Background
Methods
The metabolic syndrome and cancer project (Me-Can)
Assessment of exposure at baseline investigation
End-point assessment
Statistical analysis
Correction of a random error
Results
Cases | Total cohort1
| |||||
---|---|---|---|---|---|---|
Adenocarcinoma | Squamous cell carcinoma | Other or undifferentiated morphology | All cases | |||
Subjects, n | 114 | 184 | 26 | 324 | 577259 | |
Sex | Male | 102 (89.5) | 144 (78.3) | 22 (84.6) | 268 (82.7) | 288930 (50.1) |
Female | 12 (10.5) | 40 (21.7) | 4 (15.4) | 56 (17.3) | 288329 (49.9) | |
Age at baseline, mean (SD) | 49.6 (10.1) | 51.0 (10.9) | 51.2 (10.1) | 50.5 (10.5) | 44.0 (11.7) | |
Cohort, n (%) | Oslo | 13 (11.4) | 37 ((20.1) | 5 (19.2) | 55 (17.0) | 16714 (2.9) |
NCS | 31 (27.2) | 29 (15.8) | 4 (15.4) | 64 (19.8) | 50922 (8.8) | |
CONOR | 10 (8.8) | 14 (7.6) | 3 (11.5) | 27 (8.3) | 109403 (19.0) | |
40-y | 5 (4.4) | 6 (3.3) | 1 (3.8) | 12 (3.7) | 128742 (22.3) | |
VHM&PP | 16 (14.0) | 40 (21.7) | 5 (19.2) | 61 (18.8) | 159444 (27.6) | |
VIP | 16 (14.0) | 8 (4.3) | 1 (3.8) | 25 (7.7) | 79360 (13.7) | |
MPP | 23 (20.2) | 50 (27.2) | 7 (26.9) | 80 (24.7) | 32674 (5.7) | |
Fasting time, n (%) | < 4 hrs | 43 (37.7) | 64 (34.8) | 8 (30.8) | 115 (35.5) | 242246 (42.0) |
4-8 hrs | 14 (12.3) | 14 (7.6) | 5 (19.2) | 33 (10.2) | 57409 (9.9) | |
> 8 hrs | 57 (50.0) | 106 (57.6) | 13 (50.0) | 176 (54.3) | 277604 (48.1) | |
BMI, mean (SD) | 27.1 (3.8) | 24.0 (3.3) | 26.0 (4.2) | 25.3 (3.8) | 25.3 (4.0) | |
Mid BP2 mmHg, mean (SD) | 110.6 (12.9) | 112.4 (15.3) | 111.9 (12.7) | 111.7 (14.3) | 104.4 (13.7) | |
Glucose mmol/l, median (IQR) | 5.4 (4.8-5.4) | 5.3 (4.7-5.3) | 5.1 (4.6-5.6) | 5.3 (4.7-5.9) | 5.1 (4.6-5.6) | |
Cholesterol mmol/l, mean (SD) | 6.1 (1.1) | 6.2 (1.1) | 6.4 (1.3) | 6.2 (1.1) | 5.7 (1.2) | |
Triglycerides mmol/l, median (IQR) | 1.63 (1.11-2.43) | 1.44 (1.02-2.11) | 1.82 (1.12-2.80) | 1.57 (1.05-2.33) | 1.29 (0.91-1.91) | |
Smoking status, n (%) | Never | 25 (21.9) | 29 (15.8) | 4 (15.4) | 58 (17.9) | 257721 (44.6) |
Former | 36 (31.6) | 25 (13.6) | 5 (19.2) | 66 (20.4) | 158358 (27.4) | |
Current | 52 (45.6) | 129 (70.1) | 17 (65.4) | 198 (61.1) | 159624 (27.7) | |
Missing | 1 (0.9) | 1 (0.5) | 0 | 2 (0.6) | 1556 (0.3) |
Body mass index and risk of esophsageal adenocarcinoma
Exposure | Adenocarcinoma | Squamous cell carcinoma | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Quintile | Mean (SD) | Cases (n) | Age and cohort stratified RR | Adjusted RR1
| Adjusted, RDR corrected RR1
| Cases (n) | Age and cohort stratified RR | Adjusted RR1
| Adjusted, RDR corrected RR1
| |
BMI | 1 | 20.7 (1.5) | 5 | 1.00 | 1.00 | 1.00 | 55 | 1.00 | 1.00 | 1.00 |
2 | 23.0 (1.1) | 18 | 3.13 (1.16–8.44) | 3.37 (1.25–9.10) | 3.86 (1.28–11.66) | 29 | 0.44 (0.28–0.70) | 0.50 (0.32–0.79) | 0.47 (0.28–0.77) | |
3 | 24.7 (1.0) | 18 | 2.81 (1.04–7.60) | 3.17 (1.17–8.57) | 3.61 (1.19–10.91) | 46 | 0.62 (0.42–0.92) | 0.76 (0.51–1.12) | 0.73 (0.47–1.14) | |
4 | 26.8 (1.0) | 31 | 4.41 (1.71–11.39) | 5.19 (2.00–13.42) | 6.24 (2.17–17.97) | 30 | 0.37 (0.23–0.57) | 0.46 (0.30–0.72) | 0.42 (0.26–0.70) | |
5 | 31.3 (3.3) | 42 | 5.96 (2.34–15.16) | 7.34 (2.88–18.68) | 9.18 (3.24–25.96) | 24 | 0.29 (0.18–0.47) | 0.38 (0.23–0.62) | 0.34 (0.20–0.58) | |
Ptrend | <0.0001 | <0.0001 | <0.0001 | <0.0001 | <0.0001 | |||||
Adjusted RR per increment of 5
1
| 1.64 (1.35–2.00) | 1.78 (1.45–2.17) | 0.56 (0.44–0.70) | 0.62 (0.50–0.79) | ||||||
Mid blood pressure, mmHg | 1 | 88 (5.7) | 14 | 1.00 | 1.00 | 1.00 | 21 | 1.00 | 1.00 | 1.00 |
2 | 97 (4.1) | 18 | 1.12 (0.56–2.25) | 0.99 (0.49–2.00) | 0.99 (0.27–3.58) | 30 | 1.29 (0.74–2.26) | 1.47 (0.84–2.58) | 2.04 (0.73–5.70) | |
3 | 103 (3.8) | 22 | 1.24 (0.63–2.44) | 1.15 (0.58–2.27) | 1.29 (0.37–4.50) | 23 | 0.87 (0.48–1.58) | 1.14 (0.63–2.08) | 1.28 (0.43–3.83) | |
4 | 110 (4.1) | 25 | 1.13 (0.58–2.19) | 1.01 (0.52–1.98) | 1.02 (0.30–3.50) | 49 | 1.55 (0.93–2.61) | 2.27 (1.35–3.83) | 4.51 (1.72–11.81) | |
5 | 125 (10.4) | 35 | 1.32 (0.70–2.51) | 1.09 (0.57–2.10) | 1.17 (0.35–3.90) | 60 | 1.59 (0.95–2.66) | 2.60 (1.54–4.39) | 5.79 (2.21–15.20) | |
Ptrend | 0.44 | 0.81 | 0.035 | <0.0001 | ||||||
Adjusted RR per increment of 10 mmHg
1
| 1.09 (0.95–1.25) | 1.03 (0.89–1.19) | 1.17 (1.05–1.29) | 1.30 (1.17–1.44) | ||||||
Glucose, mmol/L | 1 | 4.1 (0.5) | 19 | 1.00 | 1.00 | 1.00 | 34 | 1.00 | 1.00 | 1.00 |
2 | 4.7 (0.3) | 21 | 1.06 (0.57–1.97) | 1.07 (0.57–2.01) | 1.29 (0.14–12.21) | 33 | 0.96 (0.59–1.55) | 1.04 (0.64–1.69) | 1.16 (0.20–6.55) | |
3 | 5.1 (0.3) | 20 | 0.96 (0.51–1.81) | 0.95 (0.51–1.80) | 0.85 (0.09–8.32) | 38 | 1.07 (0.69–1.70) | 1.20 (0.75–1.91) | 1.90 (0.35–10.27) | |
4 | 5.5 (0.3) | 28 | 1.28 (0.71–2.31) | 1.32 (0.73–2.38) | 2.69 (0.32–22.70) | 31 | 0.88 (0.54–1.44) | 1.02 (0.62–1.68) | 1.08 (0.18–6.43) | |
5 | 6.8 (1.9) | 26 | 1.07 (0.59–1.95) | 1.04 (0.57.1.90) | 1.14 (0.13–10.12) | 48 | 1.21 (0.77–1.89) | 1.44 (0.92–2.27) | 3.76 (0.74–19.17) | |
Ptrend | 0.62 | 0.70 | 0.50 | 0.14 | ||||||
Adjusted RR per increment of 1 mmol/l
2,3
| 1.14 (0.93–1.38) | 1.12 (0.92–1.38) | 1.16 (0.99–1.35) | 1.22 (1.04–1.42) | ||||||
Cholesterol, mmol/L | 1 | 4.2 (0.5) | 13 | 1.00 | 1.00 | 1.00 | 22 | 1.00 | 1.00 | 1.00 |
2 | 5.0 (0.3) | 25 | 1.60 (0.82–3.15) | 1.48 (0.75–2.91) | 1.82 (0.65–5.08) | 30 | 1.09 (0.63–1.89) | 1.08 (0.62–1.88) | 1.13 (0.49–2.62) | |
3 | 5.6 (0.3) | 18 | 1.01 (0.49–2.08) | 0.93 (0.45–1.92) | 0.90 (0.30–2.69) | 36 | 1.16 (0.68–1.99) | 1.20 (0.70–2.05) | 1.32 (0.59–2.99) | |
4 | 6.2 (0.3) | 27 | 1.34 (0.68–2.63) | 1.22 (0.62–2.40) | 1.36 (0.49–3.80) | 44 | 1.26 (0.75–2.12) | 1.32 (0.78–2.21) | 1.52 (0.69–3.35) | |
5 | 7.4 (0.8) | 31 | 1.34 (0.69–2.62) | 1.22 (0.63–2.37) | 1.35 (0.49–3.72) | 51 | 1.32 (0.79–2.21) | 1.42 (0.85–2.37) | 1.70 (0.78–3.71) | |
Ptrend | 0.68 | 0.86 | 0.22 | 0.12 | ||||||
Adjusted RR per increment of 1 mmol/l
2
| 0.99 (0.84–1.17) | 0.94 (0.80–1.10) | 1.06 (0.94–1.21) | 1.08 (0.95–1.22) | ||||||
Triglycerides, mmol/L | 1 | 0.72 (0.17) | 14 | 1.00 | 1.00 | 1.00 | 27 | 1.00 | 1.00 | 1.00 |
2 | 1.03 (0.21) | 18 | 1.20 (0.60–2.42) | 1.03 (0.51–2.07) | 1.05 (0.26–4.22) | 39 | 1.28 (0.78–2.09) | 1.26 (0.77–2.06) | 1.57 (0.59–4.17) | |
3 | 1.33 (0.29) | 16 | 0.98 (0.48–2.02) | 0.78 (0.38–1.60) | 0.61 (0.15.2.55) | 34 | 1.05 (0.63–1.74) | 1.05 (0.63–1.75) | 1.11 (0.40–3.04) | |
4 | 1.77 (0.42) | 33 | 1.95 (1.04–3.65) | 1.42 (0.75–2.69) | 2.00 (0.56–7.09) | 39 | 1.14 (0.70–1.87) | 1.22 (0.74–2.01) | 1.48 (0.55–3.99) | |
5 | 3.12 (1.54) | 28 | 1.60 (0.84–3.06) | 1.05 (0.54–2.05) | 1.11 (0.30–4.15) | 44 | 1.24 (0.77–2.02) | 1.45 (0.87–2.39) | 2.07 (0.77–5.61) | |
Ptrend | 0.038 | 0.51 | 0.58 | 0.22 | ||||||
Adjusted RR per increment of 1 mmol/l
2,4
| 1.35 (1.12–1.61) | 1.13 (0.93–1.38) | 1.15 (0.98–1.34) | 1.19 (1.01–1.40) |
Exposure
|
Adenocarcinoma (n = 114)
|
Squamous cell carcinoma (n = 184)
| ||||
---|---|---|---|---|---|---|
RR model 1
1
|
RR model 2
2
|
Regression calibrated RR
3
|
RR model 1
1
|
RR model 2
2
|
Regression calibrated RR
3
| |
BMI | 1.57 (1.35–1.83) | 1.58 (1.34–1.87) | 1.64 (1.30–2.07) | 0.69 (0.58–0.81) | 0.60 (0.50–0.72) | 0.50 (0.40–0.63) |
Mid blood pressure | 1.10 (0.92–1.32) | 0.99 (0.81–1.21) | 0.95 (0.66–1.39) | 1.28 (1.13–1.46) | 1.40 (1.23–1.60) | 1.77 (1.37–2.29) |
Glucose | 1.04 (0.86–1.24) | 0.97 (0.80–1.17) | 0.99 (0.49–1.99) | 1.11 (0.98–1.27) | 1.11 (0.97–1.27) | 1.40 (0.85–2.31) |
Cholesterol | 1.02 (0.84–1.23) | 0.95 (0.77–1.17) | 0.92 (0.66–1.29) | 1.07 (0.92–1.24) | 1.08 (0.92–1.26) | 1.10 (0.85–1.41) |
Triglycerides | 1.20 (0.99–1.45) | 1.05 (0.85–1.30) | 1.13 (0.71–1.80) | 0.99 (0.86–1.16) | 1.05 (0.88–1.24) | 1.03 (0.71–1.49) |
MetS4
| 1.36 (1.13–1.64) | – | 1.56 (1.19–2.05) | 1.06 (0.91–1.24) | – | 1.09 (0.87–1.36) |
Exposure | Category | Adenocarcinoma | Squamous cell carcinoma | ||
---|---|---|---|---|---|
Crude RR | Adjusted RR1
| Crude RR | Adjusted RR2
| ||
BMI in WHO categories | ≤ 18.4 | - | - | 1.68 (0.62–4.56) | 1.54 (0.56–4.19) |
18.5–25.0 | Reference | Reference | Reference | Reference | |
25.0–29.9 | 2.53 (1.66–3.88) | 2.32 (1.51–3.57) | 0.65 (0.47–0.90) | 0.67 (0.49–0.93) | |
≥ 30 | 2.69 (1.50–4.85) | 3.29 (1.82–5.95) | 0.39 (0.19–0.77) | 0.47 (0.24–0.94) | |
≥ 25 | 2.57 (1.70–3.88) | 2.47 (1.63–3.74) | 0.60 (0.44–0.82) | 0.64 (0.47–0.87) | |
ESH/ESC hypertension criteria3
| Normal | Reference | Reference | Reference | Reference |
Grade 1 | 1.13 (0.74–1.72) | 0.90 (0.59–1.32) | 1.34 (0.96–1.87) | 1.61 (1.15–2.26) | |
Grade 2 | 1.47 (0.84–2.57) | 1.11 (0.63–1.96) | 1.42 (0.89–2.26) | 1.98 (1.23–3.17) | |
Grade 3 | 0.93 (0.33–2.62) | 0.66 (0.23–1.87) | 1.96 (1.10–3.59) | 2.95 (1.62–5.37) | |
Grade 1–3 | 1.19 (0.81–1.74) | 0.93 (0.63–1.37) | 1.41 (1.04–1.91) | 1.77 (1.30–2.42) | |
Ptrend | 0.39 | 0.72 | 0.01 | <0.0001 |
Smoking status | Exposure | Adenocarcinoma | Squamous cell carcinoma | ||||||
---|---|---|---|---|---|---|---|---|---|
RR model 11
| RR model 22
| Regression calibrated RR3
| Interaction4p-value | RR model 11
| RR model 22
| Regression calibrated RR3
| Interaction4p-value | ||
Never smoker | BMI | 1.22 (0.83–1.77) | 1.30 (0.87–1.94) | 1.28 (0.75–2.19) | 0.72 (0.47–1.09) | 0.67 (0.43–1.06) | 0.61 (0.35–1.07) | ||
Mid BP | 1.08 (0.73–1.60) | 1.11 (0.73–1.67) | 1.15 (0.52–2.53) | 1.23 (0.89–1.70) | 1.35 (0.97–1.89) | 1.75 (0.93–3.30) | |||
Glucose | 1.19 (0.86–1.65) | 1.22 (0.86–1.71) | 2.00 (0.55–7.36) | 1.03 (0.75–1.43) | 1.01 (0.71–1.43) | 0.91 (0.25–3.32) | |||
Cholesterol | 0.81 (0.53–1.26) | 0.82 (0.50–1.34) | 0.82 (0.38–1.18) | 0.93 (0.63–1.37) | 0.90 (0.59–1.37) | 0.84 (0.43–1.65) | |||
Triglycerides | 0.77 (0.49–1.20) | 0.71 (0.44–1.17) | 0.45 (0.16–1.27) | 0.97 (0.66–1.44) | 1.07 (0.69–1.65) | 1.10 (0.43–2.83) | |||
Mets | 1.07 (0.69–1.65) | - | 1.10 (0.58–2.08) | 0.98 (0.66–1.47) | - | 0.98 (0.54–1.75) | |||
Former smoker | BMI | 1.87 (1.49–2.35) | 1.89 (1.44–2.47) | 2.14 (1.44–3.18) | 0.07 | 0.91 (0.59–1.40) | 0.78 (0.49–1.24) | 0.62 (0.35–1.10) | 0.59 |
Mid BP | 1.14 (0.83–1.56) | 0.96 (0.68–1.36) | 0.91 (0.47–1.77) | 0.28 | 1.52 (1.09–2.11) | 1.53 (1.09–2.16) | 1.93 (0.99–3.75) | 0.47 | |
Glucose | 0.86 (0.61–1.23) | 0.73 (0.51–1.06) | 0.43 (0.11–1.64) | 0.46 | 1.30 (0.98–1.72) | 1.27 (0.94–1.71) | 2.80 (0.99–7.93) | 0.14 | |
Cholesterol | 1.15 (0.83–1.58) | 1.04 (0.72–1.50) | 1.01 (0.56–1.80) | 0.14 | 1.14 (0.77–1.69) | 1.12 (0.73–1.70) | 1.21 (0.61–2.41) | 0.56 | |
Triglycerides | 1.54 (1.11–2.13) | 1.28 (0.88–1.85) | 1.96 (0.87–4.39) | 0.01 | 1.02 (0.68–1.52) | 0.92 (0.59–1.45) | 0.73 (0.28–1.94) | 0.68 | |
MetS | 1.60 (1.16–2.21) | - | 1.99 (1.25–3.16) | 0.08 | 1.39 (0.94–2.04) | - | 1.61 (0.92–2.82) | 0.21 | |
Current smoker | BMI | 1.54 (1.22–1.94) | 1.52 (1.18–1.95) | 1.53 (1.09–2.16) | 0.35 | 0.63 (0.52–0.77) | 0.55 (0.45–0.68) | 0.46 (0.35–0.61) | 0.41 |
Mid BP | 1.13 (0.87–1.48) | 1.02 (0.76–1.37) | 1.03 (0.59–1.80) | 0.71 | 1.26 (1.07–1.48) | 1.39 (1.18–1.63) | 1.75 (1.28–2.38) | 0.76 | |
Glucose | 1.03 (0.77–1.36) | 0.95 (0.71–1.29) | 0.96 (0.32–2.88) | 0.97 | 1.08 (0.92–1.27) | 1.09 (0.92–1.29) | 1.26 (0.67–2.37) | 0.83 | |
Cholesterol | 1.03 (0.78–1.35) | 0.93 (0.69–1.27) | 0.89 (0.54–1.47) | 0.36 | 1.09 (0.92–1.29) | 1.11 (0.92–1.33) | 1.14 (0.84–1.53) | 0.44 | |
Triglycerides | 1.22 (0.93–1.61) | 1.09 (0.80–1.49) | 1.24 (0.63–2.43) | 0.07 | 1.00 (0.83–1.19) | 1.07 (0.87–1.31) | 1.09 (0.70–1.69) | 0.90 | |
MetS | 1.37 (1.04–1.81) | - | 1.58 (1.05–2.37) | 0.38 | 1.01 (0.84–1.22) | - | 1.02 (0.78–1.34) | 0.96 |