The association between metabolic abnormality and endometrial cancer: a large case-control study in China

To investigate the association between insulin-resistance-related conditions (comprising the metabolic syndrome) and endometrial cancer risk in Chinese women.

We conducted a large case-control study including 942 endometrial cancers and 1721 controls on a Chinese population. The relative endometrial cancer risks from various factors were calculated by the x(2) test. Menopausal status and BMI were applied as potential confounders to analyze the joint effects with other factors.

We found that overweight/obesity, hypertension, diabetes mellitus and glucose metabolic disturbance were all associated with endometrial cancer risk. Effective medication on diabetes can significantly decrease cancer risk (uncontrolled diabetes: RR=5.563, 95% CI=2.406-12.859, p<0.001; controlled diabetes: RR=1.331, 95% CI=0.529-3.352, p>0.05) as compared with normal controls. Serum lipids were also found to be linked to endometrial cancer risk: positive correlations were present with total serum cholesterol, triglycerides, low-density lipoprotein cholesterol and dyslipidaemia, while a negative correlation was found with high-density lipoprotein cholesterol. We also observed an elevated risk for type I endometrial cancer (OR=1.839, 95% CI=1.539-2.197, p<0.001) in women with BMI>or=24.58 versus those with BMI<24.58, but not for type II cancer (OR=1.092, 95% CI=0.969-1.231, p>0.05).

Our findings support the hypothesis that metabolic abnormalities or insulin resistance may promote the initiation and progression of endometrial cancer. The effective treatment of type 2 diabetes might contribute to endometrial cancer prevention.