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Author (up) Lin, Y.; Ness-Jensen, E.; Hveem, K.; Lagergren, J.; Lu, Y. url  doi
  Title Metabolic syndrome and esophageal and gastric cancer Type Journal Article
  Year 2015 Publication Cancer Causes Control Abbreviated Journal Cancer causes & control  
  Volume 26 Issue 12 Pages 1825-1834  
  Keywords HUNT3; Adenocarcinoma/epidemiology/*etiology; Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell/epidemiology/*etiology; Cohort Studies; Esophageal Neoplasms/epidemiology/*etiology; Female; Humans; Male; Metabolic Syndrome X/*complications; Middle Aged; Norway/epidemiology; Proportional Hazards Models; Prospective Studies; Risk Factors; Stomach Neoplasms/epidemiology/*etiology; Waist Circumference/physiology; Young Adult  
  Abstract BACKGROUND: The role of the metabolic syndrome in the etiology of esophageal and gastric cancer is unclear. METHODS: This was a large nationwide cohort study based on data from 11 prospective population-based cohorts in Norway with long-term follow-up, the Cohort of Norway (CONOR) and the third Nord-Trondelag Health Study (HUNT3). The metabolic syndrome was assessed by objective anthropometric and metabolic biochemical measures and was defined by the presence of at least three of the following five factors: increased waist circumference, elevated triglycerides, low high-density lipoprotein cholesterol, hypertension and high glucose. Newly diagnosed cases of esophageal adenocarcinoma, esophageal squamous-cell carcinoma and gastric adenocarcinoma were identified from the Norwegian Cancer Registry. Hazard ratios (HRs) and 95 % confidence intervals (CIs) were estimated using Cox proportional hazard models with adjustment for potential confounders. RESULT: Among 192,903 participants followed up for an average of 10.6 years, 62 developed esophageal adenocarcinoma, 64 had esophageal squamous-cell carcinoma and 373 had gastric adenocarcinoma. The metabolic syndrome was significantly associated with an increased risk of gastric adenocarcinoma (HR 1.44, 95 % CI 1.14-1.82), but not associated with esophageal adenocarcinoma (HR 1.32, 95 % CI 0.77-2.26) or esophageal squamous-cell carcinoma (HR 1.08, 95 % CI 0.64-1.83). Increased waist circumference was associated with an increased HR of esophageal adenocarcinoma (HR 2.48, 95 % CI 1.27-4.85). No significant association was found between any single component of the metabolic syndrome and risk of esophageal squamous-cell carcinoma. High waist circumference (HR 1.71, 95 % CI 1.05-2.80), hypertension (HR 2.41, 95 % CI 1.44-4.03) and non-fasting glucose (HR 1.74, 95 % CI 1.18-2.56) were also related to an increased risk of gastric adenocarcinoma in women, but not in men. CONCLUSION: Metabolic syndrome was associated with an increased risk of gastric adenocarcinoma in women. Of the individual components of the metabolic syndrome, high waist circumference was positively associated with risk of esophageal adenocarcinoma. Positive associations were also observed for women between high waist circumference, hypertension, high non-fasting glucose and risk of gastric adenocarcinoma. However, further evidence is warranted due to the limited number of cases and the inability to effectively identify gastric cardia adenocarcinoma.  
  Corporate Author Thesis  
  Publisher Place of Publication Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Editor  
  Language Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN ISBN Medium  
  Area Expedition Conference  
  Notes Lin, YulanNess-Jensen, EivindHveem, KristianLagergren, JesperLu, YunxiaengNetherlands2015/10/10 06:00Cancer Causes Control. 2015 Dec;26(12):1825-34. doi: 10.1007/s10552-015-0675-4. Epub 2015 Oct 8. Approved no  
  Call Number HUNT @ maria.stuifbergen @ Lin2015 Serial 1840  
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