Metabolic syndrome and cardiovascular disease in cancer survivors

Kensuke Ueno; Hidehiro Kaneko; Yuta Suzuki; Akira Okada; Satoshi Matsuoka; Katsuhito Fujiu; Nobuaki Michihata; Taisuke Jo; Norifumi Takeda; Hiroyuki Morita; Kentaro Kamiya; Junya Ako; Koichi Node; Hideo Yasunaga; Issei Komuro

doi:10.1002/jcsm.13443

Metabolic syndrome and cardiovascular disease in cancer survivors

J Cachexia Sarcopenia Muscle. 2024 Mar 22. doi: 10.1002/jcsm.13443. Online ahead of print.

Authors

Kensuke Ueno^{1

2}, Hidehiro Kaneko^{1

3}, Yuta Suzuki¹, Akira Okada⁴, Satoshi Matsuoka¹, Katsuhito Fujiu^{1

3}, Nobuaki Michihata⁵, Taisuke Jo⁵, Norifumi Takeda¹, Hiroyuki Morita¹, Kentaro Kamiya⁶, Junya Ako⁷, Koichi Node⁸, Hideo Yasunaga⁹, Issei Komuro¹

Affiliations

¹ Department of Cardiovascular Medicine, University of Tokyo, Tokyo, Japan.
² Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan.
³ Department of Advanced Cardiology, University of Tokyo, Tokyo, Japan.
⁴ Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
⁵ Department of Health Services Research, University of Tokyo, Tokyo, Japan.
⁶ Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan.
⁷ Department of Cardiovascular Medicine, School of Medicine, Kitasato University, Kanagawa, Japan.
⁸ Department of Cardiovascular Medicine, Saga University, Saga, Japan.
⁹ Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan.

PMID: 38515400
DOI: 10.1002/jcsm.13443

Abstract

Background: The risk of subsequent cardiovascular disease (CVD) is high in cancer survivors. Although metabolic syndrome is an established risk factor for CVD, its association with cancer survivors has not yet been established. This study aimed to clarify whether metabolic syndrome is associated with subsequent CVD risk in patients with cancer using a nationwide epidemiological dataset.

Methods: We retrospectively analysed 53 510 patients with a history of breast, colorectal, or stomach cancer, which is reportedly a major site for developing cancer in Japan. Study participants were categorized into two groups based on the presence of metabolic syndrome, defined using the Japanese criteria (high waist circumference and ≥2 metabolic parameters including elevated blood pressure, elevated triglycerides, reduced high-density lipoprotein cholesterol, or elevated fasting plasma glucose). The clinical outcomes were collected between 2005 and 2021. The primary endpoint was defined as the composite CVD outcome, including myocardial infarction, angina pectoris, stroke, and heart failure.

Results: The median patient age was 54 years, and 37.5% of the patients were men. Metabolic syndrome was observed in 5558 (10.4%) patients. Over a mean follow-up period of 973 ± 791 days, 3085 composite CVD outcomes were recorded. Multivariable Cox regression analyses showed that metabolic syndrome was associated with a greater risk of developing CVD events (HR = 1.29, 95% CI = 1.15-1.45). Metabolic syndrome was also associated with an increased risk of CVD in patients with a follow-up period ≥1 year (HR = 1.33, 95% CI = 1.15-1.53). This relationship was also observed when metabolic syndrome was defined according to the International Diabetes Federation criteria (HR = 1.34, 95% CI = 1.21-1.49) and the National Cholesterol Education Program Adult Treatment Panel III criteria (HR = 1.32, 95% CI = 1.19-1.46). Subgroup analyses showed that the relationship between metabolic syndrome and incident CVD was more pronounced in the non-obese participants than in the obese participants.

Conclusions: Metabolic syndrome is associated with a greater risk of developing CVD, even among cancer survivors.

Keywords: Cancer survivors; Cardiovascular disease; Epidemiology; Metabolic syndrome; Onco‐cardiology.

Abstract

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