Cancer Causes & Control

, Volume 24, Issue 1, pp 107–116 | Cite as

Prospective cohort study of metabolic risk factors and gastric adenocarcinoma risk in the Metabolic Syndrome and Cancer Project (Me-Can)

  • Björn LindkvistEmail author
  • Martin Almquist
  • Tone Bjørge
  • Tanja Stocks
  • Wegene Borena
  • Dorthe Johansen
  • Göran Hallmans
  • Anders Engeland
  • Gabriele Nagel
  • Håkan Jonsson
  • Randi Selmer
  • Guenter Diem
  • Christel Häggström
  • Steinar Tretli
  • Pär Stattin
  • Jonas Manjer
Original paper



Little is known about the association between the metabolic syndrome (MetS) and the risk of gastric adenocarcinoma. The aim of this study was to investigate whether metabolic risk factors, together or combined, were associated with the risk of gastric adenocarcinoma.


The Metabolic Syndrome and Cancer Project (Me-Can) is a pooling of prospective cohorts in Austria, Norway, and Sweden with information on blood pressure, lipids, glucose, and BMI available in 578,700 individuals. Cox proportional hazards analysis was used to calculate hazard ratio (HR) of gastric adenocarcinoma using metabolic risk factors categorized into quintiles and transformed into z-scores (with mean = 0 and SD = 1). The standardized sum of all z-scores created a composite MetS score.


In total, 1,210 incident cases of gastric adenocarcinoma were identified. Glucose was significantly associated with the risk of gastric adenocarcinoma [calibrated HR 1.58 (1.14–2.20) per one unit increment in z-score] in women. There was a statistically significant association between triglycerides and risk of gastric adenocarcinoma per mmol increment in triglycerides [HR 1.20 (1.06–1.36) per mmol] but not for the adjusted z-score in women. There were no significant association between any metabolic factors and gastric cancer among men. The composite MetS score was associated with the risk of gastric adenocarcinoma in women [HR 1.18 (1.00–1.38) per one unit increment in z-score] but not in men.


Glucose and high levels of the composite MetS score were associated with an increased risk of gastric adenocarcinoma in women but not in men.


Gastric adenocarcinoma Epidemiology Cohort study Metabolic syndrome CONOR 



The metabolic syndrome


Blood pressure


Body mass index


Hazard ratio


Confidence interval


The metabolic syndrome and cancer risk project


Regression dilution ratio


Regression calibration



Financial support was provided by the World Cancer Research Fund (Grant 2007/09), The Swedish Research Council, The Ernhold Lundström Foundation, The Einar and Inga Nilsson Foundation, The Malmö University Hospital Cancer Research Fund, The Malmö University Hospital Funds and Donations, The Crafoord Foundation, the Mossfelt Foundation, and the Swedish federal government under the agreement concerning research and education of doctors in Västra Götaland, Sweden.

Conflict of interest

The authors have no potential conflicts of interest to declare.


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Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  • Björn Lindkvist
    • 1
    • 15
    Email author
  • Martin Almquist
    • 2
  • Tone Bjørge
    • 3
    • 4
  • Tanja Stocks
    • 5
    • 6
  • Wegene Borena
    • 7
  • Dorthe Johansen
    • 8
  • Göran Hallmans
    • 9
  • Anders Engeland
    • 3
    • 4
  • Gabriele Nagel
    • 10
  • Håkan Jonsson
    • 11
  • Randi Selmer
    • 4
  • Guenter Diem
    • 12
  • Christel Häggström
    • 5
  • Steinar Tretli
    • 13
  • Pär Stattin
    • 5
  • Jonas Manjer
    • 8
    • 14
  1. 1.Institute of Medicine, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
  2. 2.Department of SurgerySkåne University Hospital Lund and Lund UniversityLundSweden
  3. 3.Department of Public Health and Primary Health CareUniversity of BergenBergenNorway
  4. 4.Norwegian Institute of Public HealthOslo, BergenNorway
  5. 5.Department of Surgical and Perioperative Sciences, Urology and AndrologyUmeå UniversityUmeåSweden
  6. 6.Institute of Preventive MedicineCopenhagen University HospitalsCopenhagenDenmark
  7. 7.Department of Medical Statistics, Informatics and Health EconomicsInnsbruck Medical UniversityInnsbruckAustria
  8. 8.Department of SurgerySkåne University Hospital Malmö and Lund UniversityMalmöSweden
  9. 9.Department of Public Health and Clinical Medicine, Nutritional ResearchUmeå UniversityUmeåSweden
  10. 10.Institute of EpidemiologyUlm UniversityUlmGermany
  11. 11.Department of Radiation Sciences, OncologyUmeå UniversityUmeåSweden
  12. 12.Agency for Social and Preventive MedicineBregenzAustria
  13. 13.Cancer Registry of NorwayInstitute of Population-based Cancer ResearchOsloNorway
  14. 14.The Malmö Diet and Cancer StudyMalmö University HospitalMalmöSweden
  15. 15.Department of Internal Medicine, Division of Gastroenterology and HepatologySahlgrenska University HospitalGothenburgSweden

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