DOI QR코드

DOI QR Code

Prevalence of the Metabolic Syndrome and Associated Factors in Korean Cancer Survivors

  • Lee, Jung-Yun (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Park, Noh Hyun (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Song, Yong-Sang (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Park, Sang Min (Department of Family Medicine, Seoul National University College of Medicine) ;
  • Lee, Hae-Won (Department of Family Medicine, Seoul National University College of Medicine) ;
  • Kim, Kyae Hyung (Department of Family Medicine, Seoul National University College of Medicine) ;
  • Choi, Kyung-Hyun (Department of Family Medicine, Dongnam Institute of Radiological & Medical Science)
  • Published : 2013.03.30

Abstract

Background: This study was designed to evaluate prevalence of the metabolic syndrome among cancer survivors compared to non-cancer controls from a population-based sample and to identify associated risk factors. Materials and Methods: Data from the fourth Korean National Health and Nutrition Examination Survey were analyzed to compare the prevalence of metabolic syndrome, as defined by 2009 consensus criteria. Associated factors with were identified using multiple logistic regression analysis among cancer survivors. Results: The prevalence of the metabolic syndrome in cancer survivors (n = 335) was similar to that in the non-cancer population (n = 10,671). However, gastric cancer survivors showed lower risk of metabolic syndrome than non-cancer controls (adjusted odds ratio [aOR] 0.42, 95% confidence interval [CI] 0.20-0.86). Age of more than 60 years (aOR 4.83, 95% CI 1.94-12.03), BMI between 23 and 25 (aOR 6.71, 95% CI 2.90-15.6), BMI more than 25 (aOR 12.23, 95% CI 5.20-28.77) were significantly associated with the metabolic syndrome in cancer survivors. Conclusions: Cancer survivors are unlikely to have a higher risk of the metabolic syndrome than non-cancer controls in Korea. This finding may be due to a relatively high proportion of gastric cancer survivors in Korea than in Western countries. The risk for metabolic syndrome among cancer survivors would appear to vary according to oncological and non-oncological factors.

Keywords

References

  1. Alberti KG, Eckel RH, Grundy SM, et al (2009). Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society;and International Association for the Study of Obesity. Circulation, 120, 1640-5. https://doi.org/10.1161/CIRCULATIONAHA.109.192644
  2. Amling CL, Riffenburgh RH, Sun L, et al (2004). Pathologic variables and recurrence rates as related to obesity and race in men with prostate cancer undergoing radical prostatectomy. J Clin Oncol, 22, 439-45.
  3. Amparo P, Farr SL, Dietz PM (2011). Chronic disease risk factors among American Indian/Alaska Native women of reproductive age. Prev Chronic Dis, 8, A118.
  4. Annaloro C, Usardi P, Airaghi L, et al (2008). Prevalence of metabolic syndrome in long-term survivors of hematopoietic stem cell transplantation. Bone Marrow Transplant, 41, 797-804. https://doi.org/10.1038/sj.bmt.1705972
  5. Ashrafian H, Ahmed K, Rowland SP, et al (2011). Metabolic surgery and cancer: protective effects of bariatric procedures. Cancer, 117, 1788-99. https://doi.org/10.1002/cncr.25738
  6. Bae JM, Park JW, Yang HK, et al (1998). Nutritional status of gastric cancer patients after total gastrectomy. World J Surg, 22, 254-60; discussion 60-1. https://doi.org/10.1007/s002689900379
  7. Bechtold M, Palmer J, Valtos J, et al (2006). Metabolic syndrome in the elderly. Curr Diab Rep, 6, 64-71. https://doi.org/10.1007/s11892-006-0054-3
  8. Befort CA, Klemp JR, Austin HL, et al (2012). Outcomes of a weight loss intervention among rural breast cancer survivors. Breast Cancer Res Treat, 132, 631-9. https://doi.org/10.1007/s10549-011-1922-3
  9. Bo M, Sona A, Astengo M, et al (2009). Metabolic syndrome in older subjects: coincidence or clustering? Arch Gerontol Geriatr, 48, 146-50. https://doi.org/10.1016/j.archger.2007.12.003
  10. Boyle P, Levin B (2008). World cancer report 2008, Lyon, IARC Press.
  11. Braga-Basaria M, Dobs AS, Muller DC, et al (2006). Metabolic syndrome in men with prostate cancer undergoing long-term androgen-deprivation therapy. J Clin Oncol, 24, 3979-83. https://doi.org/10.1200/JCO.2006.05.9741
  12. Brennan MF, Karpeh MS, JR (1996). Surgery for gastric cancer: the American view. Semin Oncol, 23, 352-9.
  13. Brown BW, Brauner C, Minnotte MC (1993). Noncancer deaths in white adult cancer patients. J Natl Cancer Inst, 85, 979-87. https://doi.org/10.1093/jnci/85.12.979
  14. Cabre JJ, Martin F, Costa B, et al (2008). Metabolic syndrome as a cardiovascular disease risk factor: patients evaluated in primary care. BMC Public Health, 8, 251. https://doi.org/10.1186/1471-2458-8-251
  15. Carey S, Storey D, Biankin AV, et al (2011). Long term nutritional status and quality of life following major upper gastrointestinal surgery - a cross-sectional study. Clin Nutr, 30, 774-9. https://doi.org/10.1016/j.clnu.2011.03.003
  16. Chlebowski RT, Aiello E, Mctiernan A (2002). Weight loss in breast cancer patient management. J Clin Oncol, 20, 1128-43. https://doi.org/10.1200/JCO.20.4.1128
  17. Erem C, Hacihasanoglu A, Deger O, et al (2008). Prevalence of metabolic syndrome and associated risk factors among Turkish adults: Trabzon MetS study. Endocrine, 33, 9-20. https://doi.org/10.1007/s12020-008-9044-3
  18. Follin C, Thilen U, Ahren B, et al (2006). Improvement in cardiac systolic function and reduced prevalence of metabolic syndrome after two years of growth hormone (GH) treatment in GH-deficient adult survivors of childhood-onset acute lymphoblastic leukemia. J Clin Endocrinol Metab, 91, 1872-5. https://doi.org/10.1210/jc.2005-2298
  19. Ford ES, Giles WH, Dietz WH (2002). Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA, 287, 356-9. https://doi.org/10.1001/jama.287.3.356
  20. Forootan M, Tabatabaeefar M, Yahyaei M, et al (2012). Metabolic syndrome and colorectal cancer:a crosssectional survey. Asian Pac J Cancer Prev, 13, 4999-5002. https://doi.org/10.7314/APJCP.2012.13.10.4999
  21. Gami AS, Witt BJ, Howard DE, et al (2007). Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol, 49, 403-14. https://doi.org/10.1016/j.jacc.2006.09.032
  22. Grinker JA, Tucker K, Vokonas PS, et al (1995). Body habitus changes among adult males from the normative aging study: relations to aging, smoking history and alcohol intake. Obes Res, 3, 435-46. https://doi.org/10.1002/j.1550-8528.1995.tb00173.x
  23. Gurney JG, Ness KK, Sibley SD, et al (2006). Metabolic syndrome and growth hormone deficiency in adult survivors of childhood acute lymphoblastic leukemia. Cancer, 107, 1303-12. https://doi.org/10.1002/cncr.22120
  24. Haskell WL, Lee IM, Pate RR, et al (2007). Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc, 39, 1423-34. https://doi.org/10.1249/mss.0b013e3180616b27
  25. Haugnes HS, Aass N, Fossa SD, et al (2007). Components of the metabolic syndrome in long-term survivors of testicular cancer. Ann Oncol, 18, 241-8.
  26. Jung HS, Myung SK, Kim BS, et al (2012). Metabolic syndrome in adult cancer survivors: a meta-analysis. Diabetes Res Clin Pract, 95, 275-82. https://doi.org/10.1016/j.diabres.2011.08.029
  27. Jung KW, Park S, Kong HJ, et al (2011). Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2008. Cancer Res Treat, 43, 1-11. https://doi.org/10.4143/crt.2011.43.1.1
  28. Korea Centers for Disease Control and Prevention (2010). The fourth Korean National Health and Nutrition Examination Survey [Online], Available from: http://knhanes.cdc.go.kr. [2012, Sepember 1]. [Online].
  29. Kourti M, Tragiannidis A, Makedou A, et al (2005). Metabolic syndrome in children and adolescents with acute lymphoblastic leukemia after the completion of chemotherapy. J Pediatr Hematol Oncol, 27, 499-501. https://doi.org/10.1097/01.mph.0000181428.63552.e9
  30. Lechleitner M (2008). Obesity and the metabolic syndrome in the elderly--a mini-review. Gerontology, 54, 253-9. https://doi.org/10.1159/000161734
  31. Lehtonen R, Pahkinen E (2004). Practical methods for design and analysis of complex surveys (2nd ed.). Chichester, England: John Wiley & Sons.
  32. Liavaag AH, Tonstad S, Pripp AH, et al (2009). Prevalence and determinants of metabolic syndrome and elevated Framingham risk score in epithelial ovarian cancer survivors: a controlled observational study. Int J Gynecol Cancer, 19, 634-40. https://doi.org/10.1111/IGC.0b013e3181a13058
  33. Meyerhardt JA, Catalano PJ, Haller DG, et al (2003). Influence of body mass index on outcomes and treatmentrelated toxicity in patients with colon carcinoma. Cancer, 98, 484-95. https://doi.org/10.1002/cncr.11544
  34. Mohamud WN, Ismail A, Khir AS, et al (2011). Prevalence of metabolic syndrome and its risk factors in adult Malaysians: results of a nationwide survey. Diabetes Res Clin Pract, 96, 91-7.
  35. National Cancer Information Center (2011). Cancer incidence [Online], Available from: http://www.cancer.go.kr/ncic/cics_f/01/011/index.html. [2012, September 14].
  36. National Cancer Institute (2012). SEER Cancer Statistics Review, 1975-2009 [Online], Available from: http://seer.cancer.gov/csr/1975_2009_pops09/. [2012, April 1].
  37. Ness KK, Oakes JM, Punyko JA, et al (2005). Prevalence of the metabolic syndrome in relation to self-reported cancer history. Ann Epidemiol, 15, 202-6. https://doi.org/10.1016/j.annepidem.2004.07.092
  38. Nuver J, Smit AJ, Wolffenbuttel BH, et al (2005). The metabolic syndrome and disturbances in hormone levels in long-term survivors of disseminated testicular cancer. J Clin Oncol, 23, 3718-25. https://doi.org/10.1200/JCO.2005.02.176
  39. Oeffinger KC, Mertens AC, Sklar CA, et al (2006). Chronic health conditions in adult survivors of childhood cancer. N Engl J Med, 355, 1572-82. https://doi.org/10.1056/NEJMsa060185
  40. Park HS, Oh SW, Cho SI, et al (2004). The metabolic syndrome and associated lifestyle factors among South Korean adults. Int J Epidemiol, 33, 328-36. https://doi.org/10.1093/ije/dyh032
  41. Park SM, Lim MK, Shin SA, et al (2006). Impact of prediagnosis smoking, alcohol, obesity, and insulin resistance on survival in male cancer patients: National Health Insurance Corporation Study. J Clin Oncol, 24, 5017-24. https://doi.org/10.1200/JCO.2006.07.0243
  42. Park YW, Zhu S, Palaniappan L, et al (2003). The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994. Arch Intern Med, 163, 427-36. https://doi.org/10.1001/archinte.163.4.427
  43. Redig AJ, Munshi HG (2010). Care of the cancer survivor: metabolic syndrome after hormone-modifying therapy. Am J Med, 123, 87 e1-6.
  44. Riediger ND, Clara I (2011). Prevalence of metabolic syndrome in the Canadian adult population. CMAJ, 183, E1127-34. https://doi.org/10.1503/cmaj.110704
  45. Rodrigues AD, Theodoro H, Mendes KG, et al (2013). Factors associated with metabolic syndrome in climacteric women of southern Brazil. Climacteric, 16, 96-103. https://doi.org/10.3109/13697137.2012.659099
  46. Ronco, AL, De Stefani E. Deoneo-Pellegrini H, et al (2012). Diabetes, overweight and risk of postmenopausal breast cancer : a case-control study in Uruguay. Asian Pac J Cancer Prev, 13, 139-46. https://doi.org/10.7314/APJCP.2012.13.1.139
  47. Shin DW, Ahn E, Kim H, et al (2010a). Non-cancer mortality among long-term survivors of adult cancer in Korea: national cancer registry study. Cancer Causes Control, 21, 919-29. https://doi.org/10.1007/s10552-010-9521-x
  48. Shin DW, Nam JH, Kwon YC, et al (2008). Comorbidity in disease-free survivors of cervical cancer compared with the general female population. Oncology, 74, 207-15. https://doi.org/10.1159/000151368
  49. Shin DW, Park JH, Park EC, et al (2010b). Antihypertensive medication adherence in cancer survivors and its affecting factors: results of a Korean population-based study. Support Care Cancer, 19, 211-20.
  50. Talvensaari KK, Lanning M, Tapanainen P, et al (1996). Longterm survivors of childhood cancer have an increased risk of manifesting the metabolic syndrome. J Clin Endocrinol Metab, 81, 3051-5. https://doi.org/10.1210/jc.81.8.3051
  51. Tayek JA, Heber D, Byerley LO, et al (1990). Nutritional and metabolic effects of gonadotropin-releasing hormone agonist treatment for prostate cancer. Metabolism, 39, 1314-9. https://doi.org/10.1016/0026-0495(90)90190-N
  52. Trimis G, Moschovi M, Papassotiriou I, et al (2007). Early indicators of dysmetabolic syndrome in young survivors of acute lymphoblastic leukemia in childhood as a target for preventing disease. J Pediatr Hematol Oncol, 29, 309-14. https://doi.org/10.1097/MPH.0b013e318059c249
  53. Ulaganathan V, Kandiah M, Zalilah MS, et al (2012). Colorectal cancer and its association with the metabolic syndrome:a Malaysian multi-centric case-control study. Asian Pac J Cancer Prev, 13, 3873-7. https://doi.org/10.7314/APJCP.2012.13.8.3873
  54. Villareal DT, Apovian CM, Kushner RF, et al (2005). Obesity in older adults: technical review and position statement of the American Society for Nutrition and NAASO, The Obesity Society. Obes Res, 13, 1849-63. https://doi.org/10.1038/oby.2005.228
  55. Visser M, Langlois J, Guralnik JM, et al (1998). High body fatness, but not low fat-free mass, predicts disability in older men and women: the Cardiovascular Health Study. Am J Clin Nutr, 68, 584-90.
  56. Whiteman MK, Hillis SD, Curtis KM, et al (2005). Body mass and mortality after breast cancer diagnosis. Cancer Epidemiol Biomarkers Prev, 14, 2009-14. https://doi.org/10.1158/1055-9965.EPI-05-0106
  57. WHO/IASO/IOTF (2000). The Asia-Pacific Perspective: Redefining Obesity and its Treatment. Melbourne: Health Communication, Australia. Pty Ltd.

Cited by

  1. Risk of Cancer Mortality according to the Metabolic Health Status and Degree of Obesity vol.15, pp.22, 2014, https://doi.org/10.7314/APJCP.2014.15.22.10027
  2. Short Sleep Duration and Its Correlates among Cancer Survivors in Korea: the Korea National Health and Nutrition Examination Surveys vol.16, pp.11, 2015, https://doi.org/10.7314/APJCP.2015.16.11.4705
  3. Prevalence of Sarcopenia and Its Association with Metabolic Syndrome in Korean Cancer Survivors vol.24, pp.3, 2015, https://doi.org/10.7570/kjo.2015.24.3.140