<jats:bold>Objective: </jats:bold>The components of metabolic syndrome have been shown to be associated with lung cancer. Pulmonary nodules (PNs), early predictors of lung cancer, have become common incidental findings with the widespread use of low-dose computed tomography (LDCT) but few epidemiological studies have been performed. The present study aimed to determine the association between MetS and/or its components with PNs in Chinese adults.<jats:bold>Methods</jats:bold>:A total of 3,340 participants (51.4% women) aged 18 years or older were included from the Jidong communities. MetS was defined by the criteria from the American Heart Association, and National Heart, Lung, and Blood Institute (AHA/NHLBI). PNs were detected using LDCT. <jats:bold>Results:</jats:bold>The prevalence rate of PNs was 19.2% in participants with MetS, while 12.8% in healthy controls (<jats:italic>P</jats:italic><0.001). The odds ratio (OR) and 95% confidence internal (CI) for PNs in participants with elevated blood pressure (≥130/85 mmHg or on drugs for treatment of hypertension) was OR = 1.23, 95% CI: 1.01–1.51. Compared to individuals without MetS components, the ORs (95% CI) for PNs development among those with 1, 2, and ≥3 MetS components were 1.25 (0.94–1.67), 1.10 (0.82–1.48), and 1.43 (1.08–1.89), respectively (<jats:italic>P</jats:italic> for trend =0.04). Moreover, individuals with MetS had an approximately 30% increased risk of PNs than those who did not meet the MetS diagnostic criteria (number of MetS components<3) ( OR = 1.29, 95% CI: 1.03–1.61). <jats:bold>Conclusion:</jats:bold>The present study suggested that PNs was associated with abnormal MetS components in Chinese adults. Individuals with MetS might have a higher PNs risk than those without MetS.
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