{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T02:00:43Z","timestamp":1790733643303,"version":"4.1.0"},"reference-count":36,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2022,9,16]],"date-time":"2022-09-16T00:00:00Z","timestamp":1663286400000},"content-version":"unspecified","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Nuclear Energy Development Project, China","award":["2016-1295"],"award-info":[{"award-number":["2016-1295"]}]},{"name":"Scientific Research Foundation for Talented Scholars","award":["Q413900215"],"award-info":[{"award-number":["Q413900215"]}]},{"name":"Suzhou clinical trial institution capacity enhancement project","award":["SLT202003"],"award-info":[{"award-number":["SLT202003"]}]},{"name":"China, Social development \u2013 clinical frontier technology project of science and technology department of Jiangsu province","award":["BE2018669"],"award-info":[{"award-number":["BE2018669"]}]},{"name":"Suzhou medical and industrial integration collaborative innovation research project","award":["SL J202012"],"award-info":[{"award-number":["SL J202012"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,7,22]]},"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Synergism between the metabolic syndrome (MetSyn) components and cancer incidence still remains inconclusive. We aimed to investigate the unique or joint role of MetSyn components in cancer onset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We conducted a prospective nested case\u2013control study based on the China Health and Retirement Longitudinal Study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>An ongoing national representative longitudinal study included follow-up survey of people aged 45 years and older and their partners living in private households in China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>There were 17\u2009708 individuals included at baseline. A total of 306 incident cancers was identified during the follow-up. For every case, we used incidence-density sampling to match three concurrent cancer-free controls by age, sex, and both duration and calendar time of follow-up. Exposure of interest was any MetSyn diagnosis at baseline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We observed elevation in cancer risk associated with MetSyn in a significant way when the number of MetSyn components was over three (OR: 1.88; 95%\u2009CI: 1.19 to 2.97), or when components contained any of elevated triglycerides (OR: 1.61; 95%\u2009CI: 1.05 to 2.48), reduced high-density lipoprotein (HDL) cholesterol (OR: 2.33; 95%\u2009CI: 1.40 to 3.86) or elevated blood pressure (OR: 1.65; 95% CI: 1.04 to 2.59) after consistent multiple adjustments in different models. The highest cancer risk was in the female reproductive system and breast cancer (OR: 4.22; 95% CI: 1.62 to 10.95) followed by digestive system (OR: 1.67; 95% CI: 1.11 to 2.53). Sensitivity analyses showed similar results after first follow-up was excluded. However, any unique MetSyn component was not associated with increased cancer risk. Interestingly, the reduced HDL was observed to be widely associated with over twofold increased risk of cancer, only when together with other MetSyn components.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MetSyn components, in a collaborative manner rather than its unique component, were associated with elevated cancer risk. Not only obesity but even subtle metabolic disturbances may give rise to cancer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-061362","type":"journal-article","created":{"date-parts":[[2022,9,17]],"date-time":"2022-09-17T07:25:36Z","timestamp":1663399536000},"page":"e061362","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Synergism between the metabolic syndrome components and cancer incidence: results from a prospective nested case\u2013control study based on the China Health and Retirement Longitudinal Study (CHARLS)"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3165-9583","authenticated-orcid":false,"given":"Lin","family":"Li","sequence":"first","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Meng","sequence":"additional","affiliation":[{"name":"Institute of Systems Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China"},{"name":"Suzhou Institute of Systems Medicine, Suzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongkui","family":"Xu","sequence":"additional","affiliation":[{"name":"VIP Department, National Cancer Centre\/National Clinical Research Centre for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingkai","family":"Xu","sequence":"additional","affiliation":[{"name":"Department for Communicable Disease Control and Prevention, Suzhou Wuzhong Centre for Disease Prevention and Control, Suzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junlan","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Oncology and Hematology, the Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University, Suzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaochen","family":"Shu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, People's Republic of China"},{"name":"Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,9,17]]},"reference":[{"key":"2025121509423713000_12.9.e061362.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67402-8"},{"key":"2025121509423713000_12.9.e061362.2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000111245.75752.C6"},{"key":"2025121509423713000_12.9.e061362.3","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.192644"},{"key":"2025121509423713000_12.9.e061362.4","article-title":"Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000. 2019 Feb 11","author":"Lam"},{"key":"2025121509423713000_12.9.e061362.5","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-0336"},{"key":"2025121509423713000_12.9.e061362.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2014.10.008"},{"key":"2025121509423713000_12.9.e061362.7","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.111.189258"},{"key":"2025121509423713000_12.9.e061362.8","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.3892\/or.2017.5385","article-title":"Diets link metabolic syndrome and colorectal cancer development (review)","volume":"37","author":"Saetang","year":"2017","journal-title":"Oncol Rep"},{"key":"2025121509423713000_12.9.e061362.9","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1016\/j.molonc.2014.05.015","article-title":"Genes associated with metabolic syndrome predict disease-free survival in stage II colorectal cancer patients. A novel link between metabolic dysregulation and colorectal cancer","volume":"8","author":"Vargas","year":"2014","journal-title":"Mol Oncol"},{"key":"2025121509423713000_12.9.e061362.10","doi-asserted-by":"publisher","DOI":"10.7150\/ijbs.7.1003"},{"key":"2025121509423713000_12.9.e061362.11","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dys203"},{"key":"2025121509423713000_12.9.e061362.12","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-018-5834-6","article-title":"Obesity and the onset of depressive symptoms among middle-aged and older adults in China: evidence from the CHARLS","volume":"18","author":"Luo","year":"2018","journal-title":"BMC Public Health"},{"key":"2025121509423713000_12.9.e061362.13","doi-asserted-by":"crossref","first-page":"6429","DOI":"10.7150\/jca.47175","article-title":"Association between kidney function and the risk of cancer: results from the China health and retirement longitudinal study (CHARLS)","volume":"11","author":"Liu","year":"2020","journal-title":"J Cancer"},{"key":"2025121509423713000_12.9.e061362.14","doi-asserted-by":"publisher","DOI":"10.1136\/oem.2004.014472"},{"key":"2025121509423713000_12.9.e061362.15","doi-asserted-by":"crossref","first-page":"817S","DOI":"10.1093\/ajcn\/86.3.817S","article-title":"Symposium introduction: metabolic syndrome and the onset of cancer","volume":"86","author":"Zhou","year":"2007","journal-title":"Am J Clin Nutr"},{"key":"2025121509423713000_12.9.e061362.16","doi-asserted-by":"publisher","DOI":"10.1097\/CEJ.0b013e32834dbc81"},{"key":"2025121509423713000_12.9.e061362.17","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.25772"},{"key":"2025121509423713000_12.9.e061362.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2007.11.005"},{"key":"2025121509423713000_12.9.e061362.19","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s13098-021-00627-6","article-title":"Metabolic syndrome and esophageal cancer risk: a systematic review and meta\u2011analysis","volume":"13","author":"Zhang","year":"2021","journal-title":"Diabetol Metab Syndr"},{"key":"2025121509423713000_12.9.e061362.20","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1002\/ijc.33255","article-title":"Metabolic syndrome biomarkers and prostate cancer risk in the UK Biobank","volume":"148","author":"Monroy-Iglesias","year":"2021","journal-title":"Int J Cancer"},{"key":"2025121509423713000_12.9.e061362.21","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1097\/CEJ.0000000000000618","article-title":"Metabolic syndrome and gastric cancer risk: a systematic review and meta-analysis","volume":"30","author":"Mariani","year":"2021","journal-title":"Eur J Cancer Prev"},{"key":"2025121509423713000_12.9.e061362.22","doi-asserted-by":"crossref","first-page":"e4102","DOI":"10.1210\/clinem\/dgaa596","article-title":"Metabolic syndrome and risk of lung cancer: an analysis of Korean National health insurance Corporation database","volume":"105","author":"Sin","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"key":"2025121509423713000_12.9.e061362.23","doi-asserted-by":"crossref","first-page":"1496","DOI":"10.1089\/thy.2019.0699","article-title":"Metabolic syndrome and the risk of thyroid cancer: a nationwide population-based cohort study","volume":"30","author":"Park","year":"2020","journal-title":"Thyroid"},{"key":"2025121509423713000_12.9.e061362.24","doi-asserted-by":"crossref","DOI":"10.1177\/1756284819867839","article-title":"Metabolic syndrome is a risk factor for colorectal adenoma and cancer: a study in a white population using the harmonized criteria","volume":"12","author":"Milano","year":"2019","journal-title":"Therap Adv Gastroenterol"},{"key":"2025121509423713000_12.9.e061362.25","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/j.ygyno.2019.08.032","article-title":"Metabolic syndrome and risk of ovarian and fallopian tube cancer in the United States: an analysis of linked SEER-Medicare data","volume":"155","author":"Michels","year":"2019","journal-title":"Gynecol Oncol"},{"key":"2025121509423713000_12.9.e061362.26","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0128891","article-title":"Metabolic syndrome and breast cancer risk: a case-cohort study nested in a multicentre Italian cohort","volume":"10","author":"Agnoli","year":"2015","journal-title":"PLoS One"},{"key":"2025121509423713000_12.9.e061362.27","doi-asserted-by":"publisher","DOI":"10.1677\/ERC-07-0132"},{"key":"2025121509423713000_12.9.e061362.28","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijo.0803713"},{"key":"2025121509423713000_12.9.e061362.29","doi-asserted-by":"crossref","DOI":"10.3390\/cancers13051177","article-title":"Changes in metabolic syndrome status and breast cancer risk: a nationwide cohort study","volume":"13","author":"Choi","year":"2021","journal-title":"Cancers"},{"key":"2025121509423713000_12.9.e061362.30","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-14-0923"},{"key":"2025121509423713000_12.9.e061362.31","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-015-2260-x","article-title":"Metabolic syndrome and prostate cancer risk in a population-based case-control study in Montreal, Canada","volume":"15","author":"Blanc-Lapierre","year":"2015","journal-title":"BMC Public Health"},{"key":"2025121509423713000_12.9.e061362.32","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdq464"},{"key":"2025121509423713000_12.9.e061362.33","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.semcancer.2020.10.007","article-title":"HDL and cancer - causality still needs to be confirmed? Update 2020","volume":"73","author":"Ganjali","year":"2021","journal-title":"Semin Cancer Biol"},{"key":"2025121509423713000_12.9.e061362.34","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-011-9831-7"},{"key":"2025121509423713000_12.9.e061362.35","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1016\/j.gie.2019.04.232","article-title":"Effect of Helicobacter pylori eradication and high-density lipoprotein on the risk of de novo gastric cancer development","volume":"90","author":"Nam","year":"2019","journal-title":"Gastrointest Endosc"},{"key":"2025121509423713000_12.9.e061362.36","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-1509"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2022-061362","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T17:42:49Z","timestamp":1765820569000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2022-061362"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9]]},"references-count":36,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,9,17]]},"published-print":{"date-parts":[[2022,9]]}},"alternative-id":["10.1136\/bmjopen-2022-061362"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2022-061362","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9]]}}}