Colorectal Dis. 2022 Feb 13. doi: 10.1111/codi.16092. Online ahead of print.
ABSTRACT
AIM: Metabolic syndrome (MetS) is a cluster of factors including obesity, hypertension, diabetes, hypercholesterolemia and hyperlipidaemia. It has been associated with an increased risk of colorectal neoplasia. This systematic review and meta-analysis assessed the association between MetS and: (i) recurrence of adenomas or occurrence of CRC in patients with prior adenomas; (ii) survival in patients with CRC.
METHOD: MEDLINE, Embase, Scopus and Web of Science were searched up to 22/11/2019. Two authors independently conducted title and abstract screening; full text of eligible studies was evaluated. Where ≥3 studies reported effect measures for a specific outcome, meta-analysis using random effects model was conducted. I2 was used to assess between-study heterogeneity. Quality appraisal was undertaken with the Newcastle-Ottawa Score.
RESULTS: The search identified 1764 articles, 55 underwent full text screening, resulting in a total of 15 eligible studies. Five studies reported on metachronous neoplasia, with differing outcomes precluded a meta-analysis. No consistent relationship between MetS and metachronous neoplasia was found. Ten studies reported on survival outcomes. MetS was associated with poorer CRC-specific survival (HR=1.8, 95%CI 1.04-3.12, I2 =92.7%, n=3). Progression-free survival was also worse but this did not reach statistical significance (HR=1.12, 95%CI 0.89-1.42, I2 =85.6%, n=3). There was no association with overall survival (HR=1.04, 95%CI 0.94-1.15, I2 =43.7%, n=7). Significant heterogeneity was present but subgroup analysis did not account for this.
CONCLUSION: MetS is associated with poorer CRC-specific survival, but evidence is inconsistent on metachronous neoplasia. Further research is warranted to better understand the impact of MetS on the adenoma-carcinoma pathway.
PMID:35156283 | DOI:10.1111/codi.16092
