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Metabolic Syndrome Increases All-Cause and Disease-Specific Mortality in Colorectal Cancer

Douglas K. Rex, MD, MASGE reviewing Lu B, et al. J Gastroenterol Hepatol 2022 Oct 26.

Metabolic syndrome (MS), diabetes mellitus, and obesity are all associated with an increased prevalence of precancerous colorectal polyps and incidence of colorectal cancer (CRC). This systematic review and meta-analysis evaluated the effect of MS on overall and CRC-specific mortality. 

The authors identified 23 studies for meta-analysis, involving 399,773 participants, including 38,910 with MS. All-cause mortality was 1.34 times higher in patients with CRC and MS than in patients with CRC without MS (13 studies). There was a 2.12 times higher risk of CRC-specific mortality in patients with CRC and MS. There was no increase in postoperative complications or postoperative mortality in CRC with MS (2 studies). 

Of the 4 components of MS (diabetes, hypertension, dyslipidemia, and obesity), the analysis showed that diabetes was associated with overall mortality, and obesity was associated with CRC-specific mortality, with hazard ratios of 1.17 and 1.33, respectively. 

There was evidence of publication bias.


These data indicate that at least some factors associated with an increased prevalence of polyps and CRC are also associated with an increased risk of death from CRC once it arises. The effect of metabolic syndrome on mortality is also associated with many diseases other than CRC.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

Douglas K. Rex, MD, MASGE

Bio and Disclosures


Lu B, Qian JM, Li JN. The metabolic syndrome and its components as prognostic factors in colorectal cancer: a meta-analysis and systematic review. J Gastroenterol Hepatol 2022 Oct 26. (Epub ahead of print) (