Metabolic Dysfunction Among Colorectal Cancer Survivors: Results from the National Health and Nutrition Examination Survey

Authors: Winn M, Bulsiewicz A, Karra P, Playdon M, Hardikar S

Category: Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2020

Abstract Body:
Purpose: Metabolic syndrome (MetS) is a known risk factor for multiple cancers, including colorectal cancer (CRC). However, the prevalence of MetS and the degree of metabolic dysfunction among CRC patients is unknown. Methods: Using National Health and Nutrition Examination Survey (NHANES) data from years 1999-2016, we identified persons with physical and laboratory measurements on components of MetS that also had questionnaire data available. Presence of MetS was calculated using the National Cholesterol Education Program’s Adult Treatment Panel III (NCEP ATPIII) criteria of presence of three or more of hyperglycemia, hypertension, obesity, elevated triglycerides, and low HDL-cholesterol. A metabolic syndrome score (MSS) was calculated to determine if presence of multiple MetS criteria was associated with CRC. A metabolic dysfunction score (MDS) was also calculated using clinically validated reference ranges for MetS components (blood pressure, BMI, glucose, triglycerides, HDL-cholesterol), CRP, and HOMA-IR to assess the severity of metabolic dysfunction. Adjusted odds ratios and 95% confidence intervals were estimated using logistic regression analyses after adjusting for covariates. Results: Data were available on 164 adult participants with CRC and 25,761 controls. 63.41% of CRC cases and 53.09% of controls were classified as having MetS per the NCEP ATPIII definition. Overall, presence of MetS was not associated with CRC (OR 1.06, 95% CI 0.76-1.48). Among study participants with MetS, a positive trend with increasing age was observed for CRC (age <50 [OR 0.57, 95% CI 0.10-3.11], age 50-59 [OR 0.69, 95% CI 0.24- 1.96], age 60-69 [OR 0.83, 95% CI 0.43-1.62], age 70-79 [OR 1.01, 95% CI 0.57-1.80], age >80 [OR 1.72, 95% CI 0.86-3.43]), however this trend was not statistically significant (p-interaction = 0.73). Presence of metabolic dysfunction was also not associated with CRC, as suggested by the MSS and MDS [OR (95% CI) = 0.99(0.92- 1.06) and 1.02(0.88-1.18), respectively]. Conclusions: Our findings suggest that presence of MetS or metabolic dysfunction is not associated with CRC in this NHANES cohort. Future prospective studies, with larger number of CRC cases, are needed to understand the role of metabolic syndrome and metabolic dysfunction in CRC.

Keywords: Metabolic syndrome Metabolic dysfunction Colorectal cancer