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01.12.2017 | Research article | Ausgabe 1/2017 Open Access

BMC Cancer 1/2017

Metabolic dysregulation and cancer mortality in a national cohort of blacks and whites

BMC Cancer > Ausgabe 1/2017
Tomi Akinyemiju, Justin Xavier Moore, Suzanne Judd, Susan Lakoski, Michael Goodman, Monika M. Safford, Maria Pisu
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Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12885-017-3807-2) contains supplementary material, which is available to authorized users.



We examined the association between metabolic dysregulation and cancer mortality in a prospective cohort of Black and White adults.


A total of 25,038 Black and White adults were included in the analysis. Metabolic dysregulation was defined in two ways: 1) using the joint harmonized criteria for metabolic syndrome (MetS) and 2) based on factor analysis of 15 variables characterizing metabolic dysregulation. We estimated hazards ratios (HRs) and 95% confidence intervals (CIs) for the association of MetS and metabolic dysregulation with cancer mortality during follow-up using Cox proportional hazards models.


About 46% of Black and 39% of White participants met the criteria for MetS. Overall, participants with MetS (HR: 1.22, 95% CI: 1.03–1.45) were at increased risk of cancer-related death. In race-stratified analysis, Black participants with MetS had significantly increased risk of cancer mortality compared with those without MetS (HR: 1.32, 95% CI: 1.01–1.72), increasing to more than a 2-fold risk of cancer mortality among those with five metabolic syndrome components (HR: 2.35, 95% CI: 1.01–5.51).


There are marked racial differences in the prevalence of metabolic dysregulation defined as MetS based on the harmonized criteria. The strong positive associations between MetS and cancer mortality suggests that efforts to improve cancer outcomes in general, and racial disparities in cancer outcomes specifically, may benefit from prevention and management of MetS and its components.
Additional file 1: Appendix A: Cancer types among 997 participants with cancer deaths in the REGARDS cohort. (DOCX 45 kb)
Additional file 2: Appendix B: Hazard ratios (HRs)a and 95% confidence intervals for the association between metabolic syndrome (MetS) and cancer mortality (Excluding participants with baseline chronic medical conditions) (DOCX 100 kb)
Additional file 3: Appendix C: Rotated factor loadings for 15 metabolism-associated variables in the REGARDS cohort. (DOCX 71 kb)
Additional file 4: Appendix D: Baseline characteristics of participants by quartiles of derived metabolic factors, REGARDS. (DOCX 107 kb)
Additional file 5: Appendix E: Kaplan-Meier plot for time to cancer death by number of metabolic factor components in the 4th quartile. (DOCX 191 kb)
Additional file 6: Appendix F: Hazard ratios (HRs) a and 95% confidence intervals (CIs) for the association between metabolic dysregulation factors and cancer mortality (Excluding participants with baseline medical conditions). (DOCX 116 kb)
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