Table 3.

Associations between metabolic syndrome, its components, and tumor grade for selected histotypes of ovarian and fallopian tube cancer, SEER-Medicare linked data (1994–2013)

	Serous High Grade n=4 622		Serous Low Grade n=1 119		Pc	Endometrioid High Grade n=472		Endometrioid Low Grade n=532		Pc	Other Epithelial High Grade n=1 978		Other Epithelial Low Grade n=420		Pc	Pd
	ORb	95% CI	ORb	95% CI		ORb	95% CI	ORb	95% CI		ORb	95% CI	ORb	95% CI
Metabolic Syndromea
(≥3 vs.<3)	0.73	0.68–0.79	0.85	0.72–1.00	0.31	1.03	0.81–1.30	0.83	0.66–1.04	0.24	0.91	0.81–1.03	1.05	0.82–1.36	0.50	0.01
Number of metabolic syndrome components					0.63					0.12					0.86	0.09
0	--	Ref	--	Ref		--	Ref	--	Ref		--	Ref	--	Ref
1	1.22	1.12–1.33	1.30	1.10–1.54		1.27	0.98–1.66	1.53	1.17–1.98		1.41	1.24–1.61	1.50	1.13–2.00
2	1.19	1.09–1.30	1.41	1.19–1.67		1.26	0.96–1.64	1.67	1.29–2.16		1.41	1.24–1.62	1.43	1.06–1.91
≥3	0.85	0.77–0.94	1.08	0.88–1.33		1.23	0.91–1.67	1.18	0.87–1.60		1.20	1.03–1.40	1.44	1.03–2.00
Components of Metabolic Syndrome
Overweight/obesity	0.71	0.63–0.80	0.83	0.65–1.05	0.38	0.78	0.54–1.14	0.69	0.49–0.99	0.52	0.85	0.71–1.01	1.13	0.80–1.59	0.17	0.53
Impaired fasting glucose	0.79	0.74–0.85	0.80	0.69–0.92	0.68	0.91	0.73–1.13	0.80	0.65–0.98	0.55	0.91	0.82–1.02	0.98	0.78–1.24	0.70	0.14
Hypertension	0.93	0.87–1.00	1.17	1.02–1.33	0.09	1.08	0.88–1.33	1.64	1.33–2.02	0.001	1.22	1.10–1.35	1.29	1.03–1.61	0.98	0.01
High triglycerides	1.10	1.03–1.17	1.29	1.13–1.47	0.43	1.37	1.12–1.68	1.07	0.89–1.29	0.22	1.16	1.05–1.28	1.30	1.05–1.61	0.47	0.34

n=number, OR= odds ratio, CI=confidence interval

^aMetabolic syndrome was defined as diagnoses for 3 or more components of metabolic syndrome (central adiposity or overweight/obesity, impaired fasting glucose [including type II diabetes], hypertension, high triglycerides, low HDL cholesterol) and/or a diagnosis of ‘dysmetabolic syndrome.’ Women meeting this definition were compared to a referent group of those not meeting it (i.e., including those with diagnoses for only one or two of the components). When comparing the number of metabolic syndrome components with which women were diagnosed, those without diagnoses for any of the components are the reference group (‘dysmetabolic syndrome’ not considered in this categorization).

^bLogistic regression models were run separately for each exposure and each case group (comparing to controls as the reference). Models were adjusted for diagnosis date, age, race, geographic location, state Medicare buy-in, medical history of smoking or tobacco use, and length of Medicare enrollment.

^cChi-square test P values to assess heterogeneity by grade within histotypes. For each histotype, we used case-only logistic regression models comparing women with low grade tumors to women with high grade tumors (reference group) to obtain effect estimate p values for metabolic syndrome and each of its components.

^dChi square test P values to assess heterogeneity by histotype among high grade cancers. We used case-only non-ordinal multinomial logistic models comparing women with high grade endometrioid tumors and high grade other epithelial tumors to those with high grade serous tumors (reference) and obtained effect estimate p values for metabolic syndrome and each of its components.