Metabolic Syndrome Associated With Adverse Pathological Features In Patients With Colorectal Adenocarcinoma

Previous studies suggested a link between metabolic syndrome (MetS) and colorectal cancer (CRC). It is unclear whether MetS influences the prognosis of CRC via increasing the risk of adverse pathologic features. We aimed to assess the association between MetS and pathological features of CRC, especially in different gender. This retrospective cohort study included 2232 consecutive colorectal adenocarcinoma patients underwent radical colectomy in a single medical institution. Patients were divided into subgroups of MetS and non-MetS according to the criteria of China Diabetes Society. Data were collected for pathological subtypes, histological grade, invasion depth, lymph node (LN) status, and tumor-node-metastasis (TNM) stage. Logistic regression analysis indicated that MetS was significantly correlated with mucinous adenocarcinoma (MAC) (OR=3.56, 95% CI: 1.94-6.52, P<0.001), signet-ring cell carcinoma (SRCC) (OR=6.58, 95% CI: 1.50-28.92, P=0.013), high grade (OR=1.95, 95% CI: 1.292.97, P=0.002), positive LN status (OR=1.80, 95% CI: 1.28-2.53, P=0.001), and high TNM stage (OR=1.69, 95% CI: 1.20-2.37, P=0.002) in women, while MetS was significantly correlated with SRCC (OR=4.74, 95% CI: 1.4-16.04, P=0.012) and high grade (OR=1.58, 95% CI: 1.12-2.26, P=0.012) in men. Multivariately, hyperglycemia was significantly correlated with SRCC, high grade, positive LN, and high TNM stage in men (P<0.05), but not in women. Hyperglycemia was only significantly correlated with MAC in female (OR=2.56, 95% CI: 1.34-1.88, P=0.004). Low high-density lipoprotein cholesterol (HDL-C) was significantly correlated with positive LN (OR=1.76, 95% CI: 1.302.38, P<0.001) and high TNM stage (OR=1.85, 95% CI: 1.36-2.50, P<0.001) in women, but not in men. The finding of the present study suggested that the presence of MetS and/or low HDL-C in women predicted risk of MAC, LN metastasis of CRC and high TNM stage, while the presence of hyperglycemia in men predicted risk of high histological grade, LN metastasis, and high TNM stage. Improvement of MetS and HDL-C status in women or hyperglycemia in men may favor the prognosis of CRC patients complicated with MetS.