Metabolic Syndrome and the Risk of gastrointestinal Cancer: a Case-Control Study

Document Type: Research Articles

Authors

1 Medical Toxicology and Drug Abuse Research Center (MTDRC),Department of physiology, Birjand University of Medical Sciences, Birjand, Iran.

2 Social Determinants of Health Research Center, Department of Health Education, School of Health, Birjand University of Medical Sciences, Birjand, Iran.

3 Department of pathology, Birjand University of Medical Sciences, Birjand,Iran.

4 Social Determinants of Health Research Center, Department of physiology, Birjand University of Medical Sciences, Birjand, Iran.

5 Social Determinants of Health Research Center, Department of internal Medicine, Birjand University of Medical Sciences, Birjand, Iran.

Abstract

Background: The metabolic syndrome and its concomitant complications are a major public health challenge
worldwide. Growing evidence implies associations with cancer development and progression. Since there has been no
report on this subject in South Khorasan, we studied metabolic syndrome components in gastrointestinal (GI) cancer
patients for comparison with a control group in this province. Materials and methods: This case-control study was
performed on 68 patients with histopathologically proven gastrointestinal cancers, referred to the oncology center
in Birjand city (capital of South Khorasan province, Iran) in 2016-2017, and 100 control subjects without disease.
Patients and control subjects completed a researcher-made questionnaire covering demographic characteristics, physical
activities and food intake. Also, blood samples were obtained from both patients and control subjects after overnight
fast. Anthropometric measurements of height, weight, body mass index, waist circumference and blood pressure were
additionally performed. Results: Significant differences in the levels of blood glucose and serum HDL were noted
between the two groups (P≤0.001). Also, the percentage of pre-diabetic and diabetic patients in the case group was
higher than the control group (17.6 and 16.2% vs. 10.3 and 2.9%) (P=0.009). Multiple logistic regression showed that
the risk of gastrointestinal cancer in people with high blood glucose was 3.35 times that in those with normal blood
glucose (OR3.35, 95%CI,1.41-7.94; P=0.006) , 2.37 times higher in subjects with lower HDL (OR 2.37, 95%CI,1.18-
4.78), 10.4 times higher in overweight people (OR10.4, 95%CI,2.23-48.5) and 4.3 times higher in individuals with an
opium addiction(OR4.3, 95%CI, 1.6-11.5) than those without. The mean consumption of fish (P=0.03) and vegetables
and fruits (P=0.027) in the case group was significantly lower than in the control group. Conclusion: Emerging evidence
indicates that the metabolic syndrome or its individual components may be important in the etiology and progression
of GI cancer. Research to work toward preventing cancers should thus focus on nutritional and lifestyle modifications
which may alleviate the metabolic syndrome.

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