既往研究表明，代谢综合征（MetS）可能会创造促癌环境并增加癌症发生率。但是，针对胃癌（GC）风险的证据很有限。本研究旨在评估MetS及其成分与韩国人群GC之间的关联。其中包括参与了2004-2017年的大规模前瞻性队列研究-健康检查者宝石研究的108,397个个体。使用多变量Cox比例风险模型估计MetS及其组成部分与GC风险的危险比（HR）和95％置信区间（CI）。分析中采用年龄作为时间刻度。执行分层分析以确定MetS和不同组的生活方式因素对GC风险的联合效应。在平均随访9.1年期间，确定759例新诊断的癌症病例（408男性和351女性）。总体而言，与没有MetS的人相比，患有MetS的参与者患GC的风险增加了26％（HR 1.26；95％CI 1.07-1.47）；风险随着MetS组分数量的增加而增加（p趋势0.01）。高三酰甘油血症，低HDL-胆固醇和高血糖与GC风险独立相关。MetS和目前吸烟者（交互作用的p为0.02）以及肥胖（BMI ≥ 25.0）（交互作用的p为0.03）存在潜在的联合作用。在这项前瞻性队列研究中，我们发现MetS与韩国人群GC的风险增加有关。我们的研究结果表明，MetS可能是GC风险的可调节因素。© 2023年作者授予国际胃癌协会和日本胃癌协会独家使用许可。

Previous studies suggested that metabolic syndrome (MetS) might create a pro-cancer environment and increase cancer incidence. However, evidence on the risk of gastric cancer (GC) was limited. This study aimed to evaluate the association between MetS and its components and GC in the Korean population.Included were 108,397 individuals who participated in the large-scale prospective cohort study, the Health Examinees-Gem study during 2004-2017. The multivariable Cox proportional was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) on the association between MetS and its components with GC risk. Age was used as the time scale in the analyses. The stratified analysis was performed to determine the joint effect of lifestyle factors and MetS on GC risk in different groups.During the mean follow-up of 9.1 years, 759 cases of newly diagnosed cancer (408 men and 351 women) were identified. Overall, participants with MetS had a 26% increased risk of GC than those without MetS (HR 1.26; 95% CI 1.07-1.47); the risk increased with the number of MetS components (p for trend 0.01). Hypertriglyceridemia, low HDL-cholesterol, and hyperglycemia were independently associated with the risk of GC. The potential joint effect of MetS and current smokers (p for interaction 0.02) and obesity (BMI ≥ 25.0) (p for interaction 0.03) in GC.In this prospective cohort study, we found that MetS were associated with an increased risk of GC in the Korean population. Our findings suggest that MetS may be a potentially modifiable risk factor for GC risk.© 2023. The Author(s) under exclusive licence to The International Gastric Cancer Association and The Japanese Gastric Cancer Association.