The association between metabolic syndrome and bladder cancer susceptibility and prognosis: an updated comprehensive evidence synthesis of 95 observational studies involving 97,795,299 subjects
Authors Peng XF, Meng XY, Wei C, Xing ZH, Huang JB, Fang ZF, Hu XQ, Liu QM, Zhu ZW, Zhou SH
Received 23 July 2018
Accepted for publication 3 October 2018
Published 26 November 2018 Volume 2018:10 Pages 6263—6274
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Chien-Feng Li
Xiao-Fan Peng,1 Xiang-Yu Meng,2 Cheng Wei,1 Zhen-Hua Xing,1 Jia-Bin Huang,1 Zhen-Fei Fang,1 Xin-Qun Hu,1 Qi-Ming Liu,1 Zhao-Wei Zhu,1 Sheng-Hua Zhou1
1Department of Cardiology, The Second Xiangya Hospital, Central South University, Changsha 410000, China; 2Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
Background: The association between metabolic syndrome (MS) and bladder cancer (BC) was not fully investigated, and most primary studies and pooled analyses were only focused on certain specific components.
Objective: To further investigate this issue and obtain more precise findings, we conducted this updated evidence synthesis of published studies, which involved not only MS components but also the MS in its entirety.
Materials and methods: We searched the PubMed, EMBASE, and Web of Science databases for observational studies on the association between BC susceptibility and/or mortality, and MS and its components. We extracted data from included studies, evaluated heterogeneity, and performed meta-analytic quantitative syntheses.
Results: A total of 95 studies with 97,795,299 subjects were included in the present study. According to the results, MS significantly increased the risk of BC (risk ratio [RR]=1.11, 95% CI=1.00–1.23); diabetes significantly increased the risk of BC (RR=1.29, 95% CI=1.19–1.39) and associated with poor survival (RR=1.24, 95% CI=1.08–1.43). Excessive body weight was associated with increased susceptibility (RR=1.07, 95% CI=1.02–1.12), recurrence (RR=1.46, 95% CI=1.18–1.81), and mortality (RR=1.17, 95% CI=1.00–1.37). As indicated by cumulative meta-analysis, sample size was inadequate for the association between BC susceptibility and MS, the association between BC recurrence and excessive body weight, and the association between BC survival and diabetes. The sample size of the meta-analysis was enough to reach a stable pooled effect for other associations.
Conclusion: Diabetes and excessive body weight as components of MS are associated with increased susceptibility and poor prognosis of BC. Uncertainty remains concerning the impact of overall MS, hypertension, and dyslipidemia on BC susceptibility and prognosis, for which further investigations are needed.
Keywords: metabolic syndrome, bladder cancer, diabetes, excessive body weight, susceptibility, prognosis, meta-analysis, cumulative meta-analysis
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]