1. Metabolic Syndrome and Risk of Cancer: A Systematic Review and Meta-Analysis Featured Article: Katherine Esposito, M.D., Ph.D., Paolo Chiodini, Ph.D., AnnaMaria Colao, M.D., Andrea Lenzi, M.D., Dario Giugliano, M.D., Ph.D. Diabetes Care Volume 35: 2402-2411 November, 2012

2. STUDY OBJECTIVE Metabolic syndrome may be associated with the risk of some common cancers Systematic review and meta-analysis performed to assess the association between metabolic syndrome and risk of cancer Esposito K et al. Diabetes Care 2012;35:2402-2411

3. STUDY DESIGN AND METHODS Electronic search conducted for articles published through October 2011 Every study reported risk estimates with 95% CIs for the association between metabolic syndrome and cancer Esposito K et al. Diabetes Care 2012;35:2402-2411

5. RESULTS 116 datasets from 43 articles analyzed, including 38,940 cases of cancer In men, presence of metabolic syndrome associated with liver (relative risk 1.43, P < 0.0001), colorectal (1.25, P < 0.001), and bladder (1.10, P = 0.013) cancer In women, presence of metabolic syndrome associated with endometrial (1.61, P = 0.001), pancreatic (1.58, P < 0.0001), postmenopausal breast (1.56, P = 0.017), rectal (1.52, P = 0.005), and colorectal (1.34, P = 0.006) cancer Esposito K et al. Diabetes Care 2012;35:2402-2411

6. RESULTS Associations with metabolic syndrome stronger in women than men for pancreatic (P = 0.01) and rectal (P = 0.01) cancers Associations different between ethnic groups: o Stronger associations for liver cancer in Asian populations (P = 0.002), for colorectal cancer in women in European populations (P = 0.004), and for prostate cancer in U.S. populations (whites) (P = 0.001) Esposito K et al. Diabetes Care 2012;35:2402-2411

19. CONCLUSIONS Metabolic syndrome associated with increased risk of common cancers For some cancers, risk differs betweens sexes, populations, and definitions of metabolic syndrome Esposito K et al. Diabetes Care 2012;35:2402-2411