Background: We examined the association between metabolic dysregulation and cancer mortality in a prospective cohort of Black and White adults.
Methods: A total of 25,038 Black and White adults were included in the analysis. Metabolic dysregulation was defined in two ways: 1) using the joint harmonized criteria for metabolic syndrome (MetS) and 2) based on factor analysis of 15 variables characterizing metabolic dysregulation. We estimated hazards ratios (HRs) and 95% confidence intervals (CIs) for the association of MetS and metabolic dysregulation with cancer mortality during follow-up using Cox proportional hazards models.
Results: About 46% of Black and 39% of White participants met the criteria for MetS. Overall, participants with MetS (HR: 1.22, 95% CI: 1.03–1.45) were at increased risk of cancer-related death. In race-stratified analysis, Black participants with MetS had significantly increased risk of cancer mortality compared with those without MetS (HR: 1.32, 95% CI: 1.01–1.72), increasing to more than a 2-fold risk of cancer mortality among those with five metabolic syndrome components (HR: 2.35, 95% CI: 1.01–5.51).
Conclusions: There are marked racial differences in the prevalence of metabolic dysregulation defined as MetS based on the harmonized criteria. The strong positive associations between MetS and cancer mortality suggests that efforts to improve cancer outcomes in general, and racial disparities in cancer outcomes specifically, may benefit from prevention and management of MetS and its components.
Digital Object Identifier (DOI)
This study was supported by award R01-NR012726 from the National Institute for Nursing Research, UL1-RR025777 from the National Center for Research Resources, K08HL096841 and R01HL080477 from the National Heart, Lung, and Blood Institute, as well as by grants from the Center for Clinical and Translational Science and the Lister Hill Center for Health Policy of the University of Alabama at Birmingham. The REGARDS study was supported by cooperative agreement U01-NS041588 from the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Department of Health and Human Service. Dr. Moore received support from grants R25 CA47888 and T32CA190194 of the National Cancer Institute. Dr. Akinyemiju was funded by grant K01TW010271 by the NIH.
The data that support the findings of this study are available from REGARDS project sponsored by National Institutes of Health (NIH). REGARDS data are however available upon approval of a manuscript proposal by the REGARDS Executive Committee at: firstname.lastname@example.org or http://www.regardsstudy.org/researchers.
Akinyemiju, Tomi; Moore, Justin Xavier; Judd, Suzanne; Lakoski, Susan; Goodman, Michael; Safford, Monika M.; and Pisu, Maria, "Metabolic Dysregulation and Cancer Mortality in a National Cohort of Blacks and Whites" (2017). Epidemiology Faculty Publications. 21.
Additional file 1: Appendix A
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Additional file 2: Appendix B
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Additional file 3: Appendix C
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Additional file 4: Appendix D
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Additional file 5: Appendix E
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Additional file 6: Appendix F