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Metabolic syndrome and postmenopausal breast cancer: systematic review and meta-analysis

Esposito, Katherine MD, PhD1; Chiodini, Paolo PhD2; Capuano, Annalisa MD3; Bellastella, Giuseppe MD4; Maiorino, Maria Ida MD4; Rafaniello, Concetta MD3; Giugliano, Dario MD, PhD4

doi: 10.1097/GME.0b013e31828ce95d
Review Article

Objective The role of metabolic syndrome (MS) and its individual components in postmenopausal breast cancer (PBC) risk is still unclear. We reviewed and summarized epidemiological studies assessing the association of MS with the risk of PBC.

Methods We conducted an electronic search, without restrictions, for articles published before October 31, 2012. Every included study was to report risk estimates with 95% CIs for the association between MS and PBC. Study-specific estimates were pooled using random-effects models.

Results Nine articles (with 6,417 cancer cases), all published in English, were included in the meta-analysis. MS was associated with a 52% increase in cancer risk (P < 0.001)—for the most part confined to noncohort studies (109% increased risk); the risk estimates changed little, depending on populations (United States and Europe) and definition of the syndrome (traditional vs nontraditional). The risk estimates for PBC were 1.12 (P = 0.068) for higher values of body mass index/waist circumference, 1.19 (P = 0.005) for hyperglycemia (higher fasting glucose or diabetes), 1.13 (P = 0.027) for higher blood pressure, 1.08 (P = 0.248) for higher triglycerides, and 1.39 (P = 0.008) for lower high-density lipoprotein cholesterol. All these estimates were lower than those associated with MS in the same studies.

Conclusions MS is associated with a moderately increased risk of PBC. No single component explains the risk conveyed by the full syndrome.

From the 1Departments of Cardio-Thoracic and Respiratory Sciences, 2Medicine and Public Health, 3Experimental Medicine, and 4Geriatrics and Metabolic Diseases, Second University of Naples, Naples, Italy.

Received December 22, 2012; revised and accepted February 22, 2013.

Funding/support: This work was supported, in part, by a grant from the nonprofit association “Salute con Stile” (grant 1, 1/09/2012).

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Katherine Esposito, MD, PhD, Department of Cardio-Thoracic and Respiratory Sciences, Second University of Naples, Piazza L. Miraglia 2, Naples 80138, Italy. E-mail:

© 2013 by The North American Menopause Society.