Sex/gender differences in metabolic syndrome among cancer survivors in the US: an NHANES analysis

Background: The purpose of this study was to assess the association of metabolic syndrome (MetS) and its individual components in cancer survivors (CS) by gender, in comparison to participants without a history of cancer who have at least one chronic disease (CD) and those without a chronic disease diagnosis (NCD).

Methods: Data from participants 40 years and older (n = 12,734) were collected from the 2011 to 2018 National Health and Nutrition Examination Survey dataset. MetS was defined based on the National Cholesterol Education Program's Adult Treatment Panel III. Chi-square test and multivariate-adjusted logistic regression was used to assess group comparisons and associations respectively.

Results: Compared to NCD, CS and CD men had increased odds of meeting MetS, OR 2.60 (CI 1.75-3.87) and OR 2.18 (CI 1.59-2.98) respectively. For women, CS and CD participants also had higher odds of meeting MetS criteria compared to their healthy counterparts, OR 2.05 (CI 1.44-2.93) and OR 2.14 (CI 1.63-2.81) respectively. In subgroup analysis by cancer site, CS men with a history of hematologic malignancies (OR 4.88, CI 1.30-18.37) and CS women with cervical cancer (OR 4.25, CI 1.70-10.59) had highest odds of developing MetS, compared to NCD. CS men also showed a strong association with elevated waist circumference, low high density lipoprotein-c, and elevated triglycerides, even by cancer site, but there were no consistent findings among women.

Conclusion: This study indicates that CS men have a strong association with MetS, especially among those with blood-related cancers.