren, J.; Lu, Y. Metabolic syndrome and esophageal and gastric cancer. Cancer Causes Control 2015, 26, 1825–1834. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Cameron, A.J.; Shaw, J.E.; Zimmet, P.Z. The metabolic syndrome: Prevalence in worldwide populations. Endocrinol. Metab. Clin. N. Am. 2004, 33, 351–375. [Google Scholar] [CrossRef] [PubMed]
- Lim, S.; Shin, H.; Song, J.H.; Kwak, S.H.; Kang, S.M.; Won, Y.J.; Choi, S.H.; Cho, S.I.; Park, K.S.; Lee, H.K.; et al. Increasing prevalence of metabolic syndrome in Korea. Diabetes Care 2011, 34, 1323–1328. [Google Scholar] [CrossRef] [PubMed]
- Cornier, M.A.; Dabelea, D.; Hernandez, T.L.; Lindstrom, R.C.; Steig, A.J.; Stob, N.R.; Van, R.E.; Wang, H.; Eckel, R.H. The metabolic syndrome. Endocr. Rev. 2008, 29, 777–822. [Google Scholar] [CrossRef]
- Valentina, R.; Alessandra, T.; Cristina, B.; Claudio, P.; Renato, T.; Jerry, P.; Diego, S.; Eva, N.; Carlo La, V. Metabolic syndrome and pancreatic cancer risk: A case-control study in Italy and meta-analysis. Metabolism 2011, 60, 1372–1378. [Google Scholar] [CrossRef]
- Turati, F.; Talamini, R.; Pelucchi, C.; Polesel, J.; Franceschi, S.; Crispo, A.; Izzo, F.; La Vecchia, C.; Boffetta, P.; Montella, M. Metabolic syndrome and hepatocellular carcinoma risk. Br. J. Cancer 2013, 108, 222–228. [Google Scholar] [CrossRef] [PubMed]
- O’Neill, S.; O’Driscoll, L. Metabolic syndrome: A closer look at the growing epidemic and its associated pathologies. Obes. Rev. 2015, 16, 1–12. [Google Scholar] [CrossRef] [PubMed]
- Uzel, M.; Sahiner, Z.; Filik, L. Non-alcoholic fatty liver disease, metabolic syndrome and gastric cancer: Single center experience. J. BUON 2015, 20, 662. [Google Scholar] [PubMed]
- Jee, S.H.; Yun, J.E.; Park, E.J.; Cho, E.R.; Park, I.S.; Sull, J.W.; Ohrr, H.; Samet, J.M. Body mass index and cancer risk in Korean men and women. Int. J. Cancer 2008, 123, 1892–1896. [Google Scholar] [CrossRef]
- Tian, T.; Zhang, L.Q.; Ma, X.H.; Zhou, J.N.; Shen, J. Diabetes mellitus and incidence and mortality of gastric cancer: A meta-analysis. Exp. Clin. Endocrinol. Diabetes 2012, 120, 217–223. [Google Scholar] [CrossRef]
- Jung, M.K.; Jeon, S.W.; Cho, C.M.; Tak, W.Y.; Kweon, Y.O.; Kim, S.K.; Choi, Y.H.; Bae, H.I.; Lee, J.Y.; Chung, J.M. Hyperglycaemia, hypercholesterolaemia and the risk for developing gastric dysplasia. Dig. Liver Dis. 2008, 40, 361–365. [Google Scholar] [CrossRef]
- Bray, F.; Ferlay, J.; Soerjomataram, I.; Siegel, R.L.; Torre, L.A.; Jemal, A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 2018, 68, 394–424. [Google Scholar] [CrossRef]
- Kim, M.A.; Kim, C.O.; Seo, J.Y.; Yoo, B.W.; Cho, Y.J.; Oh, J.E.; Hong, S.H.; Cho, C.Y. The Analysis of Risk Factors of Gall Stone Associated with Metabolic Syndrome. Soonchunhyang Med. Sci. 2011, 17, 11–15. [Google Scholar] [CrossRef]
- Lindkvist, B.; Almquist, M.; Bjørge, T.; Stocks, T.; Borena, W.; Johansen, D.; Hallmans, G.; Engeland, A.; Nagel, G.; Jonsson, H.; et al. Prospective cohort study of metabolic risk factors and gastric adenocarcinoma risk in the Metabolic Syndrome and Cancer Project (Me-Can). Cancer Causes Norm. 2013, 24, 107–116. [Google Scholar] [CrossRef]
- Yamagata, H.; Kiyohara, Y.; Nakamura, S.; Kubo, M.; Tanizaki, Y.; Matsumoto, T.; Tanaka, K.; Kato, I.; Shirota, T.; Iida, M. Impact of fasting plasma glucose levels on gastric cancer incidence in a general Japanese population: The Hisayama study. Diabetes Care 2005, 28, 789–794. [Google Scholar] [CrossRef] [PubMed]
- Hu, D.; Peng, F.; Lin, X.; Chen, G.; Zhang, H.; Liang, B.; Ji, K.; Lin, J.; Chen, L.F.; Zheng, X.; et al. Preoperative metabolic syndrome is predictive of significant gastric cancer mortality after gastrectomy: The Fujian Prospective Investigation of Cancer (FIESTA) Study. EBioMedicine 2017, 15, 73–80. [Google Scholar] [CrossRef] [PubMed]
- Esposito, K.; Chiodini, P.; Colao, A.; Lenzi, A.; Giugliano, D. Metabolic syndrome and risk of cancer: A systematic review and meta-analysis. Diabetes Care 2012, 35, 2402–2411. [Google Scholar] [CrossRef] [PubMed]
- Inoue, M.; Noda, M.; Kurahashi, N.; Iwasaki, M.; Sasazuki, S.; Iso, H.; Tsugane, S.; Japan Public Health Center-based Prospective Study Group. Impact of metabolic factors on subsequent cancer risk: Results from a large-scale population-based cohort study in Japan. Eur. J. Cancer Prev. 2009, 18, 240–247. [Google Scholar] [CrossRef] [PubMed]
- Osaki, Y.; Taniguchi, S.; Tahara, A.; Okamoto, M.; Kishimoto, T. Metabolic syndrome and incidence of liver and breast cancers in Japan. Cancer Epidemiol. 2012, 36, 141–147. [Google Scholar] [CrossRef]
- Shebl, F.M.; Andreotti, G.; Meyer, T.E.; Gao, Y.T.; Rashid, A.; Yu, K.; Shen, M.C.; Wang, B.C.; Han, T.Q.; Zhang, B.H.; et al. Metabolic syndrome and insulin resistance in relation to biliary tract cancer and stone risks: A population-based study in Shanghai, China. Br. J. cancer 2011, 105, 1424–1429. [Google Scholar] [CrossRef] [PubMed]
Waist Circumference | Waist Circumference >90 cm in Men and >85 cm in Women |
---|---|
Blood Pressure | ≥130/85 mm Hg, treatment of previously diagnosed hypertension |
Triglyceride | ≥150 mg/dL (1.69 mmol/L), treatment of previously diagnosed hypertriglyceridemia |
HDL | <40 mg/dL (1.04 mmol/L) in men and <50 mg/dL (1.29 mmol/L) in women, specific treatment for this lipid abnormality |
Glucose | ≥100 mg/dL (≥5.56 mmol/L), previously diagnosed type 2 diabetes |
Characteristics | Category | Non-Cancer, N (%) | Gastric Cancer, N (%) | p |
---|---|---|---|---|
Metabolic syndrome (MS) stage | Normal | 2,585,352 (99.7) | 7389 (2.8) | <0.001 |
Pre-MS | 3,930,296 (99.5) | 18,204 (4.6) | ||
MS | 1,235,516 (99.3) | 8336 (6.7) | ||
Sex | Male | 4,405,631 (99.5) | 24,010 (5.4) | <0.001 |
Female | 3,345,533 (99.7) | 9919 (3.0) | ||
Age | 30–39 | 1,511,110 (99.9) | 635 (4.0) | <0.001 |
40–49 | 2,157,650 (99.8) | 3999 (1.8) | ||
50–59 | 2,381,187 (99.5) | 11,551 (4.8) | ||
≥60 | 1,701,217(98.9) | 17,744 (10.3) | ||
Smoke | Non-smoker | 4,367,571(99.7) | 14,866 (3.4) | <0.001 |
Ex-smoker | 1,057,292(99.4) | 6806 (6.4) | ||
Smoker | 2,278,031(99.5) | 12,048 (5.3) | ||
Alcohol consumption | No drink | 3,455,973 (99.6) | 14,092 (4.1) | <0.001 |
2–3/per month | 3,168,394 (99.6) | 12,142 (3.8) | ||
1–4/per week | 785,965 (99.4) | 4951 (6.3) | ||
≥5/per week | 241,978 (99.0) | 2401 (9.8) | ||
Physical Exercise, per week | No exercise | 3,555,044 (99.6) | 15,243 (4.3) | <0.001 |
1–4/per week | 1,568,184 (99.6) | 6284 (4.0) | ||
≥5/per week | 2,564,894 (99.5) | 12,136 (4.7) | ||
FH of HP | No | 4,476,882 (99.5) | 19,443 (4.3) | <0.001 |
Yes | 823,010 (99.6) | 3183 (3.9) | ||
FH of DM | No | 4,594,193 (99.6) | 1972 (4.3) | <0.060 |
Yes | 417,874 (99.5) | 2906 (4.1) | ||
FH of Stroke | No | 4,877,551 (99.6) | 20,450 (4.2) | <0.001 |
Yes | 253,439 (99.6) | 2182 (5.2) | ||
FH of Heart Disease | No | 5,038,086 (99.6) | 21,552 (4.3) | <0.212 |
Yes | 781,926 (99.4) | 1042 (4.1) | ||
FH of CA | No | 4,516,223 (99.4) | 18,326 (4.0) | <0.001 |
Yes | 781,926 (99.4) | 4328 (5.5) | ||
Total, N (%) | 7,785,093 (100.0) | 33,929 (0.5) |
Characteristics | Category | HR (95% CI) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Non–Adjusted | Model 1 | Model 2 | Model 3 | Model 4 | |||||||
MS stage | Normal | Ref. | Ref. | Ref. | Ref. | Ref. | |||||
Pre-MS | 1.61 | (1.56 1.66) | 1.03 | (1.00 1.07) | 1.02 | (0.99 1.05) | 1.03 | (0.99 1.06) | 1.08 | (1.04 1.12) | |
MS | 2.31 | (2.22 2.40) | 1.14 | (1.09 1.18) | 1.11 | (1.08 1.17) | 1.12 | (1.08 1.17) | 1.26 | (1.2 1.32) | |
sex | female | Ref. | Ref. | Ref. | Ref. | ||||||
male | 2.12 | (2.06 2.18) | 1.79 | (1.72 1.86) | 1.74 | (1.7 1.84) | 2.18 | (2.08 2.29) | |||
age | 30–39 | Ref. | (3.68 4.52) | Ref. | Ref. | Ref. | |||||
40–49 | 4.07 | 4.05 | (3.66 4.49) | 4.03 | (3.63 4.46) | 4.04 | (3.64 4.48) | ||||
50–59 | 11.68 | (10.59 12.89) | 11.74 | (10.64 12.95) | 11.46 | (10.39 12.56) | 11.24 | (10.17 12.41) | |||
≧60 | 25.65 | (23.26 28.29) | 26.11 | (23.68 28.79) | 25.31 | (22.94 27.93) | 24.69 | (22.36 27.27) | |||
Smoke | Non-smoker | Ref. | Ref. | Ref. | |||||||
Ex-smoker | 1.21 | (1.16 1.26) | 1.18 | (1.13 1.23) | 1.18 | (1.13 1.23) | |||||
Smoker | 1.35 | (1.3 1.4) | 1.30 | (1.25 1.35) | 1.31 | (1.26 1.37) | |||||
Alcohol Consumption | No drink | Ref. | Ref. | Ref. | |||||||
2–3/per month | 1.00 | (0.97 1.03) | 1.00 | (0.97 1.03) | 1.01 | (0.97 1.04) | |||||
1–4/per week | 1.16 | (1.11 1.22) | 1.17 | (0.97 1.03) | 1.17 | (1.12 1.23) | |||||
≥5/per week | 1.35 | (1.28 1.43) | 1.35 | (1.28 1.43) | 1.34 | (1.27 1.42) | |||||
Exercise | no exercise | Ref. | Ref. | Ref. | |||||||
1–4/per week | 0.98 | (0.94 1.01) | 0.98 | (0.94 1.01) | 0.98 | (0.94 1.02) | |||||
≥5/per week | 0.99 | (0.96 1.02) | 0.99 | (0.96 1.02) | 0.99 | (0.96 1.02) | |||||
FH of Hypertension | no | Ref. | Ref. | ||||||||
yes | 0.88 | (0.84 0.91) | 0.88 | (0.85 0.92) | |||||||
FH of DM | no | Ref. | Ref. | ||||||||
yes | 1.02 | (0.98 1.06) | 1.03 | (0.98 0.99) | |||||||
FH of Stroke | no | Ref. | Ref. | ||||||||
yes | 0.95 | (0.9 0.99) | 0.95 | (0.91 1) | |||||||
FH of Heart disease | no | Ref. | Ref. | ||||||||
yes | 0.93 | (0.87 0.99) | 0.93 | (0.87 0.99) | |||||||
FH of CA | no | Ref. | |||||||||
yes | 1.18 | (1.14 1.22 | |||||||||
BMI | 0.99 | (0.98 0.99) | |||||||||
Hemoglobin | 0.89 | (0.88 0.9) | |||||||||
Serum creatinine | 1.01 | (1.00 1.01) | |||||||||
Total cholesterol | 1.00 | (1.00 1.00) | |||||||||
LDL cholesterol | 1.00 | (1.00 1.00) | |||||||||
ALT(SGPT) | 1.00 | (1.00 1.00) | |||||||||
AIC | 675,732.09 | 659,523.22 | 659,140.48 | 658,994.70 | 656,447.46 |
© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Yoo, H.; Kim, H.; Lee, J.-H.; Lee, K.-S.; Choi, M.-J.; Song, H.-R.; Cho, J.-H.; Kim, J.-H. Study on the Relevance of Metabolic Syndrome and Incidence of Gastric Cancer in Korea. Int. J. Environ. Res. Public Health 2019, 16, 1101. https://doi.org/10.3390/ijerph16071101
Yoo H, Kim H, Lee J-H, Lee K-S, Choi M-J, Song H-R, Cho J-H, Kim J-H. Study on the Relevance of Metabolic Syndrome and Incidence of Gastric Cancer in Korea. International Journal of Environmental Research and Public Health. 2019; 16(7):1101. https://doi.org/10.3390/ijerph16071101
Chicago/Turabian StyleYoo, HaiWon, Hyeongsu Kim, Jung-Hyun Lee, Kun-Sei Lee, Min-Jung Choi, Hye-Ry Song, Jung-Hee Cho, and Jin-Hyeong Kim. 2019. "Study on the Relevance of Metabolic Syndrome and Incidence of Gastric Cancer in Korea" International Journal of Environmental Research and Public Health 16, no. 7: 1101. https://doi.org/10.3390/ijerph16071101