ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Cardiovascular Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1629675
This article is part of the Research TopicNovel Strategies for the Clinical Management of Cardiovascular-Kidney-Metabolic SyndromeView all 7 articles
Cardiovascular-Kidney-Metabolic Comorbidities in Colorectal Cancer Survivors: A Nationwide Cohort Study on the Role of Metabolic Syndrome
Provisionally accepted
- 1Department of Pathology, The First Affiliated Hospital of Wenzhou Medical University,Wenzhou, China, Wenzhou, China
- 2Department of Clinical Epidemiology and Center of Evidence Based Medicine, The First Hospital of China Medical University,, Shenyang, China
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Background: Colorectal cancer (CRC) survivors are at increased risk of cardiovascular-kidney-metabolic (CKM) complications. Although metabolic syndrome (MetS) is a recognized precursor of cardiovascular disease (CVD) in the general population, its prognostic relevance in CRC survivors has not been well established.We retrospectively analyzed 32,740 patients with a history of CRC who underwent health check-ups recorded in a national hospital-based database between 2005 and 2021. MetS was defined according to the Chinese Diabetes Society (2017) criteria, requiring central obesity (waist circumference ≥90 cm in men or ≥85 cm in women) and at least two of the following components: elevated blood pressure, hypertriglyceridemia, low high-density lipoprotein cholesterol, or elevated fasting glucose. Patients were grouped by MetS status at baseline and followed for composite CVD outcomes, including myocardial infarction, angina pectoris, stroke, and heart failure.Results: Among 32,740 CRC survivors (median age 58 years; 65.2% male), 4,970 (15.2%) met the criteria for MetS. Over a mean follow-up of 945 ± 770 days, 2,137 composite CVD events occurred. Incidence rates were significantly higher in the MetS group than the non-MetS group (368.2 vs. 200.8 per 10,000 person-years). In multivariable Cox models, MetS was independently associated with elevated CVD risk (HR = 1.36, 95% CI: 1.20-1.54). The association remained significant in male participants (HR = 1.43, 95% CI: 1.24-1.64), but not in females (HR = 1.09, 95% CI: 0.87-1.36). Subgroup analyses revealed consistent associations across strata of age, treatment status, and cancer type, with stronger effects observed in patients without obesity (P for interaction < 0.05). Among individual MetS components, elevated blood pressure and fasting glucose showed the strongest associations with CVD outcomes.Conclusions: Metabolic syndrome is a significant predictor of cardiovascular events among colorectal cancer survivors in China.
Keywords: Colorectal cancer1, Cancer survivorship2, Metabolic syndrome3, cardiovascular disease4, CKM comorbidities5
Received: 16 May 2025; Accepted: 05 Jun 2025.
Copyright: © 2025 Liu, Zhao and Zheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chang Zheng, Department of Clinical Epidemiology and Center of Evidence Based Medicine, The First Hospital of China Medical University,, Shenyang, China
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