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

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Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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

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Data availability

The datasets used and/or analysed during the current study are available from the Women’s Health Initiative Coordinating Center on reasonable request.

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Funding

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

Author information

Author notes

  1. Rhonda Arthur and Geoffrey C. Kabat have equal contribution.

Authors and Affiliations

  1. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA

    Rhonda S. Arthur, Mimi Y. Kim, Howard Strickler, Sylvia Wassertheil-Smoller & Thomas E. Rohan

  2. 16 Bon Air Avenue, New Rochelle, NY, USA

    Geoffrey C. Kabat

  3. Department of Obstetrics and Gynecology, Oklahoma University Health Sciences Center, Oklahoma City, OK, USA

    Robert A. Wild

  4. Department of Family Medicine and Public Health, University of California, La Jolla, CA, USA

    Aladdin H. Shadyab

  5. Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA

    Jean Wactawski-Wende

  6. Department of Occupational Medicine, Epidemiology and Prevention, Feinstein Institute for Medical Research, Hofstra Northwell School of Medicine, Great Neck, NY, USA

    Gloria Y. F. Ho

  7. Department of Biostatistics and Epidemiology, University of Massachusetts, Amherst, MA, USA

    Katherine W. Reeves

  8. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA

    Lewis H. Kuller

  9. Departments of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington, IN, USA

    Juhua Luo

  10. Karmanos Cancer Institute, Detroit, MI, USA

    Jennifer Beebe-Dimmer & Michael S. Simon

Authors
  1. Rhonda S. Arthur
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  2. Geoffrey C. Kabat
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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.

Corresponding author

Correspondence to Rhonda S. Arthur.

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Arthur, R.S., Kabat, G.C., Kim, M.Y. et al. Metabolic syndrome and risk of endometrial cancer in postmenopausal women: a prospective study. Cancer Causes Control 30, 355–363 (2019). https://doi.org/10.1007/s10552-019-01139-5

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  • DOI: https://doi.org/10.1007/s10552-019-01139-5

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