Metabolic syndrome and risk of kidney cancer in the United States.

Abstract

Background: Metabolic dysregulation may contribute to kidney cancer development through shared biological mechanisms and/or as an independent risk factor. However, evidence on this association in the US population remains limited.

Objective: This study identifies associations between metabolic syndrome (MetS) and kidney cancer risk in the United States.

Methods: This case-control study using administrative claims data from the MarketScan database (2007-2022) identified adult kidney cancer cases and 1:10 frequency-matched controls by age, index year, sex, insurance duration, and region. Metabolic exposures (obesity, hypertension, diabetes, and dyslipidemia) were assessed using diagnoses and prescriptions, with binary classification (MetS: ≥3 conditions; non-MetS: <3). Secondary analyses examined pre-MetS (1-2 conditions), metabolically healthy, dose-response relationships, combinations of conditions, and interaction between obesity and MetS. Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).

Results: A total of 48,587 kidney cancer cases and 480,714 controls were included. MetS was associated with an increased risk of kidney cancer compared with non-MetS (OR, 1.43; 95% CI, 1.39-1.47). MetS (OR, 1.83; 95% CI, 1.77-1.88) and pre-MetS (OR, 1.47; 95% CI, 1.44-1.50) were associated with a higher risk compared with metabolically healthy. Each additional condition was associated with a 22% increase in the odds (95% CI, 1.21-1.23). Multiple conditions had higher odds than a single condition. Metabolically healthy obesity (OR, 1.48) and metabolically unhealthy obesity (OR, 1.77) showed stronger associations than metabolically healthy nonobesity.

Conclusion: MetS was associated with an increased risk of kidney cancer, highlighting the importance of overall metabolic health in its prevention.