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  • br Discussion In this study cancer survivors in the communit

    2019-08-16


    Discussion In this study, cancer survivors in the BMS 986120 had a 1.56-fold increased association of MeS compared to the CNDZ, corresponding to prevalences of 25.7% and 18.8%, respectively. The prevalence of MeS was lower in cancer survivors than in those with chronic diseases. The prevalence of MeS in cancer survivors reported in previous studies was inconsistent, ranging from 26% to 55% from studies conducted in western countries [[9], [10], [11], [12]] and from 16% to 28.5% from studies conducted in Korea [7,8]. The prevalence of MeS in this study was closer to that reported in a population-based nationwide representative study in Korea [7]. Additionally, cancer survivors in western countries had a 1.6 to 2.1-fold increased prevalence of MeS [[9], [10], [11], [12]], compared to a 1.2-folds increase in Korea [7,8]. The results of the current study showed that the individual MeS components were also significantly higher in cancer survivors compared to those in the CNDZ. The apparent prevalence of increased MeS components among cancer survivors compared to the general population has been reported in other studies, including a higher prevalence of increased waist circumference [12], triglyceride levels [12], and HDL levels [7,12,43], supporting our findings. However, previous studies did not compare MeS in cancer survivors with subjects with chronic disease, based on the potential classification of cancer as a chronic disease. We observed that the prevalence of MeS and each of its components were higher in cancer survivors compared to the prevalence in the CNDZ, but lower than that in the CDZ. In general, cancer survivors had a higher prevalence of MeS compared to that of the general population, but the prevalence of MeS varied according to cancer type. In gastric cancer survivors, the second-most common cancer in Korea [44], we observed decreased a prevalence of MeS, although the difference was not statistically significant. Previous studies have reported significantly decreased ORs for MeS (OR = 0.37, CI = 0.27–0.50; OR = 0.42; CI = 0.20–0.86) in gastric cancer survivors [7,8]. A similar trend was observed for the components of MeS, with decreased OR for increased waist circumference and triglyceride levels in gastric cancer survivors, similar to a study finding in a Korean population [7]. This could be because those who underwent major upper gastrointestinal surgery had higher weight loss [45]. Additionally, liver cancer survivors showed lower a prevalence of high triglyceride levels compared with those of the CNDZ. A study showed decreased hepatic triglyceride levels after hepatectomy [46]. Our study did not collect data on treatment methods in the cancer survivors; thus, we were unable to determine whether the survivors of these two types of cancers had undergone surgery. However, as surgery is the common treatment for liver [47] and gastric cancers [48], we could assume that gastrointestinal tract or liver surgery may influence our results. A previous studies reporting lower prevalence of MeS in gastric cancer survivors also did not consider treatment modalities [7,8]. We observed a higher prevalence of MeS among colorectal, breast, cervical, lung, thyroid, prostate, and bladder cancer survivors compared to that in the CNDZ. Previous studies also showed a higher prevalence of MeS in colorectal [49], breast [8,12], cervical [50], prostate [8], and bladder cancer survivors [49], supporting our findings on the prevalence of MeS according to cancer type. The increased prevalence of MeS in colorectal cancer survivors may be induced by metabolic abnormalities such as fasting insulin resistance or hyperinsulinemia [51]. Prostate and breast cancer patients are exposed to treatment modalities that are known to increase the prevalence of metabolic abnormalities [52,53]. Additionally, breast cancer survivors may experience MeS due tamoxifen or aromatase inhibitor usage [8]. Although we did not have data regarding the subjects’ treatment history, medication therapy can lead to MeS or complications [16,17]; thus, it is likely that cancer treatments influenced the increased prevalence of MeS in cancer survivors.