The troubling liaison between cancer and metabolic syndrome in chronic inflammatory rheumatic diseases

Arthritis Research & Therapy

Andrea Dalbeni¹  Luigi Tarantini²  Maurizio Rossini³  Luca Idolazzi³  Ombretta Viapiana³  Federica Ognibeni³  Angelo Fassio³  Alessandro Giollo³  Giovanni Orsolini³  Davide Gatti³  Giovanni Adami³  Giovanni Cioffi⁴ 

[1] Department of Medicine, General Medicine and Hypertension Unit, University of Verona & Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy;Department of cardiology, Ospedale civile S. Martino, Belluno, Italy;Rheumatology Section, Department of Medicine, University of Verona, Verona, Italy;Rheumatology Section, Department of Medicine, University of Verona, Verona, Italy;Division of cardiac rehabilitation, San Pancrazio Hospital, Arco di Trento, Trento, Italy;Rheumatology Unit, Policlinico Borgo Roma, Piazzale Scuro 10, 37134, Verona, Italy;

关键词: Cancer;    Metabolic syndrome;    Inflammatory autoimmune diseases;    Rheumatoid arthritis;    Psoriatic arthritis;    Ankylosing spondylitis;    Disease activity;   

DOI  :  10.1186/s13075-021-02465-3

来源: Springer

【 摘 要 】

BackgroundSeveral studies on community populations found that metabolic syndrome (MetS) is associated with higher risk for total incident cancer with a predisposition for specific types of cancer. These findings have never been analyzed in patients with chronic inflammatory rheumatic and musculoskeletal diseases (RMD). We assessed prevalence/incidence and factors related to the development of cancer in a large cohort of these patients and evaluate whether MetS and its components were associated with cancer independent of traditional markers of inflammation.MethodsBetween March 2014 and April 2016, 474 patients with RMD involved in a cardiovascular primary prevention program were consecutively recruited into this ambispective (combination of retrospective/prospective) study. They underwent clinical, laboratory, and echocardiographic evaluations. MetS was diagnosed according to the ATPIII criteria.ResultsDuration of follow-up was 42 [18–60] months. Patients with a diagnosis of cancer (made before recruitment or during follow-up) were 46 (9.7%). Cancer was diagnosed in 22/76 patients (29%) with MetS and in 24/398 patients (6%, p < 0.001) without MetS; nearly two thirds of malignancies belonged to those traditionally related to MetS. MetS was the strongest cancer risk factor. Cancer was positively associated with the number of MetS components identified in each patient. Beyond MetS, cancer was associated to older age and increased inflammatory disease activity; this information allowed to build a simple performance indicator highly sensitive for cancer development.ConclusionIn light of our results, an increasingly accurate assessment of MetS would be required in patients with RMD as potential measure of clinical outcomes including the risk of cancer.

【 授权许可】

CC BY