Few studies have assessed the metabolic syndrome (MetS) as an entity in relation to breast cancer risk, and results have been inconsistent. We aimed to examine the association between MetS factors ...(individually and combined) and risk of breast cancer incidence and mortality.
Two hundred ninety thousand women from Austria, Norway, and Sweden were enrolled during 1974-2005, with measurements of height, weight, blood pressure, and levels of glucose, cholesterol, and triglycerides. Relative risks (RR) of breast cancer were estimated using Cox proportional hazards regression for each MetS factor in quintiles and for standardized levels (z-scores) and for a composite z-score for the MetS.
There were 4,862 incident cases of breast cancer and 633 deaths from breast cancer identified. In women below age 50, there was a decreased risk of incident cancer for the MetS (per 1-unit increment of z-score; RR, 0.83; 95% confidence interval, 0.76-0.90) as well as for the individual factors (except for glucose). The lowest risks were seen among the heaviest women. In women above age 60, there was an increased risk of breast cancer mortality for the MetS (RR, 1.23; 95% confidence interval, 1.04-1.45) and for blood pressure and glucose. The strongest association with mortality was seen for increased glucose concentrations.
The MetS was associated with a decreased risk of incident breast cancer in women below age 50 with high body mass index, and with an increased risk of breast cancer mortality in women above 60.
Lifestyle interventions as recommended for cardiovascular disease prevention may be of value to prevent breast cancer mortality in postmenopausal women.
Previous studies have shown that obesity and hypertension are associated with increased risk of renal cell carcinoma (RCC), but less is known about the association to other metabolic factors. In the ...Metabolic Syndrome and Cancer project (Me-Can) data on body mass index (BMI, kg/m2), blood pressure, and circulating levels of glucose, cholesterol, and triglycerides were collected from 560,388 men and women in cohorts from Norway, Austria, and Sweden. By use of Cox proportional hazard models, hazard ratios (HR) were calculated for separate and composite metabolic exposures. During a median follow-up of 10 years, 592 men and 263 women were diagnosed with RCC. Among men, we found an increased risk of RCC for BMI, highest vs. lowest quintile, (HR = 1.51, 95% CI 1.13-2.03), systolic blood pressure, (HR = 3.40, 95% CI 1.91-6.06), diastolic blood pressure, (HR = 3.33, 95% CI 1.85-5.99), glucose, (HR = 3.75, 95% CI 1.46-9.68), triglycerides, (HR = 1.79, 95% CI 1.00-3.21) and a composite score of these metabolic factors, (HR = 2.68, 95% CI 1.75-4.11). Among women we found an increased risk of RCC for BMI, highest vs. lowest quintile, (HR = 2.21, 95% CI 1.32-3.70) and the composite score, (HR = 2.29, 95% CI 1.12-4.68). High levels of the composite score were also associated with risk of death from RCC among both men and women. No multiplicative statistical or biological interactions between metabolic factors on risk of RCC were found. High levels of BMI, blood pressure, glucose and triglycerides among men and high BMI among women were associated with increased risk of RCC.
Mental health problems are a worldwide public health burden. The literature concerning the mental health benefits from physical activity among adults has grown. Adolescents are less studied, and ...especially longitudinal studies are lacking. This paper investigates the associations between weekly hours of physical activity at age 15-16 and mental health three years later.
Longitudinal self-reported health survey. The baseline study consisted of participants from the youth section of the Oslo Health Study, carried out in schools in 2000-2001 (n = 3811). The follow-up in 2003-2004 was conducted partly at school and partly through mail. A total of 2489 (1112 boys and 1377 girls) participated in the follow-up. Mental health was measured by the Strengths and Difficulties Questionnaire with an impact supplement. Physical activity was measured by a question on weekly hours of physical activity outside of school, defined as exertion 'to an extent that made you sweat and/or out of breath'. Adjustments were made for well-documented confounders and mental health at baseline.
In boys, the number of hours spent on physical activity per week at age 15-16 was negatively associated with emotional symptoms B (95%CI) = -0.09 (-0.15, -0.03) and peer problems B (95%CI) = -0.08 (-0.14, -0.03) at age 18-19 after adjustments. In girls, there were no significant differences in SDQ subscales at age 18-19 according to weekly hours of physical activity at age 15-16 after adjustments. Boys and girls with five to seven hours of physical activity per week at age 15-16 had the lowest mean scores for total difficulties and the lowest percentage with high impact score at age 18-19, but the differences were not statistically significant after adjustments.
Weekly hours of physical activity at age 15-16 years was weakly associated with mental health at three-year follow-up in boys. Results encourage a search for further knowledge about physical activity as a possible protective factor in relation to mental health problems in adolescence.
Risk of cardiovascular disease varies between ethnic groups and the aim of this study was to investigate differences in cardiovascular risk factors, and total cardiovascular risk between ethnic ...groups in Norway.
Cross-sectional study using data from the Cohort of Norway (CONOR).
A sample of 62,145 participants, 40-65 years of age, originating from 11 geographical regions, were included in our study. Self-reported variables, blood samples and physical measurements were used to estimate age- and time-adjusted mean values of cardiovascular risk factors for different ethnic groups. The 10-year risks of cardiovascular mortality and cardiovascular events were calculated using the Framingham and NORRISK risk models.
We observed differences between ethnic groups for cardiovascular risk factors and both Framingham and NORRISK risk scores. NORRISK showed significant differences by ethnicity in women only. Immigrants from the Indian subcontinent had the lowest high-density lipoprotein (HDL) levels, the highest levels of blood glucose, triglycerides, total cholesterol/HDL ratio, waist hip ratio and diabetes prevalence. Immigrants from the former Yugoslavia had the highest Framingham scores, high blood pressure, high total cholesterol/HDL ratio, overweight measures and smoking. Low cardiovascular risk was observed among East Asian immigrants.
The previously reported excess cardiovascular risk among immigrants from the Indian subcontinent was supported in this study. We also showed that immigrants from the former Yugoslavian countries had a higher total 10-year risk of cardiovascular events than other ethnic groups. This study adds information about ethnic groups in Norway which needs to be addressed in further research and targeted prevention strategies.
Metabolic components body mass index (BMI), blood pressure, serum lipids and physical activity may affect biological mechanisms of importance for breast cancer prognosis. A population-based survival ...study among 1,364 breast cancer cases within the Norwegian Counties Study during 1974-2005 was conducted. Pre-diagnostic measurements of BMI, blood pressure, serum lipids, and self-reported physical activity were assessed. Multivariable Cox proportional hazard models were used in analyses (SAS version 9.11). Among these breast cancer cases (age at diagnosis 27-79 years), 429 women died (8.2 mean follow-up years). Those with a BMI ≥ 30 kg/m² had a 1.47 higher risk of dying during follow-up than women with a BMI of 18.5-25 kg/m² hazard ratio (HR) = 1.47, 95% CI 1.08-1.99. Women with BMI < 25 kg/m² and age of diagnosis ≥55 years had a 66% reduction in overall mortality if they regularly exercised before diagnosis compared with sedentary women (HR = 0.34, 95% CI 0.16-0.71). Women in the highest tertile of total cholesterol had a 29% increase in mortality compared to women in the lowest tertile (HR = 1.29, 95% CI 1.01-1.64). Additionally, women in the highest tertile of blood pressure had a 41% increase in mortality compared to women in the lowest tertile of blood pressure (HR = 1.41, 95% CI 1.09-1.83). Our study supports a relationship between mortality not only in relation to BMI, but also blood pressure, lipids, and physical activity among breast cancer patients. These factors may all be important targets for invention among breast cancer patients.
To investigate the association between metabolic risk factors (individually and in combination) and risk of gallbladder cancer (GBC).
The metabolic syndrome and cancer project (Me-Can) includes ...cohorts from Norway, Austria, and Sweden with data on 578,700 men and women. We used Cox proportional hazard regression models to calculate relative risks of GBC by body mass index (BMI), blood pressure, and plasma levels of glucose, cholesterol, and triglycerides as continuous standardised variables and their standardised sum of metabolic syndrome (MetS) z-score. The risk estimates were corrected for random error in measurements.
During an average follow-up of 12.0 years (SD = 7.8), 184 primary gallbladder cancers were diagnosed. Relative risk of gallbladder cancer per unit increment of z-score adjusted for age, smoking status and BMI (except for BMI itself) and stratified by birth year, sex and sub-cohorts, was for BMI 1.31 (95% confidence interval 1.11, 1.57) and blood glucose 1.76 (1.10, 2.85). Further analysis showed that the effect of BMI on GBC risk is larger among women in the premenopausal age group (1.84 (1.23, 2.78)) compared to those in the postmenopausal age group (1.29 (0.93, 1.79)). For the other metabolic factors no significant association was found (mid blood pressure 0.96 (0.71, 1.31), cholesterol 0.84 (0.66, 1.06) and serum triglycerides 1.16 (0.82, 1.64)). The relative risk per one unit increment of the MetS z-score was 1.37 (1.07, 1.73).
This study showed that increasing BMI and impaired glucose metabolism pose a possible risk for gallbladder cancer. Beyond the individual factors, the results also showed that the metabolic syndrome as an entity presents a risk constellation for the occurrence of gallbladder cancer.
The aim of this study was to investigate the association between factors in metabolic syndrome (MetS; single and combined) and the risk of pancreatic cancer.
The Metabolic Syndrome and Cancer Project ...is a pooled cohort containing data on body mass index, blood pressure, and blood levels of glucose, cholesterol, and triglycerides. During follow-up, 862 individuals were diagnosed with pancreatic cancer. Cox proportional hazards analysis was used to calculate relative risks (RR) with 95% confidence intervals using the above-mentioned factors categorized into quintiles and transformed into z-scores. All z-scores were summarized and a second z-transformation creating a composite z-score for MetS was done. All risk estimates were calibrated to correct for a regression dilution bias.
The trend over quintiles was positively associated with the risk of pancreatic cancer for mid-blood pressure (mid-BP) and glucose in men and for body mass index, mid-BP, and glucose in women. The z-score for the adjusted mid-BP (RR, 1.10; 1.01-1.20) and the calibrated z-score for glucose (RR, 1.37; 1.14-1.34) were positively associated with pancreatic cancer in men. In women, a positive association was found for calibrated z-scores for mid-BP (RR, 1.34; 1.08-1.66), for the calibrated z-score for glucose (RR, 1.98; 1.41-2.76), and for the composite z-score for MetS (RR, 1.58; 1.34-1.87).
Our study adds further evidence to a possible link between abnormal glucose metabolism and risk of pancreatic cancer.
To our knowledge, this is the first study on MetS and pancreatic cancer using prediagnostic measurements of the examined factors.
Body mass index (BMI) is an established risk factor for colon cancer, but risks may differ between genders and colon subsites. Moreover, whether weight change influences risk is not yet clarified. We ...investigated these issues in a large, Norwegian, population-based cohort study.
Participants' weight was measured at examinations up to three times between 1974 and 1988. Hazard ratios (HR) and confidence intervals (CI) were estimated using Cox regression.
During follow-up of 38,822 men and 37,357 women, we identified 228 proximal and 174 distal colon cancer cases in men and 237 and 159 cases, respectively, in women. The association between BMI and colon cancer risk differed between subsites in men (P = 0.02) but not in women (P = 0.95). In men, HRs (95% CIs) per 5 kg/m(2) were 1.07 (0.86-1.33) and 1.49 (1.19-1.87) for proximal and distal colon, respectively. In women, corresponding HRs (95% CIs) were 1.15 (0.99-1.34) and 1.25 (1.05-1.49). Among overweight men (BMI > or = 25 kg/m(2)), weight gain > or = 10 kg gave higher colon cancer risk than weight maintenance (HR, 2.09; 95% CI, 1.21-3.63), whereas risks were similar among men with stable weight, weight loss, or gains <10 kg. Weight change was not associated with risk in women.
The influence of BMI on colon cancer risk differed between subsites in men. Weight gains <10 kg did not influence risk.
Our results support gender differences and the hypothesis of different etiologies for colon subsites. Whether weight loss in the overweight decreases risk of colon cancer warrants further study.
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