Association of metabolic syndrome and the risk of bladder cancer: A prospective cohort study

Shuo Fang; Yuchen Liu; Huiru Dai; Tianshun Gao; Leli Zeng; Rui Sun; Zilong Zheng; Jinqiu Yuan; Bin Xia; Yihang Pan

doi:10.3389/fonc.2022.996440

Association of metabolic syndrome and the risk of bladder cancer: A prospective cohort study

Front Oncol. 2022 Oct 3:12:996440. doi: 10.3389/fonc.2022.996440. eCollection 2022.

Authors

Shuo Fang^{1

2

3}, Yuchen Liu³, Huiru Dai¹, Tianshun Gao³, Leli Zeng³, Rui Sun^{3

4}, Zilong Zheng³, Jinqiu Yuan^{3

5}, Bin Xia^{3

5}, Yihang Pan^{3

6}

Affiliations

¹ Department of Oncology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.
² Department of Clinical Oncology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.
³ Big Data Centre, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.
⁴ Centre for Clinical Research and Biostatistics, The Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.
⁵ Clinical Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.
⁶ Precision Medicine Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.

Abstract

Background: Metabolic syndrome (MetS) and its components have been shown as risk factors for several solid cancers. However, current epidemiological evidence about the relevance of MetS and bladder cancer risk was limited.

Methods: We conducted a prospective cohort study of 476,986 participants with undiagnosed bladder cancer based on the UK Biobank. MetS was defined as the presence of at least three of the five selected indicators: hypertension, central obesity, raised triglyceride, reduced HDL-cholesterol, and raised fasting plasma glucose. Bladder cancer has been identified through contact with the British Cancer Registry (median follow-up time: 6.6 years). We assessed hazard ratio (HR) and 95% confidence interval (CI) through Cox proportional hazard regression after adjusting for demographic and lifestyle factors. Non-linear associations for individual MetS components were assessed by the restricted cubic spline method.

Results: During a follow-up of 3,112,566 person-years, 487 cases of bladder cancer were ascertained. MetS (HR = 1.32, 95% CI = 1.08-1.61), central obesity (HR = 1.39, 95% CI = 1.15-1.68), dyslipidemia for HDL cholesterol (HR = 1.31, 95% CI = 1.04-1.66), and hyperglycemia (HR = 1.44, 95% CI = 1.16-1.79) were associated with elevated risk of bladder cancer. Bladder cancer risk increased with the number of MetS components. In stratified analyses, MetS showed similar effects in bladder cancer independently with sex, age, cigarette and alcohol use, physical activity, and dietary factors. Higher waist circumference, BMI, fasting blood glucose, and glycosylated hemoglobin were independently associated with increased risk of bladder cancer, with no evidence against non-linearity.

Conclusion: MetS might be an independent risk factor for bladder cancer. Our findings highlighted the importance of individualized management of MetS components for preventing bladder cancer.

Keywords: bladder cancer; blood glucose; central obesity; independent risk; metabolic syndrome.

Abstract

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