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The Association Between Metabolic Syndrome and Colorectal Neoplasm: Systemic Review and Meta-analysis

Jinjuvadia, Raxitkumar MD, MPH*; Lohia, Prateek MD, MHA*; Jinjuvadia, Chetna MD*; Montoya, Sergio MD*; Liangpunsakul, Suthat MD, MPH†,‡

Journal of Clinical Gastroenterology: January 2013 - Volume 47 - Issue 1 - p 33–44
doi: 10.1097/MCG.0b013e3182688c15
ALIMENTARY TRACT: Original Articles

Background: There has been constant speculation about the association between metabolic syndrome (MetS) and colorectal neoplasia (CN); however, the published results are conflicting. The aims of this study are to conduct a systematic search, and assess the literature to determine the available evidence on the association between these two conditions.

Methods: Meta-analysis was conducted based on relevant studies identified through a systematic literature review from PubMed, OvidSP, and Cochrane database during January 1980 to July 2011. A combined analysis was performed, followed by a subgroup analyses stratified by the study design, type of colorectal lesions, and sex. Publication bias was assessed using the Begg and Egger tests and visual inspection of funnel plot.

Results: Eighteen studies were included in the final analysis. Overall, MetS was associated with 34% increase in the risk of CN [summary relative risk (RR), 1.34; 95% confidence interval (CI), 1.24-1.44]. The association between MetS and CN was found to be statistically significant in separate analysis for both case-control studies (summary RR, 1.58; 95% CI, 1.44-1.73) and cohort studies (summary RR, 1.21; 95% CI, 1.13-1.29). The association remained significant when analyses were restricted by type of colorectal lesions (colorectal cancer: RR, 1.30; 95% CI, 1.18-1.43; colorectal adenoma: RR, 1.37; 95% CI, 1.26-1.49). Further subgroup analysis by sex showed significant association between MetS and CN in both male and female population.

Conclusions: Our meta-analysis showed significant association between presence of MetS and CN. These results may help in identifying high-risk individuals at early stage, who might benefit from targeted colorectal cancer screening intervention.

*Department of Internal Medicine, Wayne State University/Detroit Medical Center, Detroit, MI

Department of Medicine, Division of Gastroenterology and Hepatology, Indiana University Medical Center

Roudebush Veterans Administration Medical Center, Indianapolis, IN

Supported by K08 AA016570 from the NIH/NIAAA, 1I01CX000361-01 from the Veterans Affairs Research and Administration, and Central Society for Clinical Research Career development award, and Research Support Fund Grant (S.L.).

The authors declare that they have nothing to disclose.

Reprints: Suthat Liangpunsakul, MD, MPH, Department of Medicine, Division of Gastroenterology and Hepatology, Indiana University Medical Center, 550 N, University Blvd, UH 4100, Indianapolis, IN 46202 (e-mail:

Received March 23, 2012

Accepted July 6, 2012

© 2013 Lippincott Williams & Wilkins, Inc.