Association between metabolic syndrome and incident colorectal cancer in young adults: analysis of a nationwide epidemiological database. (14th October 2021) - Seki, H
Abstract: Background: Colorectal cancer (CRC) is still increasing in young adults. Metabolic syndrome is reported to be associated with CRC incidence in middle-aged and elderly subjects. However, whether this association exists in young adults remains unclear. We sought to clarify whether metabolic syndrome was associated with incident CRC in young adults (aged<50 years). Methods: We studied 902, 599 participants (Median age=41 [37–45] years; 55.4% men) enrolled in the JMDC Claims Database during 2005 and 2018. Participants who had a history of CRC, colorectal polyps, Crohn's disease, or ulcerative colitis were excluded. Study participants were categorized into two groups according to the presence of metabolic syndrome based on the Japanese criteria (waist circumference ≥85 cm for men and ≥90 cm for women, and ≥2 metabolic parameters including elevated blood pressure, elevated triglycerides, reduced high-density lipoprotein cholesterol, or elevated fasting plasma glucose). Results: Metabolic syndrome was seen in 58, 561 individuals (6.5%). Over a median follow-up of 1, 008 (429–1, 833) days, there were 1, 884 CRC diagnoses. After multivariable adjustment, the hazard ratio (HR) of metabolic syndrome for CRC events was 1.26 (95% confidence interval [CI]=1.07–1.49). Cox regression analysis after multiple imputation for missing values showed that metabolic syndrome was associated with CRC incidence (HR=1.35, 95% CI=1.17–1.56), and metabolic syndrome was associated with a higher incidence of CRC in individuals with a follow-up period of ≥365 days (HR=1.33, 95% CI=1.10–1.60). This association was also observed when metabolic syndrome was defined according to the International Diabetes Federation criteria (HR=1.30, 95% CI=1.09–1.49) and the National Cholesterol Education Program Adult Treatment Panel III criteria (HR=1.39, 95% CI=1.12–1.72). Conclusions: Metabolic syndrome was associated with a higher incidence of CRC among individuals aged <50 years. These results could be informative for risk stratification of subsequent CRC among young adults. FUNDunding Acknowledgement: Type of funding sources: Public grant(s) – National budget only. Main funding source(s): the Ministry of Health, Labour and Welfare, Japan (19AA2007 and H30-Policy-Designated-004) and the Ministry of Education, Culture, Sports, Science and Technology, Japan (17H04141)