Annals of Hematology

, Volume 91, Issue 10, pp 1519–1531 | Cite as

Metabolic factors and blood cancers among 578,000 adults in the metabolic syndrome and cancer project (Me-Can)

  • Gabriele NagelEmail author
  • Tanja Stocks
  • Daniela Späth
  • Anette Hjartåker
  • Björn Lindkvist
  • Göran Hallmans
  • Håkan Jonsson
  • Tone Bjørge
  • Jonas Manjer
  • Christel Häggström
  • Anders Engeland
  • Hanno Ulmer
  • Randi Selmer
  • Hans Concin
  • Pär Stattin
  • Richard F. Schlenk
Original Article


We investigated associations between metabolic factors and blood cancer subtypes. Data on body mass index (BMI), blood pressure, blood glucose, total cholesterol, and triglycerides from seven prospective cohorts were pooled (n = 578,700; mean age = 44 years). Relative risks of blood cancers were calculated from Cox regression models. During mean follow-up of 12 years, 2,751 incident and 1,070 fatal cases of blood cancers occurred. Overall, higher BMI was associated with an increased blood cancer risk. In gender-specific subgroup analyses, BMI was positively associated with blood cancer risk (p = 0.002), lymphoid neoplasms (p = 0.01), and Hodgkin's lymphoma (p = 0.02) in women. Further associations with BMI were found for high-grade B-cell lymphoma (p = 0.02) and chronic lymphatic leukemia in men (p = 0.05) and women (p = 0.01). Higher cholesterol levels were inversely associated with myeloid neoplasms in women (p = 0.01), particularly acute myeloid leukemia (p = 0.003), and glucose was positively associated with chronic myeloid leukemia in women (p = 0.03). In men, glucose was positively associated with risk of high-grade B-cell lymphoma and multiple myeloma, while cholesterol was inversely associated with low-grade B-cell lymphoma. The metabolic syndrome score was related to 48 % increased risk of Hodgkin's lymphoma among women. BMI showed up as the most consistent risk factor, particularly in women. A clear pattern was not found for other metabolic factors.


Cancer Biomarker Epidemiology Leukemia Lymphoma 



We thank: in Norway, the screening team at the former National Health Screening Service of Norway, now the Norwegian Institute of Public Health, the contributing research centers delivering data to Cohort of Norway and Hilde Koch Lie research assistant at the Cancer Registry of Norway; in the Vorarlberg Heath Monitoring and Prevention Programme, Elmar Stimpfl, data base manager, Karin Parschalk at the cancer registry, Markus Wallner, Christian Bernhard, Andrea Kaufmann, Gabriela Dür from the Vorarlberg State Government, at the University Ulm, Andrea Kleiner, Daniela Oesterle, and Jürgen Salk for their excellent technical assistance; in the Västerbotten Intervention Project, Åsa Ågren, project data base manager at the Medical Biobank, Umeå University, Sweden; and in the Malmö Preventive Project, Anders Dahlin, data base manager. We gratefully thank the bwGRiD project (member of the German D-Grid initiative, funded by the Ministry for Education and Research and the Ministry for Science, Research and Arts Baden-Wuerttemberg. 2010) for the computational resources. This work was supported by the World Cancer Research Fund (Grant 2007/09).

Conflict of interest

None declared.

Supplementary material

277_2012_1489_MOESM1_ESM.doc (108 kb)
Supplemental table Relative risks (RRs) with 95% confidence intervals (CIs) of selected blood cancer entities by quintiles and Z-scores of individual and combined metabolic factors by sex (DOC 108 kb)


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Gabriele Nagel
    • 1
    • 2
    Email author
  • Tanja Stocks
    • 3
    • 4
  • Daniela Späth
    • 5
  • Anette Hjartåker
    • 6
  • Björn Lindkvist
    • 7
  • Göran Hallmans
    • 8
  • Håkan Jonsson
    • 9
  • Tone Bjørge
    • 10
    • 11
  • Jonas Manjer
    • 12
  • Christel Häggström
    • 3
  • Anders Engeland
    • 10
    • 11
  • Hanno Ulmer
    • 13
  • Randi Selmer
    • 11
  • Hans Concin
    • 2
  • Pär Stattin
    • 3
    • 14
  • Richard F. Schlenk
    • 5
  1. 1.Institute of Epidemiology and Medical BiometryUlm UniversityUlmGermany
  2. 2.Agency for Preventive and Social MedicineBregenzAustria
  3. 3.Department of Surgical and Perioperative Sciences, Urology and AndrologyUmeå UniversityUmeåSweden
  4. 4.Institute of Preventive MedicineCopenhagen University HospitalCopenhagenDenmark
  5. 5.Department of Internal Medicine IIIUniversity Hospital of UlmUlmGermany
  6. 6.Cancer Registry of NorwayOsloNorway
  7. 7.Institute of Medicine, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
  8. 8.Department of Public health and Clinical Medicine, Nutritional ResearchUmeå UniversityUmeåSweden
  9. 9.Department of Radiation Science, OncologyUmeå UniversityUmeåSweden
  10. 10.Department of Public Health and Primary Health CareUniversity of BergenBergenNorway
  11. 11.Norwegian Institute of Public HealthOslo/BergenNorway
  12. 12.Department of Surgery, Malmö University HospitalLund UniversityMalmöSweden
  13. 13.Department of Medical Statistics, Informatics and Health EconomicsInnsbruck Medical UniversityInnsbruckAustria
  14. 14.Department of Surgery, Urology ServiceMemorial Sloan-Kettering Cancer Center, New YorkNew YorkUSA

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