Associations of metabolic syndrome and C-reactive protein with mortality from total cancer, obesity-linked cancers and breast cancer among women in NHANES III

Wambui G. Gathirua-Mwangi, Yiqing Song, Patrick Monahan, Victoria Champion, Terrell W. Zollinger

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Abstract

Although metabolic syndrome (MetS) is a prognostic factor for cancer occurrence, the association of MetS and cancer mortality remains unclear. The purpose of this study was to evaluate whether MetS, components of MetS and C-reactive protein (CRP) are associated with cancer mortality in women. A total of 400 cancer deaths, with 140 deaths from obesity-linked-cancers (OLCas), [breast (BCa), colorectal, pancreatic and endometrial], linked through the National Death Index, were identified from 10,104 eligible subjects aged ≥18 years. Cox proportional hazards regression was used to estimate multivariable-adjusted hazard ratios (HR) for cancer mortality. MetS was associated with increased deaths for total cancer [HR=1.33, 95% confidence interval (CI) 1.04-1.70] and BCa [HR=2.1, 95% CI, 1.09-4.11]. The risk of total cancer [HR=1.7, 95% CI, 1.12-2.68], OLCas [HR=2.1, 95% CI, 1.00-4.37] and BCa [HR=3.8, 95% CI, 1.34-10.91] mortality was highest for women with all MetS components abnormal, compared to those without MetS. Linear associations of blood-pressure [HR=2.5, 1.02-6.12, Quartile (Q) 4 vs Q1, p trend=0.004] and blood-glucose [HR=2.2, 1.04-4.60, Q4 vs. Q1, p trend=0.04] with total-OLCas mortality were observed. A threefold increased risk of BCa mortality was observed for women with enlarged waist circumference, ≥100.9 cm, [HR=3.5, 1.14-10.51, p trend=0.008] and in those with increased blood glucose, ≥101 mg/dL, [HR=3.2, 1.11-9.20, p trend=0.03] compared to those in Q1. None of the components of MetS were associated with total-cancer mortality. CRP was not associated with cancer mortality. In conclusion, MetS is associated with total-cancer and breast-cancer mortality, with waist circumference, blood pressure and blood glucose as independent predictors of OLCas and BCa mortality.

Original languageEnglish (US)
JournalInternational Journal of Cancer
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Nutrition Surveys
C-Reactive Protein
Obesity
Breast Neoplasms
Mortality
Neoplasms
Confidence Intervals
Blood Glucose
Waist Circumference
Blood Pressure

Keywords

  • Breast cancer
  • C-reactive protein
  • Cancer mortality
  • Cohort study
  • Epidemiology
  • Metabolic syndrome
  • Obesity-linked cancers
  • Women

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

@article{1e43e3a5bec1476bb8aa7cd330442582,
title = "Associations of metabolic syndrome and C-reactive protein with mortality from total cancer, obesity-linked cancers and breast cancer among women in NHANES III",
abstract = "Although metabolic syndrome (MetS) is a prognostic factor for cancer occurrence, the association of MetS and cancer mortality remains unclear. The purpose of this study was to evaluate whether MetS, components of MetS and C-reactive protein (CRP) are associated with cancer mortality in women. A total of 400 cancer deaths, with 140 deaths from obesity-linked-cancers (OLCas), [breast (BCa), colorectal, pancreatic and endometrial], linked through the National Death Index, were identified from 10,104 eligible subjects aged ≥18 years. Cox proportional hazards regression was used to estimate multivariable-adjusted hazard ratios (HR) for cancer mortality. MetS was associated with increased deaths for total cancer [HR=1.33, 95{\%} confidence interval (CI) 1.04-1.70] and BCa [HR=2.1, 95{\%} CI, 1.09-4.11]. The risk of total cancer [HR=1.7, 95{\%} CI, 1.12-2.68], OLCas [HR=2.1, 95{\%} CI, 1.00-4.37] and BCa [HR=3.8, 95{\%} CI, 1.34-10.91] mortality was highest for women with all MetS components abnormal, compared to those without MetS. Linear associations of blood-pressure [HR=2.5, 1.02-6.12, Quartile (Q) 4 vs Q1, p trend=0.004] and blood-glucose [HR=2.2, 1.04-4.60, Q4 vs. Q1, p trend=0.04] with total-OLCas mortality were observed. A threefold increased risk of BCa mortality was observed for women with enlarged waist circumference, ≥100.9 cm, [HR=3.5, 1.14-10.51, p trend=0.008] and in those with increased blood glucose, ≥101 mg/dL, [HR=3.2, 1.11-9.20, p trend=0.03] compared to those in Q1. None of the components of MetS were associated with total-cancer mortality. CRP was not associated with cancer mortality. In conclusion, MetS is associated with total-cancer and breast-cancer mortality, with waist circumference, blood pressure and blood glucose as independent predictors of OLCas and BCa mortality.",
keywords = "Breast cancer, C-reactive protein, Cancer mortality, Cohort study, Epidemiology, Metabolic syndrome, Obesity-linked cancers, Women",
author = "Gathirua-Mwangi, {Wambui G.} and Yiqing Song and Patrick Monahan and Victoria Champion and Zollinger, {Terrell W.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1002/ijc.31344",
language = "English (US)",
journal = "International Journal of Cancer",
issn = "0020-7136",
publisher = "Wiley-Liss Inc.",

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TY - JOUR

T1 - Associations of metabolic syndrome and C-reactive protein with mortality from total cancer, obesity-linked cancers and breast cancer among women in NHANES III

AU - Gathirua-Mwangi, Wambui G.

AU - Song, Yiqing

AU - Monahan, Patrick

AU - Champion, Victoria

AU - Zollinger, Terrell W.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Although metabolic syndrome (MetS) is a prognostic factor for cancer occurrence, the association of MetS and cancer mortality remains unclear. The purpose of this study was to evaluate whether MetS, components of MetS and C-reactive protein (CRP) are associated with cancer mortality in women. A total of 400 cancer deaths, with 140 deaths from obesity-linked-cancers (OLCas), [breast (BCa), colorectal, pancreatic and endometrial], linked through the National Death Index, were identified from 10,104 eligible subjects aged ≥18 years. Cox proportional hazards regression was used to estimate multivariable-adjusted hazard ratios (HR) for cancer mortality. MetS was associated with increased deaths for total cancer [HR=1.33, 95% confidence interval (CI) 1.04-1.70] and BCa [HR=2.1, 95% CI, 1.09-4.11]. The risk of total cancer [HR=1.7, 95% CI, 1.12-2.68], OLCas [HR=2.1, 95% CI, 1.00-4.37] and BCa [HR=3.8, 95% CI, 1.34-10.91] mortality was highest for women with all MetS components abnormal, compared to those without MetS. Linear associations of blood-pressure [HR=2.5, 1.02-6.12, Quartile (Q) 4 vs Q1, p trend=0.004] and blood-glucose [HR=2.2, 1.04-4.60, Q4 vs. Q1, p trend=0.04] with total-OLCas mortality were observed. A threefold increased risk of BCa mortality was observed for women with enlarged waist circumference, ≥100.9 cm, [HR=3.5, 1.14-10.51, p trend=0.008] and in those with increased blood glucose, ≥101 mg/dL, [HR=3.2, 1.11-9.20, p trend=0.03] compared to those in Q1. None of the components of MetS were associated with total-cancer mortality. CRP was not associated with cancer mortality. In conclusion, MetS is associated with total-cancer and breast-cancer mortality, with waist circumference, blood pressure and blood glucose as independent predictors of OLCas and BCa mortality.

AB - Although metabolic syndrome (MetS) is a prognostic factor for cancer occurrence, the association of MetS and cancer mortality remains unclear. The purpose of this study was to evaluate whether MetS, components of MetS and C-reactive protein (CRP) are associated with cancer mortality in women. A total of 400 cancer deaths, with 140 deaths from obesity-linked-cancers (OLCas), [breast (BCa), colorectal, pancreatic and endometrial], linked through the National Death Index, were identified from 10,104 eligible subjects aged ≥18 years. Cox proportional hazards regression was used to estimate multivariable-adjusted hazard ratios (HR) for cancer mortality. MetS was associated with increased deaths for total cancer [HR=1.33, 95% confidence interval (CI) 1.04-1.70] and BCa [HR=2.1, 95% CI, 1.09-4.11]. The risk of total cancer [HR=1.7, 95% CI, 1.12-2.68], OLCas [HR=2.1, 95% CI, 1.00-4.37] and BCa [HR=3.8, 95% CI, 1.34-10.91] mortality was highest for women with all MetS components abnormal, compared to those without MetS. Linear associations of blood-pressure [HR=2.5, 1.02-6.12, Quartile (Q) 4 vs Q1, p trend=0.004] and blood-glucose [HR=2.2, 1.04-4.60, Q4 vs. Q1, p trend=0.04] with total-OLCas mortality were observed. A threefold increased risk of BCa mortality was observed for women with enlarged waist circumference, ≥100.9 cm, [HR=3.5, 1.14-10.51, p trend=0.008] and in those with increased blood glucose, ≥101 mg/dL, [HR=3.2, 1.11-9.20, p trend=0.03] compared to those in Q1. None of the components of MetS were associated with total-cancer mortality. CRP was not associated with cancer mortality. In conclusion, MetS is associated with total-cancer and breast-cancer mortality, with waist circumference, blood pressure and blood glucose as independent predictors of OLCas and BCa mortality.

KW - Breast cancer

KW - C-reactive protein

KW - Cancer mortality

KW - Cohort study

KW - Epidemiology

KW - Metabolic syndrome

KW - Obesity-linked cancers

KW - Women

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U2 - 10.1002/ijc.31344

DO - 10.1002/ijc.31344

M3 - Article

JO - International Journal of Cancer

JF - International Journal of Cancer

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