Cancer Causes & Control

, Volume 30, Issue 4, pp 355–363 | Cite as

Metabolic syndrome and risk of endometrial cancer in postmenopausal women: a prospective study

  • Rhonda S. ArthurEmail author
  • Geoffrey C. Kabat
  • Mimi Y. Kim
  • Robert A. Wild
  • Aladdin H. Shadyab
  • Jean Wactawski-Wende
  • Gloria Y. F. Ho
  • Katherine W. Reeves
  • Lewis H. Kuller
  • Juhua Luo
  • Jennifer Beebe-Dimmer
  • Michael S. Simon
  • Howard Strickler
  • Sylvia Wassertheil-Smoller
  • Thomas E. Rohan
Original Paper



Obesity is a strong risk factor for endometrial cancer, but it is unclear whether metabolic syndrome (MetS) contributes to endometrial cancer risk over and above the contribution of obesity.


We examined the association of MetS and its components with risk of endometrial cancer in a sub-cohort of 24,210 women enrolled in the Women’s Health Initiative cohort study. Two variants of the National Cholesterol Education Program Adult Treatment Panel III definition of the MetS were used: one including and one excluding waist circumference (WC). Cox proportional hazards models were used to estimate the association of the study exposures with disease risk.


When WC was included in the definition, MetS showed an approximately two-fold increase in endometrial cancer risk (HR 2.20; 95% CI 1.61–3.02); however, when WC was excluded, MetS was no longer associated with risk. We also observed that women with hyperglycemia, dyslipidemia and hypertension, in combination, had almost a twofold increased risk of endometrial cancer, independent of WC (HR 1.94; 95% CI 1.09, 3.46). Glucose, and, in particular, WC and body mass index were also positively associated with risk.


Our findings suggest that MetS may predict risk of endometrial cancer independent of obesity among women with the remaining four Mets components.


Metabolic syndrome Obesity Abdominal adiposity Endometrial cancer Postmenopausal women 


Author contributions

Conception and design: TER, GCK, RA; Development of methodology: GCK, TER, RA; Acquisition of data: GCK; Analysis and interpretation of data (e.g., statistical analysis, biostatistics, computational analysis): GCK, TER, RA, MYK; Writing, review, and/or revision of the manuscript: GCK, TER, RA, MYK, RAW, AHS, JW-W, GYFH, KWR, LHK, JL, JB-D, MSS, HS, SW-S.


This work was supported by institutional funds from the Albert Einstein College of Medicine.

Compliance with ethical standards

Conflict of interest

No potential conflicts of interest were disclosed.

Supplementary material

10552_2019_1139_MOESM1_ESM.docx (19 kb)
Supplementary material 1 (DOCX 19 KB)


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Rhonda S. Arthur
    • 1
    Email author
  • Geoffrey C. Kabat
    • 2
  • Mimi Y. Kim
    • 1
  • Robert A. Wild
    • 3
  • Aladdin H. Shadyab
    • 4
  • Jean Wactawski-Wende
    • 5
  • Gloria Y. F. Ho
    • 6
  • Katherine W. Reeves
    • 7
  • Lewis H. Kuller
    • 8
  • Juhua Luo
    • 9
  • Jennifer Beebe-Dimmer
    • 10
  • Michael S. Simon
    • 10
  • Howard Strickler
    • 1
  • Sylvia Wassertheil-Smoller
    • 1
  • Thomas E. Rohan
    • 1
  1. 1.Department of Epidemiology and Population HealthAlbert Einstein College of MedicineBronxUSA
  2. 2.New RochelleUSA
  3. 3.Department of Obstetrics and GynecologyOklahoma University Health Sciences CenterOklahoma CityUSA
  4. 4.Department of Family Medicine and Public HealthUniversity of CaliforniaLa JollaUSA
  5. 5.Department of Epidemiology and Environmental Health, School of Public Health and Health ProfessionsUniversity at Buffalo, The State University of New YorkBuffaloUSA
  6. 6.Department of Occupational Medicine, Epidemiology and PreventionFeinstein Institute for Medical Research, Hofstra Northwell School of MedicineGreat NeckUSA
  7. 7.Department of Biostatistics and EpidemiologyUniversity of MassachusettsAmherstUSA
  8. 8.Department of Epidemiology, Graduate School of Public HealthUniversity of PittsburghPittsburghUSA
  9. 9.Departments of Epidemiology and Biostatistics, School of Public HealthIndiana University BloomingtonBloomingtonUSA
  10. 10.Karmanos Cancer InstituteDetroitUSA

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