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Body mass index and risk of brain tumors: a systematic review and dose-response meta-analysis. Eur J Clin Nutr 2016; 70:757-65. [PMID: 26908425 DOI: 10.1038/ejcn.2016.4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 12/17/2015] [Accepted: 01/17/2016] [Indexed: 01/17/2023]
Abstract
BACKGROUND/OBJECTIVES Data regarding the relationships between body mass index (BMI) and brain tumors are inconsistent, especially for the commonly seen gliomas and meningiomas. Therefore, we conducted a dose-response meta-analysis to unravel the issue. SUBJECTS/METHODS Cochrane Library, PubMed and Embase were searched for pertinent case-control and cohort studies updated to November 2014. Dose-response and quantitative analysis were conducted with random-effect model. RESULTS Sixteen studies were included, containing 3 887 156 participants and 11 614 cases. In categorical analysis for the relationships between abnormal weight and BMI, the summary risk ratio (RR) of brain tumors was 1.34 (95% confidential interval (CI), 1.15-1.56) for obesity, 1.12 (95% CI, 1.05-1.19) for overweight and 0.77 (95% CI, 0.64-0.93) for underweight; the summary RR of gliomas was 1.13 (95% CI, 1.02-1.26) for overweight and 0.71 (95% CI, 0.58-0.88) for underweight; the summary RR of meningiomas was 1.48 (95% CI, 1.30-1.69) for obesity and 1.18 (95% CI, 1.07-1.31) for overweight. In dose-response analysis, for every 5 kg/m(2) increment of BMI, the summary RR was 1.13 (95% CI, 1.07-1.20) for overall brain tumors, 1.07 (95% CI, 0.97-1.19) for gliomas and 1.19 (95% CI, 1.14-1.25) for meningiomas. CONCLUSIONS Excess weight was associated with increased risk of brain tumors and meningiomas but not with gliomas. Selective screening for brain tumors among obesity, especially for the females, might be more instructive.
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The Activation of ERK1/2 and JNK MAPK Signaling by Insulin/IGF-1 Is Responsible for the Development of Colon Cancer with Type 2 Diabetes Mellitus. PLoS One 2016; 11:e0149822. [PMID: 26901856 PMCID: PMC4763097 DOI: 10.1371/journal.pone.0149822] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 02/04/2016] [Indexed: 12/13/2022] Open
Abstract
Previous studies showed that type 2 diabetes mellitus (T2DM) is linked to increased risk of developing colon cancer. Insulin and insulin-like growth factor 1 (IGF-1) are increased in patients with T2DM. The increased insulin and IGF-1 may be responsible for the developing of colon cancer. In this study, we investigated the effects and mechanisms of insulin and IGF-1 in colon cancer development in vitro and in vivo. Insulin and IGF-1 alone or together elevated proliferation and reduced apoptosis in colon cancer MC38 cells. Meanwhile, insulin and IGF-1 promoted the phosphorylation of extracellular-signal regulated kinase 1/2 (ERK1/2) and c-Jun N-terminal kinase (JNK). Treatment with ERK1/2 or JNK inhibitor in the presence of insulin and IGF-1 significantly decreased B-cell lymphoma 2 (Bcl-2) and increased Bcl-2-associated X protein (Bax) expression and finally increased apoptosis and inhibited the proliferation. Accelerative colon tumor growth was found in a mouse model of T2DM with db/db mice which got high level of endogenous insulin and IGF-1. Furthermore, the inhibition of ERK1/2 or JNK suppressed the development of colon tumor in vivo. These results suggest that the activation of ERK1/2 and JNK signaling by insulin and IGF-1, at least in part, is responsible for the development of colon cancer with T2DM.
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Luo S, Li JY, Zhao LN, Yu T, Zhong W, Xia ZS, Shan TD, Ouyang H, Yang HS, Chen QK. Diabetes mellitus increases the risk of colorectal neoplasia: An updated meta-analysis. Clin Res Hepatol Gastroenterol 2016; 40:110-23. [PMID: 26162991 DOI: 10.1016/j.clinre.2015.05.021] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 05/18/2015] [Accepted: 05/27/2015] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Recent studies proved that patients with diabetes were at significantly higher risk of developing colorectal cancer. However, the association between diabetes mellitus and the risk of colorectal adenoma remains undefined. Thus we conducted an updated meta-analysis to identify the association between diabetes mellitus and the risk of colorectal neoplasia including adenoma and cancer. METHODS We conducted a search in databases including Pubmed, Web of Science, EMBASE Databases, Cochrane CENTRAL, Wanfang Data, and CNKI database. Case-control and cohort studies were included. All articles were published before January 2015 and the quality of each study was evaluated by the Newcastle-Ottawa Scale. Odds ratios (ORs) or relative risks (RRs) and its corresponding 95% confidence intervals (CIs) for each study were calculated and summary relative risk estimates with corresponding 95% CIs were generated using the random-effects model. Heterogeneity and publication bias were assessed. RESULTS Twenty-nine articles including ten case-control studies and nineteen cohort studies were included in this meta-analysis. In a pooled analysis of all studies, diabetes mellitus was associated with increased risk of colorectal neoplasia (RR=1.35, 95% CI=1.28-1.42). The risk increased significantly for both colorectal cancer (RR=1.37, 95% CI=1.30-1.45) and adenoma (RR=1.26, 95% CI=1.11-1.44). Subgroup analyses on study design, gender, geographical region, and type of diabetes mellitus further evidenced these findings. CONCLUSIONS Diabetes mellitus was associated with an increased risk of colorectal neoplasia. Not only the increased risk of colorectal cancer but also the higher risk of adenoma was identified in patients with diabetes mellitus.
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Affiliation(s)
- Su Luo
- Department of gastroenterology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107, Yan Jiang Xi Road, 510120 Guangzhou, Guangdong, People's Republic of China
| | - Jie-Yao Li
- Department of gastroenterology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107, Yan Jiang Xi Road, 510120 Guangzhou, Guangdong, People's Republic of China
| | - Li-Na Zhao
- Department of gastroenterology, the First Affiliated Hospital, Guangzhou University of Traditional Chinese Medicine, 510120 Guangzhou, People's Republic of China
| | - Tao Yu
- Department of gastroenterology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107, Yan Jiang Xi Road, 510120 Guangzhou, Guangdong, People's Republic of China.
| | - Wa Zhong
- Department of gastroenterology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107, Yan Jiang Xi Road, 510120 Guangzhou, Guangdong, People's Republic of China
| | - Zhong-Sheng Xia
- Department of gastroenterology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107, Yan Jiang Xi Road, 510120 Guangzhou, Guangdong, People's Republic of China
| | - Ti-Dong Shan
- Department of gastroenterology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107, Yan Jiang Xi Road, 510120 Guangzhou, Guangdong, People's Republic of China
| | - Hui Ouyang
- Department of gastroenterology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107, Yan Jiang Xi Road, 510120 Guangzhou, Guangdong, People's Republic of China
| | - Hong-Sheng Yang
- Department of gastroenterology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107, Yan Jiang Xi Road, 510120 Guangzhou, Guangdong, People's Republic of China
| | - Qi-Kui Chen
- Department of gastroenterology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107, Yan Jiang Xi Road, 510120 Guangzhou, Guangdong, People's Republic of China.
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Martinez-Useros J, Garcia-Foncillas J. Obesity and colorectal cancer: molecular features of adipose tissue. J Transl Med 2016; 14:21. [PMID: 26801617 PMCID: PMC4722674 DOI: 10.1186/s12967-016-0772-5] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 01/05/2016] [Indexed: 02/06/2023] Open
Abstract
The huge part of population in developed countries is overweight or obese. Obesity is often determined by body mass index (BMI) but new accurate methods and ratios have recently appeared to measure body fat or fat located in the intestines. Early diagnosis of obesity is crucial since it is considered an increasing colorectal cancer risk factor. On the one hand, colorectal cancer has been strongly associated with lifestyle factors. A diet rich in red and processed meats may increase colorectal cancer risk; however, high-fiber diets (grains, cereals and fruits) have been associated with a decreased risk of colorectal cancer. Other life-style factors associated with obesity that also increase colorectal cancer risk are physical inactivity, smoking and high alcohol intake. Cutting-edge studies reported that high-risk transformation ability of adipose tissue is due to production of different pro-inflammatory cytokines like IL-8, IL-6 or IL-2 and other enzymes like lactate dehydrogenase (LDH) and tumour necrosis factor alpha (TNFα). Furthermore, oxidative stress produces fatty-acid peroxidation whose metabolites possess very high toxicities and mutagenic properties. 4-hydroxy-2-nonenal (4-HNE) is an active compounds that upregulates prostaglandin E2 which is directly associated with high proliferative colorectal cancer. Moreover, 4-HNE deregulates cell proliferation, cell survival, differentiation, autophagy, senescence, apoptosis and necrosis via mitogen-activated protein kinase (MAPK), phosphoinositide 3-kinase (PIK3CA)—AKT and protein kinase C pathways. Other product of lipid peroxidation is malondialdehyde (MDA) being able to regulate insulin through WNT-pathway as well as having demonstrated its mutagenic capability. Accumulation of point mutation enables genomic evolution of colorectal cancer described in the model of Fearon and Vogelstein. In this review, we will summarize different determination methods and techniques to assess a truthfully diagnosis and we will explain some of the capabilities that performs adipocytes as the largest endocrine organ.
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Affiliation(s)
- Javier Martinez-Useros
- Translational Oncology Division, Oncohealth Institute, FIIS-Fundacion Jimenez Diaz, Av. Reyes Catolicos 2, 28040, Madrid, Spain.
| | - Jesus Garcia-Foncillas
- Translational Oncology Division, Oncohealth Institute, FIIS-Fundacion Jimenez Diaz, Av. Reyes Catolicos 2, 28040, Madrid, Spain.
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Argolo DF, Iyengar NM, Hudis CA. Obesity and Cancer: Concepts and Challenges. Indian J Surg Oncol 2015; 6:390-8. [PMID: 27081257 DOI: 10.1007/s13193-015-0483-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 11/17/2015] [Indexed: 12/17/2022] Open
Abstract
The rates of overweight and obesity are increasing worldwide in both developed and developing countries. Obesity is a major public health problem as it is associated with many diseases, including diabetes, hypertension, dyslipidemia, atherosclerosis, and some types of cancer. Breast cancer is a malignancy in which both the risk of development and the prognosis are negatively impacted by the obese state. The precise mechanisms pathophysiologically linking obesity and cancer are still under investigation. The biological basis for these associations includes both systemic and local tissue effects and white adipose tissue inflammation appears to be a critical component. A comprehensive understanding of the mechanisms linking obesity, inflammation and cancer may provide an opportunity for the development of strategies to attenuate the negative impact of obesity.
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Affiliation(s)
- Daniel F Argolo
- Memorial Sloan Kettering Cancer Center, 300 East 66th Street - 8th floor, New York, NY 10065 USA ; CLION - CAM Group, Salvador, BA Brazil
| | - Neil M Iyengar
- Memorial Sloan Kettering Cancer Center, 300 East 66th Street - 8th floor, New York, NY 10065 USA ; Weill Cornell Medical College, New York, NY USA
| | - Clifford A Hudis
- Memorial Sloan Kettering Cancer Center, 300 East 66th Street - 8th floor, New York, NY 10065 USA ; Weill Cornell Medical College, New York, NY USA
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Steck SE, Guinter M, Zheng J, Thomson CA. Index-based dietary patterns and colorectal cancer risk: a systematic review. Adv Nutr 2015; 6:763-73. [PMID: 26567200 PMCID: PMC4642428 DOI: 10.3945/an.115.009746] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Colorectal cancer (CRC) is the third most common cancer in both men and women in the United States. Various a priori dietary patterns that take into account diet complexity have been associated with CRC risk. This systematic review augments the evidence for an association between CRC risk and the Mediterranean Diet Score (MDS) and the Healthy Eating Index (HEI), and provides new evidence for a novel Dietary Inflammatory Index (DII). Human studies published in English after 31 December 2008 were reviewed. Five case-control studies and 7 prospective cohort studies conducted in the United States and Europe were identified. Five of the studies examined the MDS, 4 examined the HEI, and 4 examined the DII. Comparing highest to lowest score groups, higher MDSs were associated with an 8-54% lower CRC risk, and higher HEI scores were associated with a 20-56% lower CRC risk. More proinflammatory diet scores were associated with a 12-65% higher CRC risk compared with more anti-inflammatory diets in studies that used the DII. The results reported by sex suggested similar associations for men and women. This review builds upon the evidence supporting the association between higher overall diet quality and lower risk of CRC. Increasing scores of MDS and HEI and anti-inflammatory DII scores are characterized by high intake of plant-based foods and low intake of animal products. Future studies in more diverse populations and with consistent scoring calculations are recommended.
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Affiliation(s)
- Susan E Steck
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC; and
| | - Mark Guinter
- Department of Epidemiology and Biostatistics and,Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC; and
| | - Jiali Zheng
- Department of Epidemiology and Biostatistics and,Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC; and
| | - Cynthia A Thomson
- Mel and Enid Zuckerman College of Public Health and,Arizona Cancer Center, University of Arizona, Tucson, AZ
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Liu L, Shi Y, Li T, Qin Q, Yin J, Pang S, Nie S, Wei S. Leisure time physical activity and cancer risk: evaluation of the WHO's recommendation based on 126 high-quality epidemiological studies. Br J Sports Med 2015; 50:372-8. [PMID: 26500336 DOI: 10.1136/bjsports-2015-094728] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND The WHO has concluded that physical activity reduces the risk of numerous diseases. However, few systemic reviews have been performed to assess the role of leisure time physical activity (LTPA) in lowering the risk of cancer in a dose-dependent manner and furthermore the suitability of recommendation of physical activity by the WHO. METHODS A systematic review and meta-analysis was designed to estimate cancer risk by LTPA in binary comparison and in a dose-dependent manner. MEDLINE and Web of Science were searched up to 30 December 2014 without language restrictions. Reference lists were reviewed for potential articles. RESULTS A total of 126 studies were recruited into the meta-analysis. Overall, the total cancer risk was reduced by 10% in people who undertook the most LTPA as compared with those who did the least. Dose-response meta-analysis indicated that the current WHO recommendation (equal to an average of 10 metabolic equivalents of energy hours per week) induced a 7% (95% CI 5% to 9%) cancer reduction. Moreover, the protective role of LTPA against cancer becomes saturated at 20 metabolic equivalents of energy hours per week, with a relative risk of 0.91 (95% CI 0.88 to 0.93). Subanalyses results based on cancer types showed that LTPA only exhibited significant protection against breast cancer and colorectal cancer. CONCLUSIONS Our meta-analysis indicates that the current WHO recommendation of physical activity can result in a 7% reduction in cancer risk, which is mainly attributed to its protective role against breast cancer and colorectal cancer. Furthermore, two-fold of current recommendation level is considered to give its saturated protection against cancer.
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Affiliation(s)
- Li Liu
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yun Shi
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tingting Li
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qin Qin
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jieyun Yin
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shuo Pang
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shaofa Nie
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Sheng Wei
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Augustin LSA, Kendall CWC, Jenkins DJA, Willett WC, Astrup A, Barclay AW, Björck I, Brand-Miller JC, Brighenti F, Buyken AE, Ceriello A, La Vecchia C, Livesey G, Liu S, Riccardi G, Rizkalla SW, Sievenpiper JL, Trichopoulou A, Wolever TMS, Baer-Sinnott S, Poli A. Glycemic index, glycemic load and glycemic response: An International Scientific Consensus Summit from the International Carbohydrate Quality Consortium (ICQC). Nutr Metab Cardiovasc Dis 2015; 25:795-815. [PMID: 26160327 DOI: 10.1016/j.numecd.2015.05.005] [Citation(s) in RCA: 394] [Impact Index Per Article: 43.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 05/08/2015] [Accepted: 05/08/2015] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND AIMS The positive and negative health effects of dietary carbohydrates are of interest to both researchers and consumers. METHODS International experts on carbohydrate research held a scientific summit in Stresa, Italy, in June 2013 to discuss controversies surrounding the utility of the glycemic index (GI), glycemic load (GL) and glycemic response (GR). RESULTS The outcome was a scientific consensus statement which recognized the importance of postprandial glycemia in overall health, and the GI as a valid and reproducible method of classifying carbohydrate foods for this purpose. There was consensus that diets low in GI and GL were relevant to the prevention and management of diabetes and coronary heart disease, and probably obesity. Moderate to weak associations were observed for selected cancers. The group affirmed that diets low in GI and GL should always be considered in the context of diets otherwise understood as healthy, complementing additional ways of characterizing carbohydrate foods, such as fiber and whole grain content. Diets of low GI and GL were considered particularly important in individuals with insulin resistance. CONCLUSIONS Given the high prevalence of diabetes and pre-diabetes worldwide and the consistency of the scientific evidence reviewed, the expert panel confirmed an urgent need to communicate information on GI and GL to the general public and health professionals, through channels such as national dietary guidelines, food composition tables and food labels.
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Affiliation(s)
- L S A Augustin
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada.
| | - C W C Kendall
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada; Department of Nutritional Science, University of Toronto, Toronto, Canada; University of Saskatchewan, Saskatoon, Canada
| | - D J A Jenkins
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada; Department of Nutritional Science, University of Toronto, Toronto, Canada
| | - W C Willett
- Department of Nutrition, Harvard School of Public Health, Boston, USA
| | - A Astrup
- Department of Nutrition, Exercise and Sports (NEXS), Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - A W Barclay
- Glycemic Index Foundation, Sydney, Australia
| | - I Björck
- Food for Health Science Centre, Lund University, Lund, Sweden
| | - J C Brand-Miller
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, Australia
| | - F Brighenti
- Department of Food Sciences, University of Parma, Parma, Italy
| | - A E Buyken
- Department of Nutritional Epidemiology, University of Bonn, Bonn, Germany
| | - A Ceriello
- Institut d' Investigación Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomedica en Red de Diabetes y Enfermedades Metabolicas Asociadas (CIBERDEM), Barcelona, Spain
| | - C La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - G Livesey
- Independent Nutrition Logic, Wymondham, UK
| | - S Liu
- Department of Epidemiology and Medicine, Brown University, Providence, USA
| | - G Riccardi
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - S W Rizkalla
- Institute Cardiometabolism and Nutrition (ICAN), University Pierre et Marie Curie, Pitié Salpêtrière Hospital, Paris, France; National Institute of Health and Medical Research (INSERM), University Pierre et Marie Curie and Pitié Salpêtrière Hospital, Paris, France
| | - J L Sievenpiper
- Department of Nutritional Science, University of Toronto, Toronto, Canada
| | - A Trichopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
| | - T M S Wolever
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada; Department of Nutritional Science, University of Toronto, Toronto, Canada
| | | | - A Poli
- Nutrition Foundation of Italy, Milan, Italy
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Hong SN, Lee TY, Yun SC. The Risk of Colorectal Neoplasia in Patients with Gallbladder Diseases. J Korean Med Sci 2015; 30:1288-94. [PMID: 26339169 PMCID: PMC4553676 DOI: 10.3346/jkms.2015.30.9.1288] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 06/03/2015] [Indexed: 01/06/2023] Open
Abstract
Cholecystectomy is associated with an increased risk of colorectal cancer, but little is known about the relationship between gallbladder disease and colorectal adenoma. Gallbladder polyps and colorectal neoplasia (CRN) share several risk factors such as obesity, diabetes and metabolic syndrome, which might account for their association. In this study, we investigated whether asymptomatic patients with gallbladder disease are at increased risk of CRN and identified the factors to their association. The study population consisted of 4,626 consecutive, asymptomatic individuals drawn from a prospective health check-up cohort who underwent both ultrasonography and colonoscopy screening. The prevalence of CRNs in patients with gallbladder polyps or gallstones was significantly higher than that in the control group (32.1% vs. 26.8%; P = 0.032, 35.8% vs. 26.9%; P = 0.020). A multivariate regression analysis showed that gallbladder polyps were an independent risk factor for CRN [adjusted odds ratio (OR): 1.29; 95% confidence interval (CI); 1.03-1.62] whereas gallstones were not (adjusted OR: 1.14; 95% CI: 0.79-1.63). The adjusted OR for the risk of CRN was 1.12 for gallbladder polyps < 5 mm (95% CI, 0.85-1.46) and 1.79 for gallbladder polyps ≥ 5 mm (95% CI, 1.15-2.77). The prevalence of CRN increased with increasing polyp size (P trend = 0.022). Our results suggest that colorectal neoplasia is significantly related to gallbladder polyps, especially those ≥ 5 mm.
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Affiliation(s)
- Sung Noh Hong
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Yoon Lee
- Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Sung-Cheol Yun
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Abstract
Oral insulin able to induce an efficient antihyperglycemic effect either to replace or complement diabetes mellitus therapy is the major goal of health providers, governments and diabetic patients. Oral therapy is associated not only with the desire to exclude needles from the daily routine of diabetic patient but also with the physiological provision of insulin they would get. Despite numerous efforts over the past few decades to develop insulin delivery systems, there is still no commercially available oral insulin. The reasons why the formulations developed to administer insulin orally fail to reach clinical trials are critically discussed in this review. The principal features of nanoformulations used so far are also addressed as well as the undergoing clinical trials.
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Abstract
Excess body adiposity, commonly expressed as body mass index (BMI), is a risk factor for many common adult cancers. Over the past decade, epidemiological data have shown that adiposity-cancer risk associations are specific for gender, site, geographical population, histological subtype and molecular phenotype. The biological mechanisms underpinning these associations are incompletely understood but need to take account of the specificities observed in epidemiology to better inform future prevention strategies.
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Affiliation(s)
- Andrew G Renehan
- Institute of Cancer Sciences, Manchester Academic Health Science Centre, The Christie NHS Foundation Trust, University of Manchester, Wilmslow Road, Manchester M20 4BX, UK
| | - Marcel Zwahlen
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Finkenhubelweg 11, Bern CH-3012, Switzerland
| | - Matthias Egger
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Finkenhubelweg 11, Bern CH-3012, Switzerland
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Hsu PC, Lin WH, Kuo TH, Lee HM, Kuo C, Li CY. A Population-Based Cohort Study of All-Cause and Site-Specific Cancer Incidence Among Patients With Type 1 Diabetes Mellitus in Taiwan. J Epidemiol 2015. [PMID: 26212724 PMCID: PMC4549608 DOI: 10.2188/jea.je20140197] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The relationship between type 1 diabetes mellitus (T1DM) and cancer incidence remains unclear. We sought to assess the all-cause and site-specific cancer incidence in patients with T1DM. METHODS A retrospective cohort study design was employed, in which 14 619 patients with T1DM were retrieved from Taiwan's National Health Insurance medical claims between 2000 and 2007. The study subjects were followed to the end of 2008, and cancer incidence was assessed. We calculated age-, sex-, and calendar year-standardized incidence ratios (SIRs) of all-cause cancer incidence and site-specific neoplasm incidence, with reference to the general population. RESULTS Seven hundred and sixty patients were identified for all-cause cancer over 86,610 person-years, representing an incidence rate of 87.75 cases per 10,000 person-years. The incidence rate was higher in males than in female patients (109.86 vs 69.75 cases per 10,000 person-years). T1DM was associated with a significantly increased SIR of all-cause cancer (1.13; 95% confidence interval [CI], 1.05-1.22). The sex-specific SIR was significantly elevated in female patients (1.19; 95% CI, 1.07-1.33), but the SIR for male patients was insignificantly elevated (1.09; 95% CI, 0.99-1.20). Pancreatic cancer showed the greatest increase in SIR among both male and female patients with T1DM. Male patients experienced significantly increased SIRs for kidney, rectum, liver, and colon neoplasm, and significantly increased SIRs were noted for ovarian, bladder, and colon cancer in female patients. CONCLUSIONS T1DM was associated with a 13% increase in risk of all-cause cancer incidence. Patients with T1DM should be advised to undergo cancer screening for certain types of cancer.
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Affiliation(s)
- Pei-Chun Hsu
- Department and Graduate Institute of Public Health, College of Medicine, National Cheng Kung University
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Basyigit S, Ozkan S, Uzman M, Ertugrul DT, Kefeli A, Aktas B, Yeniova AO, Asilturk Z, Nazligul Y, Simsek H, Simsek G, Ayturk M, Yavuz B. Should screening for colorectal neoplasm be recommended in patients at high risk for coronary heart disease: a cross-sectional study. Medicine (Baltimore) 2015; 94:e793. [PMID: 25997050 PMCID: PMC4602862 DOI: 10.1097/md.0000000000000793] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 03/26/2015] [Accepted: 03/30/2015] [Indexed: 12/24/2022] Open
Abstract
Colorectal neoplasm (CRN) and coronary heart disease (CHD) share common risk factors. We aimed to assess the risk for CRN in patients who are at high risk for developing CHD determined by measurements, which are independent from the risk factors for CRN.This study was conducted on individuals who underwent total colonoscopic examination and were without history of CHD. Two-hundred thirty-five subjects (82 with CRN and 153 with normal colonoscopic findings) participated in the study. Colorectal carcinoma (CRC) was defined as the presence of adenocarcinoma. We measured carotid intima media thickness (CIMT), flow-mediated dilation (FMD), and calculated Framingham risk score (FRS) for all participants. An increased CIMT (≥1.0 mm), a decreased FMD (<10%), and a high FRS (>20%) were defined as high risks for developing CHD. The risk and the prevalence of CRN were analyzed in relation to the risk for developing CHD.The ratio of the patients with overall-CRN and CRC was significantly higher in individuals who are at high risk for developing CHD compared with individuals who are at low risk for developing CHD by each 3 risk estimation method (P < 0.05 for all). An increased CIMT, a decreased FMD, and a high FRS score were significantly associated with the high risk for the presence of CRC (odds ratio [OR]: 6.018, OR: 3.699, and OR: 4.120, respectively). An increased CIMT, a decreased FMD, and an intermediate FRS were significantly associated with the risk for the presence of overall-CRN (OR: 3.607, OR: 1.866 and OR: 2.889, respectively).The risk for CRN increases as the risk for developing CHD increases. It can be suggested that screening for CRN can be recommended for individuals who are at high risk for developing CHD.
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Affiliation(s)
- Sebahat Basyigit
- From the Department of Gastroenterology (SB, MU, BA, YN); Department of Cardiology (SO); Department of Endocrinology, Kecioren Research and Training Hospital, Ankara (DTE); Department of Gastroenterology, Siirt State Hospital, Siirt (AK); Department of Gastroenterology, Sinop State Hospital, Sinop (AOY); Department of Internal Medicine (ZA); Department of Pathology (HS, GS); and Kecioren Research and Training Hospital, Department of Gastroenterology, Ankara, 06380, Turkey (MA, BY)
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115
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Zhang X, Wu K, Giovannucci EL, Ma J, Colditz GA, Fuchs CS, Willett WC, Stampfer MJ, Nimptsch K, Ogino S, Wei EK. Early life body fatness and risk of colorectal cancer in u.s. Women and men-results from two large cohort studies. Cancer Epidemiol Biomarkers Prev 2015; 24:690-7. [PMID: 25777804 DOI: 10.1158/1055-9965.epi-14-0909-t] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 12/13/2014] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The association between body fatness before adulthood and later risk of colorectal cancer remains unclear. We hypothesized that, independent of adult body fatness, early life body fatness would be associated with a higher risk of developing colorectal cancer. METHODS We assessed body fatness during childhood and adolescence using a validated 9-level somatotype and inquired body weight in young adulthood in the Nurses' Health Study and Health Professionals Follow-up Study. We used the Cox proportional hazard regression modeling to estimate relative risks [RR, 95% confidence intervals (CI)] adjusting for adult body mass index (BMI) and other known colorectal cancer risk factors. RESULTS We identified 2,100 incident colorectal cancer cases (1,292 in women and 808 in men) during 22 years of follow-up. Among women, the RR (95% CI) for childhood body fatness of level 5 or higher versus level 1 was 1.28 (1.04-1.58; Ptrend = 0.08) and for adolescent body fatness, it was 1.27 (1.01-1.60; Ptrend = 0.23). The corresponding RRs for men were 1.04 (0.82-1.31; Ptrend = 0.48) and 0.98 (0.75-1.27; Ptrend = 0.20), respectively. Results were generally similar across anatomic subsites within the colorectum. In addition, the RRs comparing BMI categories ≥27.5 to <19 kg/m(2) were 1.44 (1.06-1.95, at age 18; Ptrend = 0.009) for women and 1.18 (0.84-1.65, at age 21; Ptrend = 0.57) for men. CONCLUSION Increased body fatness in early life, independent of adult obesity, might be a risk factor for colorectal cancer in women, but we observed a weaker association in men. IMPACT Our findings support the growing evidence that early life body fatness affects the risk of colorectal cancer many decades later.
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Affiliation(s)
- Xuehong Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
| | - Kana Wu
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts
| | - Edward L Giovannucci
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - Jing Ma
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Graham A Colditz
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Charles S Fuchs
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Walter C Willett
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - Meir J Stampfer
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | | | - Shuji Ogino
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts. Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts. Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Esther K Wei
- California Pacific Medical Center Research Institute, San Francisco, California
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116
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Tabung FK, Steck SE, Ma Y, Liese AD, Zhang J, Caan B, Hou L, Johnson KC, Mossavar-Rahmani Y, Shivappa N, Wactawski-Wende J, Ockene JK, Hebert JR. The association between dietary inflammatory index and risk of colorectal cancer among postmenopausal women: results from the Women's Health Initiative. Cancer Causes Control 2015; 26:399-408. [PMID: 25549833 PMCID: PMC4334706 DOI: 10.1007/s10552-014-0515-y] [Citation(s) in RCA: 150] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 12/18/2014] [Indexed: 01/08/2023]
Abstract
PURPOSE Inflammation is a process central to carcinogenesis and in particular to colorectal cancer (CRC). Previously, we developed a dietary inflammatory index (DII) from extensive literature review to assess the inflammatory potential of diet. In the current study, we utilized this novel index in the Women's Health Initiative to prospectively evaluate its association with risk of CRC in postmenopausal women. METHODS The DII was calculated from baseline food frequency questionnaires administered to 152,536 women aged 50-79 years without CRC at baseline between 1993 and 1998 and followed through 30 September 2010. Incident CRC cases were ascertained through a central physician adjudication process. Multiple covariate-adjusted Cox proportional hazards regression models were used to estimate hazard ratios (HR) and 95 % confidence intervals (95 % CI) for colorectal, colon (proximal/distal locations), and rectal cancer risk, by DII quintiles (Q). RESULTS During an average 11.3 years of follow-up, a total of 1,920 cases of CRC (1,559 colon and 361 rectal) were identified. Higher DII scores (representing a more pro-inflammatory diet) were associated with an increased incidence of CRC (HRQ5-Q1 1.22; 95 % CI 1.05, 1.43; p trend = 0.02) and colon cancer, specifically proximal colon cancer (HRQ5-Q1 1.35; 95 % CI 1.05, 1.67; p trend = 0.01) but not distal colon cancer (HRQ5-Q1 0.84; 95 % CI 0.61, 1.18; p trend = 0.63) or rectal cancer (HRQ5-Q1 1.20; 95 % CI 0.84, 1.72; p trend = 0.65). CONCLUSION Consumption of pro-inflammatory diets is associated with an increased risk of CRC, especially cancers located in the proximal colon. The absence of a significant association for distal colon cancer and rectal cancer may be due to the small number of incident cases for these sites. Interventions that may reduce the inflammatory potential of the diet are warranted to test our findings, thus providing more information for colon cancer prevention.
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Affiliation(s)
- Fred K. Tabung
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
| | - Susan E. Steck
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
- Center for Research in Nutrition and Health Disparities, University of South Carolina, Columbia, SC
| | - Yunsheng Ma
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA
| | - Angela D. Liese
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
- Center for Research in Nutrition and Health Disparities, University of South Carolina, Columbia, SC
| | - Jiajia Zhang
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
| | - Bette Caan
- Kaiser Permanente Division of Research, Oakland, CA
| | - Lifang Hou
- Department of Preventive Medicine and The Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Karen C. Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, University at Buffalo, The State University of New York, Buffalo, NY
| | - Judith K. Ockene
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA
| | - James R. Hebert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
- Center for Research in Nutrition and Health Disparities, University of South Carolina, Columbia, SC
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Abbruzzese C, Diodoro MG, Sperduti I, Mileo AM, Pattaro G, De Salvo L, Cosimelli M, Perrotti N, Paggi MG. Detection of phosphorylated insulin receptor in colorectal adenoma and adenocarcinoma: implications for prognosis and clinical outcome. J Cell Physiol 2015; 230:562-7. [PMID: 25102778 DOI: 10.1002/jcp.24733] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 07/28/2014] [Indexed: 02/06/2023]
Abstract
Colorectal carcinoma remains among the most frequent causes of cancer death. Besides the well-known genetic predisposition, a key role in colorectal adenoma and adenocarcinoma etio-pathogenesis, mainly in sporadic cases, is played by definite risk factors, such as obesity, type 2 diabetes, insulin resistance, hyper-insulinemia, and insulin therapy. These epidemiological data motivated us to determine, by means of immunohistochemistry, the amount of activated (phosphorylated) insulin receptor in archival samples from 22 colorectal adenoma and 117 adenocarcinoma patients, with the objective to estimate the role of this factor in colorectal epithelium transformation and cancer progression. Statistical analysis of the results clearly showed that positive staining for phosphorylated insulin receptor was significantly more frequent in adenomas than adenocarcinomas (P < 0.0001) and, within the adenocarcinoma cohort, it was more frequent in low-grade tumors (P = 0.005). In adenomas, staining was exclusively cytoplasmic, while in adenocarcinomas it was cytoplasmic and/or nuclear (P < 0.0001). Interestingly, disease-free survival in colorectal adenocarcinoma patients pointed out a significantly better prognosis for those bearing a positive staining for phosphorylated insulin receptor (P = 0.02). From these data, we can argue that activated insulin receptor plays a fundamental role at the early stages of tumorigenesis, where late stages could be characterized by a shift toward more active oncogenic drivers. Determining the amount of phosphorylated insulin receptor could thus represent a novel prognostic/predictive tool in colorectal adenocarcinoma patients.
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Affiliation(s)
- Claudia Abbruzzese
- Department of Experimental Oncology, Regina Elena National Cancer Institute, IRCCS, Rome, Italy
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118
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Sierpina V, Levine L, McKee J, Campbell C, Lian S, Frenkel M. Nutrition, Metabolism, and Integrative Approaches in Cancer Survivors. Semin Oncol Nurs 2015; 31:42-52. [DOI: 10.1016/j.soncn.2014.11.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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119
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Television watching and risk of colorectal adenoma. Br J Cancer 2015; 112:934-42. [PMID: 25590667 PMCID: PMC4453948 DOI: 10.1038/bjc.2014.655] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 11/10/2014] [Accepted: 12/04/2014] [Indexed: 01/05/2023] Open
Abstract
Background: Prolonged TV watching, a major sedentary behaviour, is associated with increased risk of obesity and diabetes and may involve in colorectal carcinogenesis. Methods: We conducted a cross-sectional analysis among 31 065 men with ⩾1 endoscopy in the Health Professionals Follow-up Study (1988–2008) to evaluate sitting while watching TV and its joint influence with leisure-time physical activity on risk of colorectal adenoma. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Results: Prolonged sitting while watching TV was significantly associated with increased risk of colorectal adenoma (n=4280), and adjusting for physical activity or a potential mediator body mass index did not change the estimates. The ORs (95% CIs) across categories of TV watching (0–6, 7–13, 14–20, and 21+ h per week) were 1.00 (referent), 1.09 (1.01–1.17), 1.16 (1.06–1.27), and 1.10 (0.97–1.25) (OR per 14-h per week increment=1.11; 95% CI: 1.04–1.18; Ptrend=0.001). Compared with the least sedentary (0–6 h per week of TV) and most physically active (highest quintile) men, the most sedentary (14+ h per week) and least active (lowest quintile) men had a significant increased risk of adenoma (OR=1.25; 95% CI: 1.05–1.49), particularly for high-risk adenoma. Conclusions: Prolonged TV viewing is associated with modest increased risk of colorectal adenoma independent of leisure-time physical activity and minimally mediated by obesity.
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120
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Hu XQ, Yuan P, Luan RS, Li XL, Liu WH, Feng F, Yan J, Yang YF. Calpain-10 SNP43 and SNP19 polymorphisms and colorectal cancer: a matched case-control study. Asian Pac J Cancer Prev 2015; 14:6673-80. [PMID: 24377587 DOI: 10.7314/apjcp.2013.14.11.6673] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Insulin resistance (IR) is an established risk factor for colorectal cancer (CRC). Given that CRC and IR physiologically overlap and the calpain-10 gene (CAPN10) is a candidate for IR, we explored the association between CAPN10 and CRC risk. METHODS Blood samples of 400 case-control pairs were genotyped, and the lifestyle and dietary habits of these pairs were recorded and collected. Unconditional logistic regression (LR) was used to assess the effects of CAPN10 SNP43 and SNP19, and environmental factors. Both generalized multifactor dimensionality reduction (GMDR) and the classification and regression tree (CART) were used to test gene-environment interactions for CRC risk. RESULTS The GA+AA genotype of SNP43 and the Del/Ins+Ins/Ins genotype of SNP19 were marginally related to CRC risk (GA+AA: OR = 1.35, 95% CI = 0.92-1.99; Del/Ins+Ins/ Ins: OR = 1.31, 95% CI = 0.84-2.04). Notably, a high-order interaction was consistently identified by GMDR and CART analyses. In GMDR, the four-factor interaction model of SNP43, SNP19, red meat consumption, and smoked meat consumption was the best model, with a maximum cross-validation consistency of 10/10 and testing balance accuracy of 0.61 (P < 0.01). In LR, subjects with high red and smoked meat consumption and two risk genotypes had a 6.17-fold CRC risk (95% CI = 2.44-15.6) relative to that of subjects with low red and smoked meat consumption and null risk genotypes. In CART, individuals with high smoked and red meat consumption, SNP19 Del/Ins+Ins/Ins, and SNP43 GA+AA had higher CRC risk (OR = 4.56, 95%CI = 1.94-10.75) than those with low smoked and red meat consumption. CONCLUSIONS Though the single loci of CAPN10 SNP43 and SNP19 are not enough to significantly increase the CRC susceptibility, the combination of SNP43, SNP19, red meat consumption, and smoked meat consumption is associated with elevated risk.
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Affiliation(s)
- Xiao-Qin Hu
- Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China E-mail :
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Mahmoudi T, Majidzadeh-A K, Karimi K, Karimi N, Farahani H, Dabiri R, Nobakht H, Dolatmoradi H, Arkani M, Zali MR. An exon variant in insulin receptor gene is associated with susceptibility to colorectal cancer in women. Tumour Biol 2015; 36:3709-15. [PMID: 25557790 DOI: 10.1007/s13277-014-3010-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Accepted: 12/23/2014] [Indexed: 12/13/2022] Open
Abstract
Given the role of insulin resistance in colorectal cancer (CRC), we explored whether genetic variants in insulin (INS), insulin receptor (INSR), insulin receptor substrate 1 (IRS1), insulin receptor substrate 2 (IRS2), insulin-like growth factor 1 (IGF1), and insulin-like growth factor binding protein 3 (IGFBP3) genes were associated with CRC risk. A total of 600 subjects, including 261 cases with CRC and 339 controls, were enrolled in this case-control study. Six polymorphisms in INS (rs689), INSR (rs1799817), IRS1 (rs1801278), IRS2 (rs1805097), IGF1 (rs5742612), and IGFBP3 (rs2854744) genes were genotyped using PCR-RFLP method. No significant difference was observed for INS, INSR, IRS1, IRS2, IGF1, and IGFBP3 genes between the cases and controls. However, the INSR rs1799817 "TT + CT" genotype and "CT" genotype compared with "CC" genotype occurred more frequently in the women with CRC than women controls (P = 0.007; OR = 1.93, 95 %CI = 1.20-3.11 and P = 0.002, OR = 2.15, 95 %CI = 1.31-3.53, respectively), and the difference remained significant after adjustment for confounding factors including age, BMI, smoking status, NSAID use, and family history of CRC (P = 0.018; OR = 1.86, 95 %CI = 1.11-3.10 and P = 0.004, OR = 2.18, 95 %CI = 1.28-3.71, respectively). In conclusion, to our knowledge, this study indicated for the first time that the INSR rs1799817 TT + CT genotype and CT genotype compared with the CC genotype had 1.86-fold and 2.18-fold increased risks for CRC among women, respectively. Furthermore, this finding is in line with previous studies which found significant associations between other variants of the INSR gene and CRC risk. Nevertheless, further studies are required to confirm our findings.
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Affiliation(s)
- Touraj Mahmoudi
- Department of Cancer, Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Sciences, Velenjak, Shahid Chamran Highway, Tehran, 1985711151, Iran,
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Tayyem RF, Shehadeh IN, Abumweis SS, Bawadi HA, Hammad SS, Bani-Hani KE, Al-Jaberi TM, Alnusair MM. Physical inactivity, water intake and constipation as risk factors for colorectal cancer among adults in Jordan. Asian Pac J Cancer Prev 2014; 14:5207-12. [PMID: 24175802 DOI: 10.7314/apjcp.2013.14.9.5207] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical activity has been found to play a role in cancer prevention. The purpose of this matched case-control study was to investigate the association between physical activity levels, water intake, constipation and colorectal cancer (CRC). MATERIALS AND METHODS Two hundred and thirty-two patients diagnosed with CRC (125 male, 107 female) were enrolled in this case-control study. Cases were matched to 271 population controls (137 male, 134 female). RESULTS Drinking more than 4 cups of water daily decreased the risk of CRC by 33-42%; however, this effect was non-significant. Having constipation was found to be a significant risk factor for developing CRC with an OR=6.284 (95%CI=2.741-14.40). With reference to sedentary behavior, minimum activity (600-3000 Metabolic Equivalents Task (MET)) had 43% protection against CRC and the level of Health Enhancing Physical Activity OR was 0.58 (at 95%CI; 0.37-0.92). A significant negative association was found between CRC and physical activity levels expressed as both METs and MET-hours/week (p for trend=0.017 and 0.03, respectively). Among females, a significant trend of reduction in CRC by 62% was observed with increasing the level of physical activity expressed in MET (p for trend=0.04). CONCLUSIONS The risk of CRC may be reduced by adopting a healthy lifestyle and practicing physically activity regularly, especially among females. Consuming adequate amounts of water and healthy bowel motility could also reduce the risk of CRC.
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Affiliation(s)
- Reema Fayez Tayyem
- Department of Clinical Nutrition and Dietetic, The Hashemite University, Zarqa, Jordan E-mail :
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Karimi K, Mahmoudi T, Karimi N, Dolatmoradi H, Arkani M, Farahani H, Vahedi M, Parsimehr E, Dabiri R, Nobakht H, Asadi A, Zali MR. Is there an association between variants in candidate insulin pathway genes IGF-I, IGFBP-3, INSR, and IRS2 and risk of colorectal cancer in the Iranian population? Asian Pac J Cancer Prev 2014; 14:5011-6. [PMID: 24175768 DOI: 10.7314/apjcp.2013.14.9.5011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Several epidemiological studies have shown associations between colorectal cancer (CRC) risk and type 2 diabetes and obesity. Any effects would be expected to be mediated through the insulin pathway. Therefore it is possible that variants of genes encoding components of the insulin pathway play roles in CRC susceptibility. In this study, we hypothesized that polymorphisms in the genes involving the insulin pathway are associated with risk of CRC. MATERIALS AND METHODS The associations of four single nucleotide polymorphisms (SNPs) in IGF-I (rs6214), IGFBP-3 (rs3110697), INSR (rs1052371), and IRS2 (rs2289046) genes with the risk of CRC were evaluated using a case-control design with 167 CRC cases and 277 controls by the PCR-RFLP method. RESULTS Overall, we observed no significant difference in genotype and allele frequencies between the cases and controls for the IGF-I, IGFBP-3, INSR, IRS2 gene variants and CRC before or after adjusting for confounders (age, BMI, sex, and smoking status). However, we observed that the IRS2 (rs2289046) GG genotype compared with AA+AG genotypes has a protective effect for CRC in normal weight subjects (p=0.035, OR=0.259, 95%CI= 0.074-0.907). CONCLUSIONS These findings do not support plausible associations between polymorphic variations in IGF-I, IGFBP-3, INSR, IRS2 genes and risk of CRC. However, the evidence for a link between the IRS2 (rs2289046) variant and risk of CRC dependent on the BMI of the subjects, requires confirmation in subsequent studies with greater sample size.
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Affiliation(s)
- Khatoon Karimi
- Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran E-mail :
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de Queiroz EAIF, Akamine EH, de Carvalho MHC, Sampaio SC, Fortes ZB. Metformin reduces the Walker-256 tumor development in obese-MSG rats via AMPK and FOXO3a. Life Sci 2014; 121:78-87. [PMID: 25497710 DOI: 10.1016/j.lfs.2014.11.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 11/11/2014] [Accepted: 11/24/2014] [Indexed: 11/24/2022]
Abstract
AIMS Studies have associated obesity with a wide variety of cancers. Metformin, an anti-diabetic drug, has recently received attention as a potentially useful therapeutic agent for treating cancer. Therefore, the objective of this study was to analyze the mechanisms involved in the increase in tumor development and the reduction of it by metformin in obesity using an experimental breast tumor model. MATERIAL AND METHODS Newborn male Wistar rats were subcutaneously injected with 400mg/kg monosodium glutamate (MSG) (obese) or saline (control) at 2, 3, 4, 5 and 6 days of age. After 16 weeks, 1 × 10(7) Walker-256 tumor cells were subcutaneously injected in the right flank of the rats and concomitantly the treatment with metformin 300 mg/kg/15 days, via gavage, started. The rats were divided into 4 groups: control tumor (CT), control tumor metformin (CTM), obese-MSG tumor (OT) and obese-MSG tumor metformin (OTM). On the 18th week the tumor development and metformin effect were analyzed. KEY FINDINGS Tumor development was higher in OT rats compared with CT rats. Activation of insulin-IR-ERK1/2 pathway and an anti-apoptotic effect might be the mechanisms involved in the higher development of tumor in obesity. The effect of metformin reducing the tumor development in obese rats might involve increased mRNA expression of pRb and p27, increased activity of AMPK and FOXO3a and decreased expression of p-ERK1/2 (Thr202/Tyr204) in Walker-256 tumor. SIGNIFICANCE Our data allow us to suggest that metformin, reducing the stimulatory effect of obesity on tumor development, has a potential role in the management of cancers.
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Affiliation(s)
- Eveline A I F de Queiroz
- Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil; Department of Physiological Sciences, State University of Londrina, Londrina, Brazil.
| | - Eliana H Akamine
- Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Maria Helena C de Carvalho
- Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Sandra C Sampaio
- Laboratory of Pathophysiology, Butantan Institute, São Paulo, Brazil
| | - Zuleica B Fortes
- Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
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Kasdagly M, Radhakrishnan S, Reddivari L, Veeramachaneni DR, Vanamala J. Colon carcinogenesis: Influence of Western diet-induced obesity and targeting stem cells using dietary bioactive compounds. Nutrition 2014; 30:1242-56. [DOI: 10.1016/j.nut.2014.02.016] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 02/07/2014] [Accepted: 02/12/2014] [Indexed: 02/07/2023]
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Schmit SL, Gollub J, Shapero MH, Huang SC, Rennert HS, Finn A, Rennert G, Gruber SB. MicroRNA polymorphisms and risk of colorectal cancer. Cancer Epidemiol Biomarkers Prev 2014; 24:65-72. [PMID: 25342389 DOI: 10.1158/1055-9965.epi-14-0219] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND miRNAs act as post-transcriptional regulators of gene expression. Genetic variation in miRNA-encoding sequences or their corresponding binding sites may affect the fidelity of the miRNA-mRNA interaction and subsequently alter the risk of cancer development. METHODS This study expanded the search for miRNA-related polymorphisms contributing to the etiology of colorectal cancer across the genome using a novel platform, the Axiom miRNA Target Site Genotyping Array (237,858 markers). After quality control, the study included 596 cases and 429 controls from the Molecular Epidemiology of Colorectal Cancer study, a population-based case-control study of colorectal cancer in northern Israel. The association between each marker and colorectal cancer status was examined assuming a log-additive genetic model using logistic regression adjusted for sex, age, and two principal components. RESULTS Twenty-three markers had P values less than 5.0E-04, and the most statistically significant association involved rs2985 (chr6:34845648; intronic of UHRF1BP1; OR = 0.66; P = 3.7E-05). Furthermore, this study replicated a previously published risk locus, rs1051690, in the 3'-untranslated region of the insulin receptor gene INSR (OR = 1.38; P = 0.03), with strong evidence of differences in INSR gene expression by genotype. CONCLUSIONS This study is the first to examine associations between genetic variation in miRNA target sites and colorectal cancer using a genome-wide approach. Functional studies to identify allele-specific effects on miRNA binding are needed to confirm the regulatory capacity of genetic variation to influence risk of colorectal cancer. IMPACT This study demonstrates the potential for an miRNA-targeted genome-wide association study to identify candidate susceptibility loci and prioritize them for functional characterization.
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Affiliation(s)
- Stephanie L Schmit
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California. USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California
| | | | | | - Shu-Chen Huang
- USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Hedy S Rennert
- Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa, Israel
| | - Andrea Finn
- Affymetrix, Incorporated, Santa Clara, California
| | - Gad Rennert
- Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa, Israel. Clalit Health Services National Cancer Control Center, Haifa, Israel. Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Stephen B Gruber
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California. USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California.
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Jia Y, Xu G, Zhou W, Wang Z, Meng L, Zhou S, Xu X, Yuan H, Tian K. Diabetes promotes DMH-induced colorectal cancer by increasing the activity of glycolytic enzymes in rats. PLoS One 2014; 9:e110455. [PMID: 25329503 PMCID: PMC4201553 DOI: 10.1371/journal.pone.0110455] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 09/12/2014] [Indexed: 01/05/2023] Open
Abstract
The objective of the present study was to investigate the association between diabetes mellitus and colorectal carcinogenesis as well as the possible mechanism involved in this interaction. Diabetes rat models were induced with a low dose of STZ followed by a low dose of DMH to induce colorectal cancer. The formation of ACF in the colon and the incidence, number and size of tumors were measured. The activity of glycolytic enzymes in colonic tissues was also measured. The results demonstrated that both the total number of ACF and the number of foci that contain a different number of crypts were increased in diabetic rats. At the end of the experimental treatment, the incidence, number and size of tumors were also increased in diabetic rats. Overall, these data indicated that diabetes increased the risk of colorectal cancer. The activity of HK and PK in colonic tissues was increased in diabetic rats, whereas the activity of PDH was decreased. In addition, the activities of these enzymes in intratumor were higher than that of in peritumor. These data indicated that the high rate of glycolysis may play a role in colorectal carcinogenesis in diabetic rats.
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Affiliation(s)
- Yanglei Jia
- Department of Biochemistry and Molecular Biology, Shandong University School of Medicine, Jinan, Shandong, China
| | - Gang Xu
- Department of Gastroenterology, 456 Hospital of PLA, Jinan, Shandong, China
| | - Wenjing Zhou
- Department of Biochemistry and Molecular Biology, Shandong University School of Medicine, Jinan, Shandong, China
| | - Zhenzheng Wang
- Department of Pathology, 456 Hospital of PLA, Jinan, Shandong, China
| | - Linlin Meng
- Department of Biochemistry and Molecular Biology, Shandong University School of Medicine, Jinan, Shandong, China
| | - Songnan Zhou
- Department of Biochemistry and Molecular Biology, Shandong University School of Medicine, Jinan, Shandong, China
| | - Xia Xu
- Department of Biochemistry and Molecular Biology, Shandong University School of Medicine, Jinan, Shandong, China
| | - Huiqing Yuan
- Department of Biochemistry and Molecular Biology, Shandong University School of Medicine, Jinan, Shandong, China
| | - Keli Tian
- Department of Biochemistry and Molecular Biology, Shandong University School of Medicine, Jinan, Shandong, China
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Chen Y, Xu R. Mining cancer-specific disease comorbidities from a large observational health database. Cancer Inform 2014; 13:37-44. [PMID: 25392682 PMCID: PMC4216041 DOI: 10.4137/cin.s13893] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 04/29/2014] [Accepted: 04/30/2014] [Indexed: 12/28/2022] Open
Abstract
Cancer comorbidities often reflect the complex pathogenesis of cancers and provide valuable clues to discover the underlying genetic mechanisms of cancers. In this study, we systematically mine and analyze cancer-specific comorbidity from the FDA Adverse Event Reporting System. We stratified 3,354,043 patients based on age and gender, and developed a network-based approach to extract comorbidity patterns from each patient group. We compared the comorbidity patterns among different patient groups and investigated the effect of age and gender on cancer comorbidity patterns. The results demonstrated that the comorbidity relationships between cancers and non-cancer diseases largely depend on age and gender. A few exceptions are depression, anxiety, and metabolic syndrome, whose comorbidity relationships with cancers are relatively stable among all patients. Literature evidences demonstrate that these stable cancer comorbidities reflect the pathogenesis of cancers. We applied our comorbidity mining approach on colorectal cancer and detected its comorbid associations with metabolic syndrome components, diabetes, and osteoporosis. Our results not only confirmed known cancer comorbidities but also generated novel hypotheses, which can illuminate the common pathophysiology between cancers and their co-occurring diseases.
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Affiliation(s)
- Yang Chen
- Division of Medical Informatics, Case Western Reserve University, Cleveland, OH, USA
| | - Rong Xu
- Division of Medical Informatics, Case Western Reserve University, Cleveland, OH, USA
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Yang L, Allred CD, Awika JM. Emerging Evidence on the Role of Estrogenic Sorghum Flavonoids in Colon Cancer Prevention. CEREAL FOOD WORLD 2014. [DOI: 10.1094/cfw-59-5-0244] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- L. Yang
- Corresponding author. Department of Soil & Crop Sciences, 2474 TAMU, Texas A&M University, College Station, TX 77843-2474, USA. Current affiliation: Kellogg Company, Global Breakfast R&D.Tel: +1.269.961.6149; Fax: +1.269.961.9107
| | - C. D. Allred
- Texas A&M University, College Station, TX, U.S.A
| | - J. M. Awika
- Texas A&M University, College Station, TX, U.S.A
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Lopes MA, Abrahim BA, Cabral LM, Rodrigues CR, Seiça RMF, de Baptista Veiga FJ, Ribeiro AJ. Intestinal absorption of insulin nanoparticles: Contribution of M cells. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2014; 10:1139-51. [DOI: 10.1016/j.nano.2014.02.014] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2013] [Revised: 01/19/2014] [Accepted: 02/28/2014] [Indexed: 01/28/2023]
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Chen KH, Shao YY, Lin ZZ, Yeh YC, Shau WY, Kuo RN, Chen HM, Lai CL, Yeh KH, Cheng AL, Lai MS. Type 2 diabetes mellitus is associated with increased mortality in Chinese patients receiving curative surgery for colon cancer. Oncologist 2014; 19:951-8. [PMID: 25061090 DOI: 10.1634/theoncologist.2013-0423] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND We investigated the association between diabetes mellitus (DM) and the prognosis of patients with early colon cancer who had undergone curative surgery. METHODS From three national databases of patients in Taiwan, we selected a cohort of colon cancer patients who had been newly diagnosed with stage I or stage II colon cancer between January 1, 2004 and December 31, 2008 and had undergone curative surgery. We collected information regarding DM (type 2 DM only), the use of antidiabetic medications, other comorbidities, and survival outcomes. The colon cancer-specific survival (CSS) and the overall survival (OS) were compared between patients with and without DM. RESULTS We selected 6,937 colon cancer patients, among whom 1,371 (19.8%) had DM. The colon cancer patients with DM were older and less likely to receive adjuvant chemotherapy but had a similar tumor stage and grade, compared with colon cancer patients without DM. Compared with colon cancer patients without DM, patients with DM had significantly shorter OS (5-year OS: 71.0% vs. 81.7%) and CSS (5-year CSS: 86.7% vs. 89.2%). After adjusting for age, sex, stage, adjuvant chemotherapy, and comorbidities in our multivariate analysis, DM remained an independent prognostic factor for overall mortality (adjusted hazards ratio: 1.32, 95% confidence interval: 1.18-1.49), but not for cancer-specific mortality. Among the colon cancer patients who had received antidiabetic drug therapy, patients who had used insulin had significantly shorter CSS and OS than patients who had not. CONCLUSION Among patients who receive curative surgery for early colon cancer, DM is a predictor of increased overall mortality.
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Affiliation(s)
- Kuo-Hsing Chen
- Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan, Republic of China; Department of Oncology and Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Graduate Institutes of Oncology and Clinical Medicine and Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China; Institutes of Health Policy and Management and Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Yu-Yun Shao
- Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan, Republic of China; Department of Oncology and Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Graduate Institutes of Oncology and Clinical Medicine and Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China; Institutes of Health Policy and Management and Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Zhong-Zhe Lin
- Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan, Republic of China; Department of Oncology and Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Graduate Institutes of Oncology and Clinical Medicine and Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China; Institutes of Health Policy and Management and Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Yi-Chun Yeh
- Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan, Republic of China; Department of Oncology and Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Graduate Institutes of Oncology and Clinical Medicine and Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China; Institutes of Health Policy and Management and Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Wen-Yi Shau
- Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan, Republic of China; Department of Oncology and Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Graduate Institutes of Oncology and Clinical Medicine and Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China; Institutes of Health Policy and Management and Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Raymond Nienchen Kuo
- Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan, Republic of China; Department of Oncology and Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Graduate Institutes of Oncology and Clinical Medicine and Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China; Institutes of Health Policy and Management and Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Ho-Min Chen
- Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan, Republic of China; Department of Oncology and Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Graduate Institutes of Oncology and Clinical Medicine and Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China; Institutes of Health Policy and Management and Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Chiu-Ling Lai
- Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan, Republic of China; Department of Oncology and Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Graduate Institutes of Oncology and Clinical Medicine and Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China; Institutes of Health Policy and Management and Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Kun-Huei Yeh
- Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan, Republic of China; Department of Oncology and Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Graduate Institutes of Oncology and Clinical Medicine and Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China; Institutes of Health Policy and Management and Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Ann-Lii Cheng
- Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan, Republic of China; Department of Oncology and Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Graduate Institutes of Oncology and Clinical Medicine and Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China; Institutes of Health Policy and Management and Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Mei-Shu Lai
- Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan, Republic of China; Department of Oncology and Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Graduate Institutes of Oncology and Clinical Medicine and Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China; Institutes of Health Policy and Management and Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China
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Hayat I, Ahmad A, Masud T, Ahmed A, Bashir S. Nutritional and health perspectives of beans (Phaseolus vulgaris L.): an overview. Crit Rev Food Sci Nutr 2014; 54:580-92. [PMID: 24261533 DOI: 10.1080/10408398.2011.596639] [Citation(s) in RCA: 162] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Beans, the variants of Phaseolus vulagris, are nutritionally and economically important food crop in each part of the world. Besides providing nutrients such as multifaceted carbohydrates, elevated proteins, dietary fiber, minerals, and vitamins, these also contain rich variety of polyphenolic compounds with prospective health benefits. This review mainly focuses the important nutritional aspects of beans as well as their contribution in decreasing the risks of chronically degenerative diseases.
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Affiliation(s)
- Imran Hayat
- a Department of Food Technology , University of Poonch Rawalakot 12350 , Azad Kashmir , Pakistan
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133
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Noto H, Tsujimoto T, Noda M. Significantly increased risk of cancer in diabetes mellitus patients: A meta-analysis of epidemiological evidence in Asians and non-Asians. J Diabetes Investig 2014; 3:24-33. [PMID: 24843541 PMCID: PMC4014928 DOI: 10.1111/j.2040-1124.2011.00183.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Aims/Introduction: Emerging evidence from observational studies suggests that diabetes mellitus affects the cancer risk. However, whether there are differences in the magnitude of the influence of diabetes among ethnic groups is unknown. Materials and Methods: We searched MEDLINE and the Cochrane Library for pertinent articles that had been published as of 4 April 2011, and included them in a meta‐analysis of the risk of all‐cancer mortality and incidence in diabetic subjects. Results: A total of 33 studies were included in the meta‐analysis, and they provided 156,132 diabetic subjects for the mortality analysis and 993,884 for the incidence analysis. Cancer mortality was approximately 3%, and cancer incidence was approximately 8%. The pooled adjusted risk ratio (RR) of all‐cancer mortality was significantly higher than for non‐diabetic people (RR 1.32 [CI 1.20–1.45] for Asians; RR 1.16 [CI 1.01–1.34] for non‐Asians). Diabetes was also associated with an increased RR of incidence across all cancer types (RR 1.23 [CI 1.09–1.39] for Asians; RR 1.15 [CI 0.94–1.43] for non‐Asians). The RR of incident cancer for Asian men was significantly higher than for non‐Asian men (P = 0.021). Conclusions: Diabetes is associated with a higher risk for incident cancer in Asian men than in non‐Asian men. In light of the exploding global epidemic of diabetes, particularly in Asia, a modest increase in the cancer risk will translate into a substantial socioeconomic burden. Our current findings underscore the need for clinical attention and better‐designed studies of the complex interactions between diabetes and cancer. (J Diabetes Invest, doi: 10.1111/j.2040‐1124.2011.00183.x, 2012)
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Affiliation(s)
- Hiroshi Noto
- Department of Diabetes and Metabolic Medicine, Center Hospital ; Department of Diabetes Research, Diabetes Research Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tetsuro Tsujimoto
- Department of Diabetes and Metabolic Medicine, Center Hospital ; Department of Diabetes Research, Diabetes Research Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mitsuhiko Noda
- Department of Diabetes and Metabolic Medicine, Center Hospital ; Department of Diabetes Research, Diabetes Research Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
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Kim EH, Kim H, Bae SJ, Chang H, Park HW, Do MY, Kim K, Jung CH, Lee WJ, Park J, Choe J. Fasting serum insulin levels and insulin resistance are associated with colorectal adenoma in Koreans. J Diabetes Investig 2014; 5:297-304. [PMID: 24843778 PMCID: PMC4020334 DOI: 10.1111/jdi.12178] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 06/24/2013] [Accepted: 08/22/2013] [Indexed: 12/13/2022] Open
Abstract
AIMS/INTRODUCTION Insulin has been associated with the risk of colorectal cancer (CRC). However, few studies have evaluated the association between insulin and colorectal adenoma. We investigated the relationship between fasting serum insulin levels or homeostasis model assessment of insulin resistance (HOMA-IR) and colorectal adenoma. MATERIALS AND METHODS We retrospectively enrolled 15,427 participants who underwent both fasting serum insulin measurement and colonoscopy for a routine health examination at Asan Medical Center from January 2007 to December 2008. Participants with a history of any cancer, previous colectomy or polypectomy, those taking antidiabetic medications, and inflammatory bowel disease, non-specific colitis, non-adenomatous polyps only or CRC on colonoscopic findings were excluded. Finally, 3,606 participants with histologically confirmed colorectal adenoma and 6,019 controls with no abnormal findings on colonoscopy were included. Participants were categorized into quartiles (Q) based on fasting serum insulin levels and HOMA-IR. RESULTS Fasting serum insulin and HOMA-IR were significantly higher in participants with colorectal adenomas compared with controls. Multivariate regression analysis adjusting for age, sex, smoking habits, drinking habits and family history of CRC showed that participants with higher quartiles of fasting serum insulin levels (odd ratio [OR] 1.17 for 2nd Q, 1.19 for 3rd Q, and 1.42 for 4th Q, P < 0.05) or HOMA-IR (OR 1.18 for 2nd Q and 1.45 for 4th Q, P < 0.05) showed significantly increased ORs of colorectal adenoma compared with the lowest quartiles. CONCLUSIONS These findings showed that increased serum insulin levels and insulin resistance were significantly associated with the presence of colorectal adenoma.
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Affiliation(s)
- Eun Hee Kim
- Health Screening and Promotion CenterAsan Medical CenterSeoulKorea
| | - Hong‐Kyu Kim
- Health Screening and Promotion CenterAsan Medical CenterSeoulKorea
| | - Sung Jin Bae
- Health Screening and Promotion CenterAsan Medical CenterSeoulKorea
| | - Hye‐Sook Chang
- Health Screening and Promotion CenterAsan Medical CenterSeoulKorea
| | - Hye Won Park
- Health Screening and Promotion CenterAsan Medical CenterSeoulKorea
| | - Mi Young Do
- Health Screening and Promotion CenterAsan Medical CenterSeoulKorea
| | - Kyung‐Jo Kim
- Division of GastroenterologyDepartment of Internal MedicineUniversity of Ulsan College of MedicineSeoulKorea
| | - Chang Hee Jung
- Division of Endocrinology & MetabolismDepartment of Internal MedicineUniversity of Ulsan College of MedicineSeoulKorea
| | - Woo Je Lee
- Division of Endocrinology & MetabolismDepartment of Internal MedicineUniversity of Ulsan College of MedicineSeoulKorea
| | - Joong‐Yeol Park
- Division of Endocrinology & MetabolismDepartment of Internal MedicineUniversity of Ulsan College of MedicineSeoulKorea
| | - Jaewon Choe
- Health Screening and Promotion CenterAsan Medical CenterSeoulKorea
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Zelenskiy S, Thompson CL, Tucker TC, Li L. High dietary glycemic load is associated with increased risk of colon cancer. Nutr Cancer 2014; 66:362-8. [PMID: 24611536 DOI: 10.1080/01635581.2014.884231] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
High dietary glycemic load (GL) has been inconsistently associated with risk of colon cancer. We analyzed data for 1093 incident cases and 1589 controls in a population-based case-control study of colon cancer to further clarify the GL-colon cancer relationship. GL was assessed using a self-administered food frequency questionnaire. Cases had a significantly higher GL intake (mean = 136.4, SD = 24.5) than controls (mean = 132.8, SD = 25.2) (P = 0.0003). In a multivariate unconditional logistic regression model, the odds ratios (ORs) for colon cancer increased significantly with increasing GL: compared to the bottom quartile of GL, the ORs (95% CI) for the 2nd through the upper quartiles were 1.38 (1.06, 1.80), 1.67 (1.30, 2.13), and 1.61 (1.25, 2.07), respectively (P trend < 0.0001). Stratified analyses showed that the association was more pronounced among older participants [ORs (95% CI) for the 2nd through the upper quartiles were 1.35 (0.91, 2.00), 1.87 (1.29, 2.71), 2.02 (1.39, 2.95), respectively] than among younger participants [ORs were 1.46 (1.02, 2.10), 1.53 (1.09, 2.15), and 1.35 (0.96, 1.91), respectively] (P int = 0.02). Our results provide support for the hypothesis that a diet with high GL increases the risk of colon cancer.
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Affiliation(s)
- Svetlana Zelenskiy
- a Department of Family Medicine and Community Health and Department of Epidemiology and Biostatistics , Case Western Reserve University , Cleveland , Ohio , USA
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Sun A, Liu R, Sun G. Insulin therapy and risk of colorectal cancer: an updated meta-analysis of epidemiological studies. Curr Med Res Opin 2014; 30:423-30. [PMID: 24156655 DOI: 10.1185/03007995.2013.858622] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE An increasing number of studies show that exogenous insulin therapy may promote colorectal carcinogenesis. However, the results of the association between insulin therapy and risk of colorectal cancer (CRC) among type 2 diabetes patients are inconsistent. The purpose of our study is to examine the effect of insulin therapy on CRC risk among patients with type 2 diabetes in an updated meta-analysis. RESEARCH DESIGN AND METHODS Medline and Embase were searched for the reference lists of pertinent articles published from January 1970 to April 2013. Two investigators independently extracted the data and reached consensus on the inclusion and exclusion criteria. Pooled relative risks and 95% confidence intervals were calculated with a random-effects model. RESULTS Analysis of six studies, including 374,950 participants, showed that compared with non-insulin or metformin treatment, insulin treatment was associated with an increase of 37% in the risk of colorectal neoplasm among patients with type 2 diabetes, with moderate heterogeneity (I2=40%). The sensitivity analysis showed that exclusion of one small case-control study had no appreciable changes on the pooled results. Subgroup analyses suggested that there were significant positive associations between insulin therapy and risk of CRC in some subgroups, rather than all subgroups. CONCLUSIONS Our meta-analysis supports a relationship between insulin therapy and increased risk of CRC in patients with type 2 diabetes. Because of bias and confounding of included studies, caution is needed when interpreting our results. Further investigations are needed.
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Affiliation(s)
- Ao Sun
- Tianjin Medical University , Tianjin , China
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138
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Preuss HG, Echard B, Bagchi D, Perricone NV. Comparing effects of carbohydrate (CHO) blockers and trivalent chromium on CHO-induced insulin resistance and elevated blood pressure in rats. J Am Coll Nutr 2014; 32:58-65. [PMID: 24015700 DOI: 10.1080/07315724.2013.770335] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE In Sprague-Dawley rats (SD), we compared two categories of natural dietary supplements that influence carbohydrate (CHO) metabolism via different basic mechanisms to ameliorate insulin resistance (IR) and elevated blood pressure (BP) associated with heavy sugar/starch consumption. Two dietary supplements (bean extract and l-arabinose) are often referred to as carb blockers (CBs), because they slow the gastrointestinal absorption of CHO. Trivalent chromium (CR) falls into a group of so-called insulin sensitizers, because its major effect is to enhance peripheral insulin sensitivity. METHOD We divided 48 mature male SD into 4 groups of 12. The first group received powdered baseline diet alone (Con). The remaining 3 SD groups (groups 2-4) ingested regular rat chow containing 20% w/w sucrose and 20% w/w rice starch. The second group received only this CHO-enriched chow. To the high-CHO diets of the remaining two groups, either CB to slow CHO absorption (CHO + CB) (group 3) or an insulin sensitizer, trivalent CR (CHO + CR; group 4), was added. RESULTS Compared to Con group 1, adding high CHO content to the diet of group 2 significantly increased circulating glucose levels and systolic BP (SBP). Addition of CB or CR to the feed of groups 3 and 4 overcame the perturbations that occurred with high CHO challenge in group 2; that is, they lowered circulating glucose concentrations to Con levels, enhanced response to exogenous insulin, and overcame the gradual elevation of SBP. Compared to group 2, the two treatment groups (3 and 4) also showed decreased renin-angiotensin system activity, decreased serum angiotensin-converting enzyme activity, and enhanced nitric oxide activity. CONCLUSIONS Our data indicate that high doses of CB and CR, despite their different mechanisms of action, can completely overcome CHO-induced IR and BP elevations. The data further suggest that CB and CR affect only the changes brought on by heavy CHO ingestion, because IR and SBP in groups 3 and 4 mirrored Con values (group 1), never producing values lower than baseline. Earlier use of CB and CR in the life cycle appears more effective in overcoming CHO-induced perturbations than later use.
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Affiliation(s)
- Harry G Preuss
- Georgetown University Medical Center, Department of Biochemistry, Washington, DC 20057, USA.
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139
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IGF-I levels and visceral fat accumulation in colonic neoplasia. Clin Res Hepatol Gastroenterol 2014; 38:99-105. [PMID: 23954111 DOI: 10.1016/j.clinre.2013.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2013] [Revised: 06/13/2013] [Accepted: 06/19/2013] [Indexed: 02/04/2023]
Abstract
BACKGROUND IGF-I, visceral obesity, IGF binding protein-3 and insulin are reported to be potential risk factors for colorectal carcinogenesis. Many studies report a relation between obesity, insulin resistance and the risk of colon cancer. This study investigates the association between IGF-I levels, insulin resistance and visceral fat accumulation in patients with colon cancer and adenoma. METHODS In this cross sectional study, 48 sequential patients were diagnosed with either colorectal adenoma or carcinoma were enrolled. The control subjects were 30 sequential subjects. Serum IGF-I, HOMA insulin resistance index and visceral fat were measured in patients with colorectal adenoma and carcinoma. RESULTS Serum IGF-I levels were significantly higher in patients with colorectal adenoma and carcinoma compared with controls. Visceral fat accumulation was lower in colorectal carcinoma group compared with colorectal adenoma group, but no statistically significant difference was observed among them and controls. No statistically significant difference was observed in HOMA insulin resistance index, fasting insulin and fasting glucose concentrations among the three groups. No correlation was found between insulin resistance and serum IGF-I levels and visceral fat accumulation. Logistic regression analysis showed that plasma IGF-I concentration was significantly associated with colorectal adenoma and carcinoma. Body mass index and waist circumference were associated with colorectal, carcinoma but were not associated with adenoma. CONCLUSION In our study we found that, IGF-I levels are associated with colorectal adenomas and carcinomas, independent of insulin resistance and visceral fat accumulation; supporting the hypothesis that an increase in IGF-I levels may be a factor involved in the development of colon cancer.
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140
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Oxidative Stress and DNA Damage in Obesity-Related Tumorigenesis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2014; 824:5-17. [DOI: 10.1007/978-3-319-07320-0_2] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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141
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Dash C, Palmer JR, Boggs DA, Rosenberg L, Adams-Campbell LL. Type 2 diabetes and the risk of colorectal adenomas: Black Women's Health Study. Am J Epidemiol 2014; 179:112-9. [PMID: 24091887 DOI: 10.1093/aje/kwt227] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Evidence for the association of type 2 diabetes mellitus (DM) with colorectal neoplasms is contradictory, and African Americans have been underrepresented in the studies published to date. In a nested case-control study (1995-2009), we examined DM and insulin therapy as risk factors for colorectal adenomas in African American women enrolled in the ongoing Black Women's Health Study. From women reporting ever having undergone a gastrointestinal endoscopy, 917 cases of colorectal adenoma were compared with 2,751 controls without a colorectal polyp, matched on age and follow-up time. Cases were verified by medical record review. We used multivariable logistic regression analyses that included DM exposures and selected confounders. There were no overall associations between DM and adenoma risk or between insulin use and adenoma risk. However, DM without insulin use was inversely associated with risk of colon adenomas (odds ratio (OR) = 0.71, 95% confidence interval (CI): 0.52, 0.97) but not rectal adenomas. DM was inversely associated with adenoma risk in women older than 55 years (OR = 0.64, 95% CI: 0.44, 0.91) but not in women 55 years or younger (OR = 1.24, 95% CI: 0.81, 1.89). Future research should attempt to replicate the unexpected inverse association of DM with colon adenoma risk among older African American women.
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142
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Pericleous M, Mandair D, Caplin ME. Diet and supplements and their impact on colorectal cancer. J Gastrointest Oncol 2013; 4:409-23. [PMID: 24294513 DOI: 10.3978/j.issn.2078-6891.2013.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Accepted: 01/17/2013] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Colorectal cancer is the third commonest cancer and the third leading cause of cancer death among men and women. It has been proposed that dietary factors are responsible for 70-90% of colorectal cancer and diet optimization may prevent most cases. AIM To evaluate the role of dietary components and supplements in colorectal cancer. METHODS Bibliographical searches were performed in Pubmed for the terms "diet and colorectal cancer", "diet and colon cancer", "diet and rectal cancer", "nutrition and colorectal cancer", "probiotics and colorectal cancer", "prebiotics and colorectal cancer", "alcohol and cancer" and "colorectal cancer epidemiology". RESULTS Consumption of processed or red meat, especially when cooked at high temperatures may be associated with increased risk of colorectal cancer. The evidence for dietary fibre is unclear but foods that contain high amounts of fibre are usually rich in polyphenols which have been shown to alter molecular processes that can encourage colorectal carcinogenesis. Meta-analyses provide evidence on the benefits of circulating, diet-derived and supplemented, vitamin D and Calcium. We also found that diets rich in Folate may prevent colorectal carcinoma. The evidence on dietary micronutrients such as Zinc and Selenium in association with colorectal cancer is not conclusive. It has been suggested that there may be a direct association between alcohol intake and colorectal cancer. In vitro and in vivo studies have highlighted a possible protective role of prebiotics and probiotics. CONCLUSIONS The lack of randomized trials and the presence of confounding factors including smoking, physical activity, obesity and diabetes may often yield inconclusive results. Carefully designed randomized trials are recommended.
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143
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Goh LY, Goh KL. Obesity: an epidemiological perspective from Asia and its relationship to gastrointestinal and liver cancers. J Gastroenterol Hepatol 2013; 28 Suppl 4:54-8. [PMID: 24251705 DOI: 10.1111/jgh.12293] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Obesity is major health problem in the Asia-Pacific region. The proportion of people who are overweight and obese in the region has increased dramatically and is closely linked to the increasing affluence in the region. While the body mass index has been used as a yardstick in many published studies, it has been noted that Asian patients have a greater percentage body fat for a given body mass index and especially abdominal or visceral obesity. The association of obesity and cancers is intriguing and worrisome at the same time, as obesity is rising exponentially throughout the world especially in the Asia-Pacific region. Evidence of its association with gastrointestinal cancers is well documented and is reported with cardioesophageal, colorectal, liver, pancreatic, and gallbladder cancers. The strength of association varies between individual cancers but is of particular concern with colorectal cancer, which is perhaps the fastest emerging cancer in this region. Biological mechanisms for obesity-related carcinogenesis have been described, which includes insulin resistance and secretion of adipokines and chronic inflammation. A "dose-response" relationship between severity of excess body weight and risks of cancer has been reported. However, there is a paucity of data looking at a decrease in incidence of these cancers with a decrease in body weight with treatment, for example, bariatric surgery. Such studies will be difficult to perform and which would require a long period of longitudinal follow-up.
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Affiliation(s)
- Li-Yen Goh
- Faculty of Medicine, University of Nottingham, UK
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144
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Cong YJ, Gan Y, Sun HL, Deng J, Cao SY, Xu X, Lu ZX. Association of sedentary behaviour with colon and rectal cancer: a meta-analysis of observational studies. Br J Cancer 2013; 110:817-26. [PMID: 24263062 PMCID: PMC3915109 DOI: 10.1038/bjc.2013.709] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 10/12/2013] [Accepted: 10/16/2013] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Sedentary behaviour is ubiquitous in modern society. Emerging studies have focused on the health consequences of sedentary behaviour, including colorectal cancer, but whether sedentary behaviour is associated with the risks of colon and rectal cancer remains unclear. No systematic reviews have applied quantitative techniques to independently compute summary risk estimates. We aimed to conduct a meta-analysis to investigate this issue. METHODS We searched PubMed, Embase, and Google Scholar databases up to May 2013 to identify cohort and case-control studies that evaluated the association between sedentary behaviour and colon or rectal cancer. A random-effect model was used to pool the results of included studies. Publication bias was assessed by using Begg's funnel plot. RESULTS Twenty-three studies with 63 reports were included in our meta-analysis. These groups included 4,324,462 participants (27,231 colon cancer cases and 13,813 rectal cancer cases). Sedentary behaviour was significantly associated with colon cancer (relative risk (RR): 1.30, 95% confidence interval (CI): 1.22-1.39) but did not have a statistically significant association with rectal cancer (RR 1.05, 95% CI, 0.98-1.13). Subgroup analyses suggested that the odds ratio (OR) of colon cancer was 1.46 (95% CI: 1.22-1.68) in the case-control studies, and the RR was 1.27 (95% CI: 1.18-1.36) in the cohort studies, the OR of rectal cancer was 1.06 (95% CI: 0.85-1.33) in the case-control studies, and the RR was 1.06 (95% CI, 1.01-1.12) in the cohort studies. CONCLUSION Sedentary behaviour is associated with an increased risk of colon cancer. Subgroup analyses suggest a positive association between sedentary behaviour and risk of rectal cancer in cohort studies. Reducing sedentary behaviour is potentially important for the prevention of colorectal cancer.
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Affiliation(s)
- Y J Cong
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Y Gan
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - H L Sun
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - J Deng
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - S Y Cao
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - X Xu
- 1] School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China [2] Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Z X Lu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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145
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Augustin LSA, Malerba S, Lugo A, Franceschi S, Talamini R, Serraino D, Jenkins DJA, La Vecchia C. Associations of bread and pasta with the risk of cancer of the breast and colorectum. Ann Oncol 2013; 24:3094-9. [PMID: 24155133 DOI: 10.1093/annonc/mdt383] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Carbohydrate foods with high glycemic and insulinemic potential may influence cancer risk possibly through the insulin/growth-factor axis. Two staple carbohydrate foods of the Mediterranean diet, bread and pasta, have different glycemic and insulinemic responses and hence may affect cancer risk differently. MATERIALS AND METHODS We studied the association of bread and pasta with breast and colorectal cancer risk using data from two Italian case-control studies. These studies included 2569 women with histologically confirmed breast cancer and 1953 men and women with colorectal cancer. Controls were 2588 and 4154, respectively, admitted to the same hospitals as cases for acute, non-neoplastic conditions. Multivariate odds ratios (ORs) were obtained after allowance for relevant confounding factors. RESULTS The ORs of breast cancer for the highest versus the lowest quintile were 1.28 (95% confidence interval, CI: 1.03-1.58, P-trend = 0.0342) for bread and 1.07 (95% CI: 0.88-1.31, P-trend = 0.7072) for pasta. The association with bread remained virtually unchanged with postmenopause and overweight. The ORs of colorectal cancer in women for the highest versus the lowest quintile were 2.02 (95% CI: 1.46-2.80, P-trend = 0.0002) for bread and 1.37 (95% CI: 1.00-1.88, P-trend = 0.0164) for pasta. The associations remained significant only for bread in strata of menopausal status and in women with overweight. No significant associations were seen in men for either bread or pasta. CONCLUSIONS Overall, these two cancer case-control studies showed stronger positive associations with bread than pasta in women, particularly if overweight, suggesting possible hormonal-related mechanisms.
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Affiliation(s)
- L S A Augustin
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto and Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, Canada
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Sundaram S, Johnson AR, Makowski L. Obesity, metabolism and the microenvironment: Links to cancer. J Carcinog 2013; 12:19. [PMID: 24227994 PMCID: PMC3816318 DOI: 10.4103/1477-3163.119606] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 08/06/2013] [Indexed: 02/06/2023] Open
Abstract
Historically, cancer research has focused on identifying mutations or amplification of genes within the tumor, which informed the development of targeted therapies against affected pathways. This work often considers tumor cells in isolation; however, it is becoming increasingly apparent that the microenvironment surrounding tumor cells strongly influences tumor onset and progression. This is the so-called “seed and soil” hypothesis wherein the seed (cancer cell) is fed and molded by the metabolites, growth factors, modifications of the extracellular matrix or angiogenic factors provided by the soil (or stroma). Currently, 65% of the US population is obese or overweight; similarly staggering figures are reported in US children and globally. Obesity mediates and can exacerbate, both normal and tumor microenvironment dysfunction. Many obesity-associated endocrine, metabolic and inflammatory mediators are suspected to play a role in oncogenesis by modifying systemic nutrient metabolism and the nutrient substrates available locally in the stroma. It is vitally important to understand the biological processes linking obesity and cancer to develop better intervention strategies aimed at curbing the carcinogenic events associated with obesity. In this review, obesity-driven changes in both the normal and tumor microenvironment, alterations in metabolism, and release of signaling molecules such as endocrine, growth, and inflammatory mediators will be highlighted. In addition, we will discuss the effects of the timing of obesity onset or particular “windows of susceptibility,” with a focus on breast cancer etiology.
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Affiliation(s)
- Sneha Sundaram
- Department of Nutrition, Nutrition Obesity Research Center, and Lineberger Comprehensive Cancer Center, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, CB #7461, Chapel Hill, NC, 27599, USA
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147
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Eating frequency and risk of colorectal cancer. Cancer Causes Control 2013; 24:2107-15. [PMID: 24057417 DOI: 10.1007/s10552-013-0288-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 09/04/2013] [Indexed: 12/20/2022]
Abstract
PURPOSE Eating frequency is a modifiable aspect of dietary behavior that may affect risk of colorectal cancer (CRC). Although most previous case-control studies indicate a positive association, two prospective studies suggest an inverse association between eating frequency and CRC risk, with evidence of effect modification by diet composition. We examined the association between eating frequency and CRC in a large, prospective cohort study, and explored whether this relationship was modified by sex, coffee consumption, or dietary glycemic load. METHODS Between 2000 and 2002, 67,912 western Washington residents aged 50-76 reported average daily meal and snack frequency using a mailed questionnaire as part of the vitamins and lifestyle study. Participants were followed for CRC through linkage with SEER through 2008, over which time 409 CRC cases developed. Hazard Ratios and 95 % Confidence Intervals were obtained using Cox regression. RESULTS In age- and sex-adjusted models higher (5+ times/d) vs. lower (1-2 times/d) eating frequency was associated with a HR of 0.62 (95 % CI 0.43-0.88, Ptrend = 0.001). However, following further adjustment for BMI, race/ethnicity, alcohol, and other known CRC risk factors, the relationship was no longer statistically significant (HR: 0.76; 95 % CI 0.51, 1.14). No effect modification was observed by sex (Pinteraction = 0.45), coffee consumption (Pinteraction = 0.44), or dietary glycemic load (Pinteraction = 0.90). In subgroup analyses by tumor site, higher vs. lower eating frequency was associated with lower risk for colon (HR 0.65 95 % CI 0.39-1.07, Ptrend = 0.04), but not rectal cancers (HR = 1.08 95 % CI 0.54-2.18, Ptrend = 0.94). CONCLUSION The weak inverse association observed between eating frequency and CRC is consistent with findings from other prospective studies. Modification of this relationship by diet quality and participant characteristics should be considered in the future studies.
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148
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Lombardi M, Scattina I, Sardella C, Urbani C, Marciano E, Signori S, Ruocco L, Pellegrini G, Martino E, Bogazzi F. Serum factors associated with precancerous colonic lesions in acromegaly. J Endocrinol Invest 2013; 36:545-9. [PMID: 23324452 DOI: 10.3275/8812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Insulin, 25-hydroxy vitamin D3 [25(OH)D3] and folate have been differently associated with a risk of colonic neoplasms in the general population. Acromegalic patients have an increased risk of colorectal tumors and an association between fasting insulin concentrations and colonic lesions has been reported. However, it is unknown whether insulin, 25(OH)D3, folate, and homocysteine interact to determine the risk of colonic tumors in acromegaly. AIM To investigate whether serum insulin, 25(OH)D3, folate, and homocysteine concentrations were associated with precancerous colonic lesions in acromegalic patients. MATERIAL AND METHODS A cohort of 146 consecutive acromegalic patients was evaluated for colonoscopy findings and fasting insulin, 25(OH)D3, folate, and homocysteine levels. A preliminary study was conducted in 9 naïve acromegalic patients to evaluate the effect of somatostatin analogues (SSA) on serum levels of those factors. RESULTS Insulin reduced during SSA whereas the other factors did not change. In the cohort study, colonic lesions (14 adenomas; 32 hyperplastic polyps) were detected in 46 patients. Fasting insulin, 25(OH)D3, folate, and homocysteine levels did not differ in patients with or without colonic adenomas. High folate levels were associated with a lower risk of developing precancerous colonic lesions at the multivariate analysis, when corrected by age, gender, disease activity and SSA therapy. CONCLUSIONS Serum insulin, 25(OH)D3 and homocysteine serum concentrations do not seem to influence the development of precancerous colonic lesions in acromegalic patients, while higher folate levels may be associated with a lower risk of colonic lesions.
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Affiliation(s)
- M Lombardi
- Department of Endocrinology and Metabolism, University of Pisa, Ospedale di Cisanello, Via Paradisa 2, 56124 Pisa, Italy
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Sasazuki S, Charvat H, Hara A, Wakai K, Nagata C, Nakamura K, Tsuji I, Sugawara Y, Tamakoshi A, Matsuo K, Oze I, Mizoue T, Tanaka K, Inoue M, Tsugane S. Diabetes mellitus and cancer risk: pooled analysis of eight cohort studies in Japan. Cancer Sci 2013; 104:1499-507. [PMID: 23889822 DOI: 10.1111/cas.12241] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 07/18/2013] [Accepted: 07/19/2013] [Indexed: 12/26/2022] Open
Abstract
Although a growing body of evidence suggests a link between diabetes and cancer, it is not clear whether diabetes independently increases the risk of cancer. We conducted a comprehensive assessment of the association between pre-existing diabetes and total and site-specific cancer risk based on a pooled analysis of eight cohort studies in Japan (>330 000 subjects). We estimated a summary hazard ratio by pooling study-specific hazard ratios for total and site-specific cancer by using a random-effects model. A statistically increased risk was observed for cancers at specific sites, such as colon (hazard ratio; HR = 1.40), liver (HR = 1.97), pancreas (HR = 1.85) and bile duct (HR = 1.66; men only). Increased risk was also suggested for other sites, and diabetes mellitus was associated with an overall 20% increased risk in total cancer incidence in the Japanese population. The association between these two diseases has important implications for reiterating the importance of controlling lifestyle factors and may suggest a possible strategy for cancer screening among patients with diabetes. Studies continuously investigating the risk factors for diabetes are also important.
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Affiliation(s)
- Shizuka Sasazuki
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan
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150
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Potential targets for colorectal cancer prevention. Int J Mol Sci 2013; 14:17279-303. [PMID: 23975167 PMCID: PMC3794728 DOI: 10.3390/ijms140917279] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 08/09/2013] [Accepted: 08/14/2013] [Indexed: 12/18/2022] Open
Abstract
The step-wise development of colorectal neoplasia from adenoma to carcinoma suggests that specific interventions could delay or prevent the development of invasive cancer. Several key factors involved in colorectal cancer pathogenesis have already been identified including cyclooxygenase 2 (COX-2), nuclear factor kappa B (NF-κB), survivin and insulin-like growth factor-I (IGF-I). Clinical trials of COX-2 inhibitors have provided the “proof of principle” that inhibition of this enzyme can prevent the formation of colonic adenomas and potentially carcinomas, however concerns regarding the potential toxicity of these drugs have limited their use as a chemopreventative strategy. Curcumin, resveratrol and quercetin are chemopreventive agents that are able to suppress multiple signaling pathways involved in carcinogenesis and hence are attractive candidates for further research.
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