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Hovsepyan G, Barac A, Brasky TM, Shadyab AH, Lehman A, McLaughlin EM, Saquib N, Iyengar NM, Wild RA, Caan BJ, Desai P, Beebe Dimmer J, Thomson CA, Simon MS. Pre-diagnosis lipid levels and mortality after obesity-related cancer diagnosis in the Women's Health Initiative cardiovascular disease biomarker cohort. Cancer Med 2023; 12:16626-16636. [PMID: 37381978 PMCID: PMC10469749 DOI: 10.1002/cam4.6266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 06/03/2023] [Accepted: 06/06/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Published studies have demonstrated inconclusive relationships between serum lipid levels and mortality after cancer. METHODS The primary objective was to evaluate the relationship between fasting lipid levels and mortality after cancer. Data were obtained on baseline lipids and outcomes after cancer from 1263 postmenopausal women diagnosed with 13 obesity-related cancers who were part of the Women's Health Initiative (WHI) lipid biomarkers cohort. Obesity-related cancers included incident invasive cancers of the breast, colorectum, endometrium, esophagus (adenocarcinoma), kidney, liver, gallbladder, pancreas, ovaries, small intestine, thyroid, stomach, as well as multiple myeloma. Baseline lipid measurements included high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol, and non-HDL-cholesterol. Outcomes were all cause, cancer-specific, and CVD mortality. Multivariable Cox proportional hazards models were used to measure associations between lipid levels and mortality (all cause, cancer, and CVD) after a cancer diagnosis, with lipids analyzed as continuous variables. RESULTS Among women with obesity-related cancer, there were 707 deaths, of which 379 (54%) were due to cancer and 113 (16%) were due to CVD. Mean time from blood draw to cancer diagnosis was 5.1 years (range: 0.05-10 years). LDL-C values above the 95th percentile were associated with higher risk of all-cause mortality (p < 0.001), and cancer-specific mortality (p < 0.001), but not mortality due to CVD. Non-HDL-C values above the 65th percentile were associated with higher risk of all-cause mortality (p = 0.01) and mortality due to CVD (p = 0.003), but not cancer-specific mortality (p = 0.37). HDL-C values above the 95th percentile were associated with lower all-cause mortality (p = 0.002), and above the 65th percentile with lower cancer-specific mortality (p = 0.003), but no significant relationship with mortality due to CVD was observed. CONCLUSIONS The relationship between pre-diagnosis fasting lipid levels and mortality after cancer diagnosis is complex. These results suggest that improved lipid control through lifestyle and anti-lipid medications could have a meaningful impact on outcomes after cancer.
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Affiliation(s)
- Gayane Hovsepyan
- Wayne State University School of MedicineDetroitMichiganUSA
- Scripps Green Internal Medicine Residency ProgramLa JollaCaliforniaUSA
| | - Ana Barac
- Georgetown UniversityWashingtonDistrict of ColumbiaUSA
- Inova Heart and Vascular InstituteFalls ChurchVirginiaUSA
| | | | - Aladdin H. Shadyab
- Herbert Wertheim School of Public Health and Human Longevity ScienceUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Amy Lehman
- Center for BiostatisticsOhio State UniversityColumbusOhioUSA
| | | | - Nazmus Saquib
- College of MedicineSulaiman AlRajhi UniversityAl BukayriyahSaudi Arabia
| | | | - Robert A. Wild
- University of Oklahoma Health Sciences CenterOklahoma CityOklahomaUSA
| | - Bette J. Caan
- Division of ResearchKaiser Permanente Medical Program of Northern CaliforniaOaklandCaliforniaUSA
| | - Pinkal Desai
- Department of OncologyWeill Cornell Medical CenterNew YorkNew YorkUSA
| | - Jennifer Beebe Dimmer
- Wayne State University School of MedicineDetroitMichiganUSA
- Department of OncologyBarbara Ann Karmanos Cancer Institute at Wayne Sate UniversityDetroitMichiganUSA
| | - Cynthia A. Thomson
- Department of Health Promotion SciencesMel & Enid Zuckerman College of Public Health and Arizona Cancer CenterUniversity of ArizonaTucsonArizonaUSA
| | - Michael S. Simon
- Wayne State University School of MedicineDetroitMichiganUSA
- Department of OncologyBarbara Ann Karmanos Cancer Institute at Wayne Sate UniversityDetroitMichiganUSA
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Zhao L, Zou Y, Wu Y, Cai L, Zhao Y, Wang Y, Xiao X, Yang Q, Yang J, Ren H, Tong N, Liu F. Metabolic phenotypes and risk of end-stage kidney disease in patients with type 2 diabetes. Front Endocrinol (Lausanne) 2023; 14:1103251. [PMID: 37234807 PMCID: PMC10206309 DOI: 10.3389/fendo.2023.1103251] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 04/13/2023] [Indexed: 05/28/2023] Open
Abstract
Background Obesity often initiates or coexists with metabolic abnormalities. This study aimed to investigate the pathological characteristics and the independent or mutual relations of obesity and metabolic abnormalities with end-stage kidney disease (ESKD) in patients with type 2 diabetes (T2D) and associated diabetic kidney disease (DKD). Methods A total of 495 Chinese patients with T2D and biopsy-confirmed DKD between 2003 and 2020 were enrolled in this retrospective study. The metabolic phenotypes were based on the body weight index (BMI)-based categories (obesity, BMI ≥ 25.0 kg/m2) and metabolic status (metabolically unhealthy status, ≥ 1 criterion National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP III) excluding waist circumference and hyperglycemia) and were categorized into four types: metabolically healthy non-obesity (MHNO), metabolically healthy obesity (MHO), metabolically unhealthy non-obesity (MUNO), and metabolically unhealthy obesity (MUO). The pathological findings were defined by the Renal Pathology Society classification. Cox proportional hazards models were used to estimate hazard ratios (HRs) for ESKD. Results There are 56 (11.3%) MHNO patients, 28 (5.7%) MHO patients, 176 (35.6%) MUNO patients, and 235 (47.5%) MUO patients. The high prevalence of the Kimmelstiel-Wilson nodule and severe mesangial expansion were associated with obesity, whereas severe IFTA was related to metabolically unhealthy status. In the multivariate analysis, the adjusted HR (aHR) was 2.09 [95% confidence interval (CI) 0.99-4.88] in the MHO group, 2.16 (95% CI 1.20-3.88) in the MUNO group, and 2.31 (95% CI 1.27-4.20) in the MUO group compared with the MHNO group. Furthermore, the presence of obesity was insignificantly associated with ESKD compared with non-obese patients (aHR 1.22, 95% CI 0.88-1.68), while the metabolically unhealthy status was significantly associated with ESKD compared to the metabolically healthy status in the multivariate analysis (aHR 1.69, 95% CI 1.10-2.60). Conclusion Obesity itself was insignificantly associated with ESKD; however, adding a metabolically unhealthy status to obesity increased the risk for progression to ESKD in T2D and biopsy-proven DKD.
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Affiliation(s)
- Lijun Zhao
- Department of General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yutong Zou
- Department of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yucheng Wu
- Department of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Linli Cai
- Department of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yuancheng Zhao
- Department of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yiting Wang
- Department of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xiang Xiao
- Department of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Qing Yang
- Department of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Jia Yang
- Department of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Honghong Ren
- Department of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Nanwei Tong
- Division of Endocrinology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Fang Liu
- Department of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China
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Zhang H, Qiu J, Meng F, Shu X. Insight into the causality between basal metabolic rate and endometrial and ovarian cancers: Analysis utilizing systematic Mendelian randomization and genetic association data from over 331,000 UK biobank participants. Eur J Clin Invest 2023; 53:e13971. [PMID: 36807123 DOI: 10.1111/eci.13971] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 01/15/2023] [Accepted: 02/13/2023] [Indexed: 02/20/2023]
Abstract
BACKGROUND Observational studies have demonstrated that basal metabolic rate (BMR) is associated with the risk of endometrial cancer (EC) and ovarian cancer (OC). However, it is unclear whether these associations reflect a causal relationship. OBJECTIVE To reveal the causality between BMR and EC and OC, we performed the first comprehensive two-sample Mendelian randomization (MR) analyses. METHODS Genetic variants were used as proxies of BMR. GWAS summary statistics of BMR, EC and OC were obtained from the UK Biobank Consortium, Endometrial Cancer Association Consortium and Ovarian Cancer Association Consortium respectively. The inverse variance weighted method was employed as the main approach for MR analysis. A series of sensitivity analyses were implemented to validate the robustness and reliability of the results. RESULTS BMR was significantly related to an increased risk of EC (ORSD = 1.49; 95% CI: 1.29-1.72; p-Value < .001) and OC (ORSD = 1.21; 95% CI: 1.08-1.35; p-Value < .001). Furthermore, the stratified analysis indicated that BMR was positively associated with endometrioid endometrial cancer (EEC) (ORSD = 1.45; 95% CI, 1.23-1.70; p-Value < .001), clear cell ovarian cancer(CCOC) (ORSD = 1.89; 95% CI:1.35-2.64; p-Value < .001) and endometrioid ovarian cancer risk (EOC) (ORSD = 1.45; 95% CI: 1.12-1.88; p-Value = .005). However, there were no significant associations of BMR with invasive mucinous ovarian cancer (IMOC), high-grade serous ovarian cancer (HGSOC) and low-grade serous ovarian cancer (LGSOC). The robustness of the above results was further verified in sensitivity analyses. CONCLUSION The MR study provided etiological evidence for the positive association of BMR with the risk of EC, EEC, OC, CCOC and EOC. But this study did not provide enough evidence suggesting the causal associations of BMR with IMOC, HGSOC and LGSOC.
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Affiliation(s)
- Haifeng Zhang
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Junlan Qiu
- Department of Oncology and Hematology, Suzhou Science and Technology Town Hospital, Suzhou, China
| | - Fang Meng
- Centre of Systems Medicine, Chinese Academy of Medical Sciences, Beijing, China.,Suzhou Institute of Systems Medicine, Suzhou, China
| | - Xiaochen Shu
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
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Shimada BK, Swanson S, Toh P, Seale LA. Metabolism of Selenium, Selenocysteine, and Selenoproteins in Ferroptosis in Solid Tumor Cancers. Biomolecules 2022; 12:biom12111581. [PMID: 36358931 PMCID: PMC9687593 DOI: 10.3390/biom12111581] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 11/16/2022] Open
Abstract
A potential target of precision nutrition in cancer therapeutics is the micronutrient selenium (Se). Se is metabolized and incorporated as the amino acid selenocysteine (Sec) into 25 human selenoproteins, including glutathione peroxidases (GPXs) and thioredoxin reductases (TXNRDs), among others. Both the processes of Se and Sec metabolism for the production of selenoproteins and the action of selenoproteins are utilized by cancer cells from solid tumors as a protective mechanism against oxidative damage and to resist ferroptosis, an iron-dependent cell death mechanism. Protection against ferroptosis in cancer cells requires sustained production of the selenoprotein GPX4, which involves increasing the uptake of Se, potentially activating Se metabolic pathways such as the trans-selenation pathway and the TXNRD1-dependent decomposition of inorganic selenocompounds to sustain GPX4 synthesis. Additionally, endoplasmic reticulum-resident selenoproteins also affect apoptotic responses in the presence of selenocompounds. Selenoproteins may also help cancer cells adapting against increased oxidative damage and the challenges of a modified nutrient metabolism that result from the Warburg switch. Finally, cancer cells may also rewire the selenoprotein hierarchy and use Se-related machinery to prioritize selenoproteins that are essential to the adaptations against ferroptosis and oxidative damage. In this review, we discuss both the evidence and the gaps in knowledge on how cancer cells from solid tumors use Se, Sec, selenoproteins, and the Se-related machinery to promote their survival particularly via resistance to ferroptosis.
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Wu E, Ni J, Tao L, Xie T. A bidirectional Mendelian randomization study supports the causal effects of a high basal metabolic rate on colorectal cancer risk. PLoS One 2022; 17:e0273452. [PMID: 35994506 PMCID: PMC9394792 DOI: 10.1371/journal.pone.0273452] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 08/09/2022] [Indexed: 12/04/2022] Open
Abstract
Purpose We conducted a bidirectional two-sample Mendelian randomization (MR) study to determine whether genetically predicted basal metabolic rate (BMR) was a causal risk factor for colorectal cancer (CRC) or whether a genetically predicted CRC risk can influence the BMR level (i.e., reverse causation). Methods We employed 1,040 genetic variants as proxies for BMR to obtain effect estimates on CRC risk. Another 58 CRC-associated variants were used to estimate effects on BMR levels. Stratified analysis by tumor site was used to examine the causal associations between BMR and colon/rectal cancer risk. Results The inverse variance weighted (IVW) method indicated a significant causal effect of genetically determined BMR on CRC risk (ORSD = 1.27, 95% CI = 1.07–1.51). No significant reverse causal association was identified between genetically increased CRC risk and BMR levels [IVW (β = 0, 95% CI = -0.01 to 0)]. The results of MR-Egger and the weighted median method were consistent with the IVW method. Stratified analysis by CRC sites identified significant causal associations between BMR and colon cancer [IVW (ORSD = 1.45, 95% CI = 1.16-1-80)], and null evidence of a causal association between BMR and rectal cancer risk was found (p > 0.05). Conclusion Our findings add to the current literature by validating a positive relationship between high BMR levels and CRC risk instead of reverse causality. The genetically predicted BMR level was causally associated with colon cancer risk but not rectal cancer risk.
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Affiliation(s)
- E. Wu
- School of Pharmacy, Hangzhou Normal University, Hangzhou, Zhejiang, China
- Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Juntao Ni
- Women’s Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Lin Tao
- School of Pharmacy, Hangzhou Normal University, Hangzhou, Zhejiang, China
- Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, Zhejiang, China
- * E-mail: (LT); (TX)
| | - Tian Xie
- School of Pharmacy, Hangzhou Normal University, Hangzhou, Zhejiang, China
- Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, Zhejiang, China
- * E-mail: (LT); (TX)
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Goodarzi G, Mozaffari H, Raeisi T, Mehravar F, Razi B, Ghazi ML, Garousi N, Alizadeh S, Janmohammadi P. Metabolic phenotypes and risk of colorectal cancer: a systematic review and meta-analysis of cohort studies. BMC Cancer 2022; 22:89. [PMID: 35062912 PMCID: PMC8781040 DOI: 10.1186/s12885-021-09149-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/24/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The association of obesity with colorectal cancer (CRC) may vary depending on metabolic status. OBJECTIVE This meta-analysis aimed to investigate the combined impacts of obesity and metabolic status on CRC risk. METHODS The Scopus, PubMed, and web of sciences databases were systematically searched up to Jun 2021 to find all eligible publications examining CRC risk in individuals with metabolically unhealthy normal-weight (MUHNW), metabolically healthy obesity (MHO), and metabolically unhealthy obesity (MUHO) phenotypes. RESULTS A total of 7 cohort studies with a total of 759,066 participants were included in this meta-analysis. Compared with healthy normal-weight people, MUHNW, MHO, and MUHO individuals indicated an increased risk for CRC with a pooled odds ratio of 1.19 (95% CI = 1.09-1.31) in MUHNW, 1.14 (95% CI = 1.06-1.22) in MHO, and 1.24 (95% CI = 1.19-1.29) in MUHO subjects. When analyses were stratified based on gender, associations remained significant for males. However, the elevated risk of CRC associated with MHO and MUHO was not significant in female participants. CONCLUSIONS The individuals with metabolic abnormality, although at a normal weight, have an increased risk for CRC. Moreover, obesity is associated with CRC irrespective of metabolic status.
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Affiliation(s)
- Golnoosh Goodarzi
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Hadis Mozaffari
- Faculty of Land and Food Systems, University of British Columbia, Vancouver, Canada
| | - Tahereh Raeisi
- Department of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Fatemeh Mehravar
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Bahman Razi
- Department of Hematology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Maryam Lafzi Ghazi
- Department of Exercise Physiology, Central Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Nazila Garousi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahab Alizadeh
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Tehran Province, Iran
| | - Parisa Janmohammadi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Tehran Province, Iran.
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Metabolic syndrome and the risk of colorectal cancer: a systematic review and meta-analysis. Int J Colorectal Dis 2021; 36:2215-2225. [PMID: 34331119 DOI: 10.1007/s00384-021-03974-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE Observational studies have reported an association between metabolic syndrome (MetS) and colorectal cancer risk with inconsistent risk estimates. We conducted this meta-analysis to evaluate the risk of colorectal cancer in individuals with MetS. METHODS PubMed, Embase, and Web of Science were searched for related studies from database inception to 21 January 2021. Risk estimates for colorectal cancer were extracted from individual articles and pooled using a fixed-effect or random-effect model according to the heterogeneity. RESULTS MetS was significantly associated with a higher risk of colorectal cancer in both sexes (relative risk [RR] 1.36, 95% confidence interval [CI] 1.26-1.47, P < 0.001), men (RR 1.33, 95% CI 1.21-1.47, P < 0.001), and women (RR 1.34, 95% CI 1.19-1.52, P < 0.001). The risk of colorectal cancer seemed to increase as the number of MetS components rose. Moreover, the high body mass index (BMI)/waist circumference (WC) and hyperglycemia were all significantly associated with a higher risk of colorectal cancer (RR 1.28 [1.20-1.37] and 1.31 [1.14-1.50] in both sexes, RR 1.31 [1.19-1.45] and 1.23 [1.03-1.46] in men, and RR 1.22 [1.02-1.46] and 1.63 [1.16-2.28] in women, respectively). CONCLUSIONS MetS was significantly associated with a higher risk of colorectal cancer. The high BMI/WC or hyperglycemia might largely account for this association. Further analysis suggested that, as the number of MetS components increased, the risk of colorectal cancer rose.
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Kliemann N, Viallon V, Murphy N, Beeken RJ, Rothwell JA, Rinaldi S, Assi N, van Roekel EH, Schmidt JA, Borch KB, Agnoli C, Rosendahl AH, Sartor H, Huerta JM, Tjønneland A, Halkjær J, Bueno-de-Mesquita B, Gicquiau A, Achaintre D, Aleksandrova K, Schulze MB, Heath AK, Tsilidis KK, Masala G, Panico S, Kaaks R, Fortner RT, Van Guelpen B, Dossus L, Scalbert A, Keun HC, Travis RC, Jenab M, Johansson M, Ferrari P, Gunter MJ. Metabolic signatures of greater body size and their associations with risk of colorectal and endometrial cancers in the European Prospective Investigation into Cancer and Nutrition. BMC Med 2021; 19:101. [PMID: 33926456 PMCID: PMC8086283 DOI: 10.1186/s12916-021-01970-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/22/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The mechanisms underlying the obesity-cancer relationship are incompletely understood. This study aimed to characterise metabolic signatures of greater body size and to investigate their association with two obesity-related malignancies, endometrial and colorectal cancers, and with weight loss within the context of an intervention study. METHODS Targeted mass spectrometry metabolomics data from 4326 participants enrolled in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort and 17 individuals from a single-arm pilot weight loss intervention (Intercept) were used in this analysis. Metabolic signatures of body size were first determined in discovery (N = 3029) and replication (N = 1297) sets among EPIC participants by testing the associations between 129 metabolites and body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) using linear regression models followed by partial least squares analyses. Conditional logistic regression models assessed the associations between the metabolic signatures with endometrial (N = 635 cases and 648 controls) and colorectal (N = 423 cases and 423 controls) cancer risk using nested case-control studies in EPIC. Pearson correlation between changes in the metabolic signatures and weight loss was tested among Intercept participants. RESULTS After adjustment for multiple comparisons, greater BMI, WC, and WHR were associated with higher levels of valine, isoleucine, glutamate, PC aa C38:3, and PC aa C38:4 and with lower levels of asparagine, glutamine, glycine, serine, lysoPC C17:0, lysoPC C18:1, lysoPC C18:2, PC aa C42:0, PC ae C34:3, PC ae C40:5, and PC ae C42:5. The metabolic signature of BMI (OR1-sd 1.50, 95% CI 1.30-1.74), WC (OR1-sd 1.46, 95% CI 1.27-1.69), and WHR (OR1-sd 1.54, 95% CI 1.33-1.79) were each associated with endometrial cancer risk. Risk of colorectal cancer was positively associated with the metabolic signature of WHR (OR1-sd: 1.26, 95% CI 1.07-1.49). In the Intercept study, a positive correlation was observed between weight loss and changes in the metabolic signatures of BMI (r = 0.5, 95% CI 0.06-0.94, p = 0.03), WC (r = 0.5, 95% CI 0.05-0.94, p = 0.03), and WHR (r = 0.6, 95% CI 0.32-0.87, p = 0.01). CONCLUSIONS Obesity is associated with a distinct metabolic signature comprising changes in levels of specific amino acids and lipids which is positively associated with both colorectal and endometrial cancer and is potentially reversible following weight loss.
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Affiliation(s)
- Nathalie Kliemann
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Vivian Viallon
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Neil Murphy
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Rebecca J Beeken
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
- Department of Behavioural Science and Health, University College London, London, UK
| | - Joseph A Rothwell
- Health Across Generations team, Centre for Research in Epidemiology and Population Health (CESP), INSERM U1018, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | - Sabina Rinaldi
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Nada Assi
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Eline H van Roekel
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Julie A Schmidt
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Kristin Benjaminsen Borch
- Department of Community Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Claudia Agnoli
- Epidemiology and Prevention Unit. Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Ann H Rosendahl
- Clinical Sciences Lund, Oncology, Lund University and Skåne University Hospital, Lund, Sweden
| | - Hanna Sartor
- Diagnostic Radiology, Lund University, Lund, Sweden
| | - José María Huerta
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
| | | | - Jytte Halkjær
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Bas Bueno-de-Mesquita
- Department for Determinants of Chronic Diseases, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Audrey Gicquiau
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - David Achaintre
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Krasimira Aleksandrova
- Nutrition, Immunity and Metabolism Senior Scientist Group, Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
| | - Matthias B Schulze
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Alicia K Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Giovanna Masala
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy
| | - Salvatore Panico
- Dipartimento di Medicin Clinica e Chirurgia, Frederico II Univeristy, Naples, Italy
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Renée T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Bethany Van Guelpen
- Department of Radiation Sciences, Oncology, Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
| | - Laure Dossus
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Augustin Scalbert
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Hector C Keun
- Cancer Metabolism and Systems Toxicology Group, Division of Cancer, Department of Surgery and Cancer, Imperial College, London, UK
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Mazda Jenab
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Mattias Johansson
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Pietro Ferrari
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Marc J Gunter
- International Agency for Research on Cancer, World Health Organization, Lyon, France.
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9
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Scully T, Ettela A, LeRoith D, Gallagher EJ. Obesity, Type 2 Diabetes, and Cancer Risk. Front Oncol 2021; 10:615375. [PMID: 33604295 PMCID: PMC7884814 DOI: 10.3389/fonc.2020.615375] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 12/09/2020] [Indexed: 12/12/2022] Open
Abstract
Obesity and type 2 diabetes have both been associated with increased cancer risk and are becoming increasingly prevalent. Metabolic abnormalities such as insulin resistance and dyslipidemia are associated with both obesity and type 2 diabetes and have been implicated in the obesity-cancer relationship. Multiple mechanisms have been proposed to link obesity and diabetes with cancer progression, including an increase in insulin/IGF-1 signaling, lipid and glucose uptake and metabolism, alterations in the profile of cytokines, chemokines, and adipokines, as well as changes in the adipose tissue directly adjacent to the cancer sites. This review aims to summarize and provide an update on the epidemiological and mechanistic evidence linking obesity and type 2 diabetes with cancer, focusing on the roles of insulin, lipids, and adipose tissue.
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Affiliation(s)
- Tiffany Scully
- Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York City, NY, United States
| | - Abora Ettela
- Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York City, NY, United States
| | - Derek LeRoith
- Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York City, NY, United States
- Tisch Cancer Institute at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York City, NY, United States
| | - Emily Jane Gallagher
- Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York City, NY, United States
- Tisch Cancer Institute at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York City, NY, United States
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10
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Xuan K, Zhao T, Sun C, Patel AS, Liu H, Chen X, Qu G, Sun Y. The association between hypertension and colorectal cancer: a meta-analysis of observational studies. Eur J Cancer Prev 2021; 30:84-96. [PMID: 32039929 DOI: 10.1097/cej.0000000000000578] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The relationship between hypertension and risk of colorectal cancer (CRC) is unclear. This meta-analysis aims to explore the association between them. Six databases were searched for studies published before August 2019. The pooled relative risk (RR) and 95% confidence intervals (CIs) were calculated to estimate the association between the hypertension and CRC risk. A total of 2841 potentially relevant articles were obtained, and 25 studies with a pooled 1.95 million participants were finally included in the meta-analysis. These results suggested a positive association between hypertension and risk of CRC with a pooled RR of 1.15 (95% CI: 1.08, 1.23). Male patients with hypertension had a 13% (95% CI: 1.06, 1.20) increased risk of CRC. The risk of colon cancer and rectal cancer in male patients was 1.17 (95% CI: 1.01, 1.36) and 1.35 (95% CI: 1.04, 1.74), respectively, while no association between hypertension and the risk of CRC in females was elucidated. This meta-analysis demonstrated that a positive association between hypertension and CRC exists, with male patients having a higher risk of developing CRC than female patients.
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Affiliation(s)
- Kun Xuan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Tianming Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Chenyu Sun
- AMITA Health Saint Joseph Hospital Chicago
| | - Akash S Patel
- University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA
| | - Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Xin Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Guangbo Qu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Center for Evidence-Based Practice, Anhui Medical University, Hefei, Anhui, China
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11
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Han F, Wu G, Zhang S, Zhang J, Zhao Y, Xu J. The association of Metabolic Syndrome and its Components with the Incidence and Survival of Colorectal Cancer: A Systematic Review and Meta-analysis. Int J Biol Sci 2021; 17:487-497. [PMID: 33613107 PMCID: PMC7893592 DOI: 10.7150/ijbs.52452] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 11/13/2020] [Indexed: 12/22/2022] Open
Abstract
Background: This meta-analysis was aimed to quantitatively assess the associations of metabolic syndrome (MetS) and its components with colorectal cancer (CRC). Methods: PubMed, EMBASE and Web of Science databases were systematically searched for eligible studies. A total of 18 studies for CRC incidence and 12 studies for CRC mortality were identified. Results: MetS was associated with an increased risk of CRC incidence and mortality in male (RR: 1.28, 95 % CI 1.16-1.39, and 1.24, 1.18-1.31, respectively) and correlated with an increased risk of CRC incidence in female (RR: 1.21, 1.13-1.30), but not with CRC mortality in female. MetS increased the risk of cancer-specific mortality (RR: 1.72, 1.03-2.42), but not overall mortality. The risk estimates of CRC incidence changed little depending on age, sex, cancer site, the type of studies, ethnicity, publication year, or definition of MetS. As for CRC mortality, further stratified analyses indicated statistical significance in studies with assessing cancer-specific survival outcome, in male, a cohort design, ethnicity of non-Chinese or with definition of MetS as ≥ 3 metabolic abnormalities. Obesity and hyperglycemia are risk factors of CRC incidence in both male and female. Only dysglycemia is the risk factor for CRC mortality. Conclusions: MetS is associated with an increased risk of CRC incidence and cancer-specific mortality, but not overall mortality. In addition, MetS may increase the CRC mortality in male rather than in female. However, since most of the studies on CRC mortality were conducted in Chinese, further studies are needed to clarify this connection.
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Affiliation(s)
- Fei Han
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300134, China
| | - Guanghai Wu
- Department of General Surgery, Tianjin Union Medical Center, Tianjin 300121, China
| | - Shuai Zhang
- Department of General Surgery, Tianjin Union Medical Center, Tianjin 300121, China
| | - Judong Zhang
- Department of General Surgery, Tianjin Union Medical Center, Tianjin 300121, China
| | - Yongjie Zhao
- Department of General Surgery, Tianjin Union Medical Center, Tianjin 300121, China
| | - Jing Xu
- Department of General Surgery, Tianjin Union Medical Center, Tianjin 300121, China
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12
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Aparecida Silveira E, Vaseghi G, de Carvalho Santos AS, Kliemann N, Masoudkabir F, Noll M, Mohammadifard N, Sarrafzadegan N, de Oliveira C. Visceral Obesity and Its Shared Role in Cancer and Cardiovascular Disease: A Scoping Review of the Pathophysiology and Pharmacological Treatments. Int J Mol Sci 2020; 21:E9042. [PMID: 33261185 PMCID: PMC7730690 DOI: 10.3390/ijms21239042] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/09/2020] [Accepted: 11/12/2020] [Indexed: 12/11/2022] Open
Abstract
The association between obesity, cancer and cardiovascular disease (CVD) has been demonstrated in animal and epidemiological studies. However, the specific role of visceral obesity on cancer and CVD remains unclear. Visceral adipose tissue (VAT) is a complex and metabolically active tissue, that can produce different adipokines and hormones, responsible for endocrine-metabolic comorbidities. This review explores the potential mechanisms related to VAT that may also be involved in cancer and CVD. In addition, we discuss the shared pharmacological treatments which may reduce the risk of both diseases. This review highlights that chronic inflammation, molecular aspects, metabolic syndrome, secretion of hormones and adiponectin associated to VAT may have synergistic effects and should be further studied in relation to cancer and CVD. Reductions in abdominal and visceral adiposity improve insulin sensitivity, lipid profile and cytokines, which consequently reduce the risk of CVD and some cancers. Several medications have shown to reduce visceral and/or subcutaneous fat. Further research is needed to investigate the pathophysiological mechanisms by which visceral obesity may cause both cancer and CVD. The role of visceral fat in cancer and CVD is an important area to advance. Public health policies to increase public awareness about VAT's role and ways to manage or prevent it are needed.
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Affiliation(s)
- Erika Aparecida Silveira
- Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, London WC1E 6BT, UK;
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia 74690-900, Goiás, Brazil; (A.S.d.C.S.); (M.N.)
| | - Golnaz Vaseghi
- Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan 8158388994, Iran;
| | - Annelisa Silva de Carvalho Santos
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia 74690-900, Goiás, Brazil; (A.S.d.C.S.); (M.N.)
- United Faculty of Campinas, Goiânia 74525-020, Goiás, Brazil
| | - Nathalie Kliemann
- Nutritional Epidemiology Group, Nutrition and Metabolism Section, International Agency for Research on Cancer, World Health Organization, 69372 Lyon, France;
| | - Farzad Masoudkabir
- Cardiac Primary Prevention Research Center, Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1416753955, Iran;
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran
| | - Matias Noll
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia 74690-900, Goiás, Brazil; (A.S.d.C.S.); (M.N.)
- Instituto Federal Goiano, Ceres 76300-000, Goiás, Brazil
| | - Noushin Mohammadifard
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan 8158388994, Iran;
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan 8158388994, Iran
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, London WC1E 6BT, UK;
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13
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Mikaeel RR, Symonds EL, Kimber J, Smith E, Horsnell M, Uylaki W, Tapia Rico G, Hewett PJ, Yong J, Tonkin D, Jesudason D, Poplawski NK, Ruszkiewicz AR, Drew PA, Hardingham JE, Wong S, Frank O, Tomita Y, Patel D, Vatandoust S, Townsend AR, Roder D, Young GP, Parry S, Tomlinson IP, Wittert G, Wattchow D, Worthley DL, Brooks WJ, Price TJ, Young JP. Young-onset colorectal cancer is associated with a personal history of type 2 diabetes. Asia Pac J Clin Oncol 2020; 17:131-138. [PMID: 32885561 DOI: 10.1111/ajco.13428] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 06/20/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Colorectal cancer (CRC) is rising in incidence in young adults, and this observation is currently unexplained. We investigated whether having a personal history of type 2 diabetes mellitus (T2D) was a potential risk factor for young-onset colorectal cancer (YOCRC). METHODS The South Australian Young Onset (SAYO) CRC study is a series of young adults with CRC below age 55. Ninety unrelated YOCRC cases were recruited to the study. Personal history and detailed family history of T2D were obtained at face-to-face interview and confirmed from medical records. Whole exome sequencing was conducted on germline DNA from each CRC case. Controls for personal history studies of T2D were 240 patients with proven clear colonoscopies and no known CRC predispositions. RESULTS The median age of YOCRC cases was 44 years (18-54) and of controls was 45 years (18-54), and 53% of both cases and controls were females (P = 0.99). Left-sided (distal) CRC was seen in 67/89 (75%) of cases. A personal history of T2D was confirmed in 17/90 (19%) YOCRC patients compared with controls (12/240, 5%; P < 0.001; odds ratio = 4.4; 95% confidence interval, 2.0-9.7). YOCRC patients frequently reported at least one first-degree relative with T2D (32/85, 38%). Ten of 87 (12%) of YOCRC cases had CRC-related pathogenic germline variants, however, no pathogenic variants in familial diabetes-associated genes were seen. CONCLUSIONS Though the mechanism remains unclear, our observations suggest that there is enrichment for personal history of T2D in YOCRC patients. IMPACT A diagnosis of T2D could therefore potentially identify a subset of young adults at increased risk for CRC and in whom early screening might be appropriate.
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Affiliation(s)
- Reger R Mikaeel
- Department of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.,SAHMRI Colorectal Node, Basil Hetzel Institute, Woodville South, South Australia, Australia.,Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.,Biology Department, College of Science, University of Duhok, Duhok, Kurdistan, Iraq
| | - Erin L Symonds
- Bowel Health Service, Flinders Medical Centre, Bedford Park, South Australia, Australia.,Flinders Centre for Innovation in Cancer, Flinders University, Bedford Park, South Australia, Australia
| | - James Kimber
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Eric Smith
- Department of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.,University of Adelaide Department of Surgery, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia
| | - Mehgan Horsnell
- Department of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia
| | - Wendy Uylaki
- Department of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.,Department of Gastroenterology, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia
| | - Gonzalo Tapia Rico
- Department of Medical Oncology, Royal Adelaide Hospital, Adelaide, Australia
| | - Peter J Hewett
- University of Adelaide Department of Surgery, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia
| | - Jonathan Yong
- University of Adelaide Department of Surgery, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia
| | - Darren Tonkin
- University of Adelaide Department of Surgery, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia
| | - David Jesudason
- Department of Endocrinology, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia
| | - Nicola K Poplawski
- Adult Genetics Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Discipline of Paediatrics, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Andrew R Ruszkiewicz
- Division of Anatomical Pathology, SA Pathology, Adelaide, South Australia, Australia.,Centre for Cancer Biology, University of South Australia, Adelaide, South Australia, Australia
| | - Paul A Drew
- University of Adelaide Department of Surgery, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia
| | - Jenny E Hardingham
- Department of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.,SAHMRI Colorectal Node, Basil Hetzel Institute, Woodville South, South Australia, Australia.,Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Stephanie Wong
- Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, Australia
| | - Oliver Frank
- Discipline of General Practice, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Yoko Tomita
- Department of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia
| | - Dainik Patel
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.,Department of Medical Oncology, Lyell McEwin Hospital, Elizabeth Vale, South Australia, Australia
| | - Sina Vatandoust
- Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - Amanda R Townsend
- Department of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia
| | - David Roder
- Cancer Epidemiology and Population Health, University of South Australia, Adelaide, South Australia, Australia
| | - Graeme P Young
- Flinders Centre for Innovation in Cancer, Flinders University, Bedford Park, South Australia, Australia
| | - Susan Parry
- New Zealand Familial GI Cancer Service, Auckland City Hospital, Auckland, New Zealand.,National Bowel Screening Programme, Ministry of Health, New Zealand
| | - Ian P Tomlinson
- Institute of Cancer and Genomic Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Gary Wittert
- Discipline of Medicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - David Wattchow
- Flinders University, Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - Daniel L Worthley
- South Australian Health & Medical Research Institute & School of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - William J Brooks
- Adelaide Medical Solutions, Adelaide Health Solutions, Woodville, South Australia, Australia
| | - Timothy J Price
- Department of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.,Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Joanne P Young
- Department of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.,SAHMRI Colorectal Node, Basil Hetzel Institute, Woodville South, South Australia, Australia.,Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
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14
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Kliemann N, Murphy N, Viallon V, Freisling H, Tsilidis KK, Rinaldi S, Mancini FR, Fagherazzi G, Boutron-Ruault MC, Boeing H, Schulze MB, Masala G, Krogh V, Sacerdote C, de Magistris MS, Bueno-de-Mesquita B, Weiderpass E, Kühn T, Kaaks R, Jakszyn P, Redondo-Sánchez D, Amiano P, Chirlaque MD, Gurrea AB, Ericson U, Drake I, Nøst TH, Aune D, May AM, Tjønneland A, Dahm CC, Overvad K, Tumino R, Quirós JR, Trichopoulou A, Karakatsani A, La Vecchia C, Nilsson LM, Riboli E, Huybrechts I, Gunter MJ. Predicted basal metabolic rate and cancer risk in the European Prospective Investigation into Cancer and Nutrition. Int J Cancer 2020; 147:648-661. [PMID: 31652358 DOI: 10.1002/ijc.32753] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/24/2019] [Accepted: 10/07/2019] [Indexed: 12/27/2022]
Abstract
Emerging evidence suggests that a metabolic profile associated with obesity may be a more relevant risk factor for some cancers than adiposity per se. Basal metabolic rate (BMR) is an indicator of overall body metabolism and may be a proxy for the impact of a specific metabolic profile on cancer risk. Therefore, we investigated the association of predicted BMR with incidence of 13 obesity-related cancers in the European Prospective Investigation into Cancer and Nutrition (EPIC). BMR at baseline was calculated using the WHO/FAO/UNU equations and the relationships between BMR and cancer risk were investigated using multivariable Cox proportional hazards regression models. A total of 141,295 men and 317,613 women, with a mean follow-up of 14 years were included in the analysis. Overall, higher BMR was associated with a greater risk for most cancers that have been linked with obesity. However, among normal weight participants, higher BMR was associated with elevated risks of esophageal adenocarcinoma (hazard ratio per 1-standard deviation change in BMR [HR1-SD ]: 2.46; 95% CI 1.20; 5.03) and distal colon cancer (HR1-SD : 1.33; 95% CI 1.001; 1.77) among men and with proximal colon (HR1-SD : 1.16; 95% CI 1.01; 1.35), pancreatic (HR1-SD : 1.37; 95% CI 1.13; 1.66), thyroid (HR1-SD : 1.65; 95% CI 1.33; 2.05), postmenopausal breast (HR1-SD : 1.17; 95% CI 1.11; 1.22) and endometrial (HR1-SD : 1.20; 95% CI 1.03; 1.40) cancers in women. These results indicate that higher BMR may be an indicator of a metabolic phenotype associated with risk of certain cancer types, and may be a useful predictor of cancer risk independent of body fatness.
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Affiliation(s)
| | - Neil Murphy
- International Agency for Research on Cancer, Lyon, France
| | - Vivian Viallon
- International Agency for Research on Cancer, Lyon, France
| | | | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Sabina Rinaldi
- International Agency for Research on Cancer, Lyon, France
| | - Francesca R Mancini
- CESP, Faculté de Médecine, Université Paris-Sud, Villejuif, France
- Faculté de Médecine, Université de Versailles St-Quentin En-Yvelines, Villejuif, France
- INSERM, Université Paris-Saclay, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Guy Fagherazzi
- CESP, Faculté de Médecine, Université Paris-Sud, Villejuif, France
- Faculté de Médecine, Université de Versailles St-Quentin En-Yvelines, Villejuif, France
- INSERM, Université Paris-Saclay, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Marie-Christine Boutron-Ruault
- CESP, Faculté de Médecine, Université Paris-Sud, Villejuif, France
- Faculté de Médecine, Université de Versailles St-Quentin En-Yvelines, Villejuif, France
- INSERM, Université Paris-Saclay, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam, Rehbruecke, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam, Rehbruecke, Nuthetal, Germany
- Institute of Nutrition Science, University of Potsdam, Nuthetal, Germany
| | - Giovanna Masala
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano,Via Venezian, Milan, Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | | | - Bas Bueno-de-Mesquita
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre (UMC), Utrecht, The Netherlands
- Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, Lyon, France
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Paula Jakszyn
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology- IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Facultat Ciències Salut Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Daniel Redondo-Sánchez
- CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain
- Andalusian School of Public Health (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA). Universidad de Granada, Granada, Spain
| | - Pilar Amiano
- CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain
- Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain
| | - Maria-Dolores Chirlaque
- CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia University, Murcia, Spain
| | - Aurelio B Gurrea
- CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Ulrica Ericson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Isabel Drake
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Therese H Nøst
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department of Nutrition, Bjørknes University College, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University, Hospital, Oslo, Norway
| | - Anne M May
- Department of Epidemiology, Julius Center Research Program Cancer, Utrecht, The Netherlands
| | - Anne Tjønneland
- Diet, Genes and Environment, Danish Cancer Society Research Center, København, Denmark
| | | | - Kim Overvad
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, Azienda Sanitaria Provinciale (ASP), Ragusa, Italy
| | | | | | - Anna Karakatsani
- Hellenic Health Foundation, Athens, Greece
- Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, "ATTIKON" University Hospital, Haidari, Greece
| | - Carlo La Vecchia
- Hellenic Health Foundation, Athens, Greece
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Lena M Nilsson
- Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umea, Sweden
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | | | - Marc J Gunter
- International Agency for Research on Cancer, Lyon, France
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15
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Hill EM, Esper RM, Sen A, Simon BR, Aslam MN, Jiang Y, Dame MK, McClintock SD, Colacino JA, Djuric Z, Wicha MS, Smith WL, Brenner DE. Dietary polyunsaturated fatty acids modulate adipose secretome and is associated with changes in mammary epithelial stem cell self-renewal. J Nutr Biochem 2019; 71:45-53. [PMID: 31272031 PMCID: PMC6917480 DOI: 10.1016/j.jnutbio.2019.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 05/09/2019] [Accepted: 05/10/2019] [Indexed: 02/07/2023]
Abstract
Chronic low-grade adipose inflammation, characterized by aberrant adipokine production and pro-inflammatory macrophage activation/polarization is associated with increased risk of breast cancer. Adipocyte fatty acid composition is influenced by dietary availability and may regulate adipokine secretion and adipose inflammation. After feeding F344 rats for 20 weeks with a Western diet or a fish oil-supplemented diet, we cultured primary rat adipose tissue in a three-dimensional explant culture and collected the conditioned medium. The rat adipose tissue secretome was assayed using the Proteome Profiler Cytokine XL Array, and adipose tissue macrophage polarization (M1/M2 ratio) was assessed using the iNOS/ARG1 ratio. We then assessed the adipokine's effects upon stem cell self-renewal using primary human mammospheres from normal breast mammoplasty tissue. Adipose from rats fed the fish oil diet had an ω-3:ω-6 fatty acid ratio of 0.28 compared to 0.04 in Western diet rats. The adipokine profile from the fish oil-fed rats was shifted toward adipokines associated with reduced inflammation compared to the rats fed the Western diet. The M1/M2 macrophage ratio decreased by 50% in adipose of fish oil-fed rats compared to that from rats fed the Western diet. Conditioned media from rats fed the high ω-6 Western diet increased stem cell self-renewal by 62%±9% (X¯%±SD) above baseline compared to only an 11%±11% increase with the fish oil rat adipose. Modulating the adipokine secretome with dietary interventions therefore may alter stromal-epithelial signaling that plays a role in controlling mammary stem cell self-renewal.
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Affiliation(s)
- Evan M Hill
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA; Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Raymond M Esper
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Ananda Sen
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Becky R Simon
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Muhammad N Aslam
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Yan Jiang
- MD Anderson Cancer Center, Houston, TX, USA
| | - Michael K Dame
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Shannon D McClintock
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Justin A Colacino
- Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Zora Djuric
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI, USA; Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Max S Wicha
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - William L Smith
- Department of Biological Chemistry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Dean E Brenner
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA; Department of Pharmacology, University of Michigan Medical School, Ann Arbor, MI, USA.
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16
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Pearson-Stuttard J, Zhou B, Kontis V, Bentham J, Gunter MJ, Ezzati M. Worldwide burden of cancer attributable to diabetes and high body-mass index: a comparative risk assessment. Lancet Diabetes Endocrinol 2018; 6:e6-e15. [PMID: 29803268 PMCID: PMC5982644 DOI: 10.1016/s2213-8587(18)30150-5] [Citation(s) in RCA: 174] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Diabetes and high body-mass index (BMI) are associated with increased risk of several cancers, and are increasing in prevalence in most countries. We estimated the cancer incidence attributable to diabetes and high BMI as individual risk factors and in combination, by country and sex. METHODS We estimated population attributable fractions for 12 cancers by age and sex for 175 countries in 2012. We defined high BMI as a BMI greater than or equal to 25 kg/m2. We used comprehensive prevalence estimates of diabetes and BMI categories in 2002, assuming a 10-year lag between exposure to diabetes or high BMI and incidence of cancer, combined with relative risks from published estimates, to quantify contribution of diabetes and high BMI to site-specific cancers, individually and combined as independent risk factors and in a conservative scenario in which we assumed full overlap of risk of diabetes and high BMI. We then used GLOBOCAN cancer incidence data to estimate the number of cancer cases attributable to the two risk factors. We also estimated the number of cancer cases in 2012 that were attributable to increases in the prevalence of diabetes and high BMI from 1980 to 2002. All analyses were done at individual country level and grouped by region for reporting. FINDINGS We estimated that 5·7% of all incident cancers in 2012 were attributable to the combined effects of diabetes and high BMI as independent risk factors, corresponding to 804 100 new cases. 187 600 (24·5%) of 766 000 cases of liver cancer and 121 700 (38·4%) of 317 000 cases of endometrial cancer were attributable to these risk factors. In the conservative scenario, about 4·5% (629 000 new cases) of all incident cancers assessed were attributable to diabetes and high BMI combined. Individually, high BMI (544 300 cases) was responsible for almost twice as many cancer cases as diabetes (293 300 cases). 25·8% of diabetes-related cancers (equating to 75 600 new cases) and 31·9% of high BMI-related cancers (174 040 new cases) were attributable to increases in the prevalence of these risk factors from 1980 to 2002. INTERPRETATION A substantial number of cancer cases are attributable to diabetes and high BMI. As the prevalence of these cancer risk factors increases, clinical and public health efforts should focus on identifying optimal preventive and screening measures for whole populations and individual patients. FUNDING NIHR and Wellcome Trust.
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Affiliation(s)
- Jonathan Pearson-Stuttard
- School of Public Health, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
| | - Bin Zhou
- School of Public Health, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Vasilis Kontis
- School of Public Health, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - James Bentham
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK; School of Public Health, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK; School of Mathematics, Statistics and Actuarial Science (SMSAS), University of Kent, Canterbury, UK
| | - Marc J Gunter
- Nutrition and Metabolism Section, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Majid Ezzati
- School of Public Health, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK; WHO Collaborating Centre on NCD Surveillance and Epidemiology, Imperial College London, London, UK
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17
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LoConte NK, Gershenwald JE, Thomson CA, Crane TE, Harmon GE, Rechis R. Lifestyle Modifications and Policy Implications for Primary and Secondary Cancer Prevention: Diet, Exercise, Sun Safety, and Alcohol Reduction. Am Soc Clin Oncol Educ Book 2018; 38:88-100. [PMID: 30231343 DOI: 10.1200/edbk_200093] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Improved cancer treatments and cancer detection methods are not likely to completely eradicate the burden of cancer. Primary prevention of cancer is a logical strategy to use to control cancer while also seeking novel treatments and earlier detection. Lifestyle modification strategies to improve primary prevention and risk reduction for the development of cancer include choosing a healthy diet with an emphasis on plant sources, maintaining a healthy weight throughout life, being physically active, regularly using sunscreen and wearing protective clothing, limiting sun exposure during the hours of 10 AM to 2 PM, avoiding indoor tanning, and reducing or eliminating alcohol use. In addition to continued use of ongoing education of the public, health care providers, and cancer support communities, other policy and public health efforts should be pursued as well. Examples of supported and successful policy approaches are included in this article, including efforts to limit indoor tanning and improve community-wide interventions to reduce ultraviolet radiation exposure as well as to formally support various alcohol policy strategies including increasing alcohol taxes, reducing alcohol outlet density, improving clinical screening for alcohol use disorders, and limiting youth exposure to alcohol marketing and advertising. These prevention strategies are expected to have the largest impact on the development of melanoma as well as breast, colorectal, head and neck, liver, and esophageal cancers. The impact of these strategies as secondary prevention is less well understood. Areas of additional needed research and implementation are also highlighted. Future areas of needed research are the effects of these modifications after the diagnosis of cancer (as secondary prevention).
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Affiliation(s)
- Noelle K LoConte
- From the Carbone Cancer Center and University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Surgical Oncology, Melanoma and Skin Center, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona Cancer Center, Tucson, AZ; Biobehavioral Health Sciences Division, College of Nursing, University of Arizona Cancer Center, Tucson, AZ; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI; Be Well Communities, Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jeffrey E Gershenwald
- From the Carbone Cancer Center and University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Surgical Oncology, Melanoma and Skin Center, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona Cancer Center, Tucson, AZ; Biobehavioral Health Sciences Division, College of Nursing, University of Arizona Cancer Center, Tucson, AZ; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI; Be Well Communities, Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Cynthia A Thomson
- From the Carbone Cancer Center and University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Surgical Oncology, Melanoma and Skin Center, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona Cancer Center, Tucson, AZ; Biobehavioral Health Sciences Division, College of Nursing, University of Arizona Cancer Center, Tucson, AZ; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI; Be Well Communities, Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Tracy E Crane
- From the Carbone Cancer Center and University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Surgical Oncology, Melanoma and Skin Center, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona Cancer Center, Tucson, AZ; Biobehavioral Health Sciences Division, College of Nursing, University of Arizona Cancer Center, Tucson, AZ; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI; Be Well Communities, Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Gil E Harmon
- From the Carbone Cancer Center and University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Surgical Oncology, Melanoma and Skin Center, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona Cancer Center, Tucson, AZ; Biobehavioral Health Sciences Division, College of Nursing, University of Arizona Cancer Center, Tucson, AZ; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI; Be Well Communities, Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ruth Rechis
- From the Carbone Cancer Center and University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Surgical Oncology, Melanoma and Skin Center, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona Cancer Center, Tucson, AZ; Biobehavioral Health Sciences Division, College of Nursing, University of Arizona Cancer Center, Tucson, AZ; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI; Be Well Communities, Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX
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18
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Kabat GC, Kim MY, Stefanick M, Ho GYF, Lane DS, Odegaard AO, Simon MS, Bea JW, Luo J, Wassertheil-Smoller S, Rohan TE. Metabolic obesity phenotypes and risk of colorectal cancer in postmenopausal women. Int J Cancer 2018; 143:543-551. [PMID: 29488210 DOI: 10.1002/ijc.31345] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 12/22/2017] [Accepted: 02/02/2018] [Indexed: 12/19/2022]
Abstract
Obesity has been postulated to increase the risk of colorectal cancer by mechanisms involving insulin resistance and the metabolic syndrome. We examined the associations of body mass index (BMI), waist circumference, the metabolic syndrome, metabolic obesity phenotypes and homeostasis model-insulin resistance (HOMA-IR-a marker of insulin resistance) with risk of colorectal cancer in over 21,000 women in the Women's Health Initiative CVD Biomarkers subcohort. Women were cross-classified by BMI (18.5-<25.0, 25.0-<30.0 and ≥30.0 kg/m2 ) and presence of the metabolic syndrome into 6 phenotypes: metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUNW), metabolically healthy overweight (MHOW), metabolically unhealthy overweight (MUOW), metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO). Neither BMI nor presence of the metabolic syndrome was associated with risk of colorectal cancer, whereas waist circumference showed a robust positive association. Relative to the MHNW phenotype, the MUNW phenotype was associated with increased risk, whereas no other phenotype showed an association. Furthermore, HOMA-IR was not associated with increased risk. Overall, our results do not support a direct role of metabolic dysregulation in the development of colorectal cancer; however, they do suggest that higher waist circumference is a risk factor, possibly reflecting the effects of increased levels of cytokines and hormones in visceral abdominal fat on colorectal carcinogenesis.
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Affiliation(s)
- Geoffrey C Kabat
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Mimi Y Kim
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | | | - Gloria Y F Ho
- Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health, Great Neck, NY
| | - Dorothy S Lane
- Department of Preventive Medicine, School of Medicine, Stony Brook University, Stony Brook, NY
| | - Andrew O Odegaard
- Department of Epidemiology, School of Medicine, University of California at Irvine, Irvine, CA
| | | | - Jennifer W Bea
- Department of Medicine, Arizona Cancer Center, Tucson, AZ
| | - Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health, University of Indiana, Bloomington, IN
| | | | - Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
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19
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Pearson-Stuttard J, Zhou B, Kontis V, Bentham J, Gunter MJ, Ezzati M. Worldwide burden of cancer attributable to diabetes and high body-mass index: a comparative risk assessment. Lancet Diabetes Endocrinol 2018; 6:95-104. [PMID: 29195904 PMCID: PMC5805864 DOI: 10.1016/s2213-8587(17)30366-2] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 10/15/2017] [Accepted: 10/16/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Diabetes and high body-mass index (BMI) are associated with increased risk of several cancers, and are increasing in prevalence in most countries. We estimated the cancer incidence attributable to diabetes and high BMI as individual risk factors and in combination, by country and sex. METHODS We estimated population attributable fractions for 12 cancers by age and sex for 175 countries in 2012. We defined high BMI as a BMI greater than or equal to 25 kg/m2. We used comprehensive prevalence estimates of diabetes and BMI categories in 2002, assuming a 10-year lag between exposure to diabetes or high BMI and incidence of cancer, combined with relative risks from published estimates, to quantify contribution of diabetes and high BMI to site-specific cancers, individually and combined as independent risk factors and in a conservative scenario in which we assumed full overlap of risk of diabetes and high BMI. We then used GLOBOCAN cancer incidence data to estimate the number of cancer cases attributable to the two risk factors. We also estimated the number of cancer cases in 2012 that were attributable to increases in the prevalence of diabetes and high BMI from 1980 to 2002. All analyses were done at individual country level and grouped by region for reporting. FINDINGS We estimated that 5·6% of all incident cancers in 2012 were attributable to the combined effects of diabetes and high BMI as independent risk factors, corresponding to 792 600 new cases. 187 600 (24·5%) of 766 000 cases of liver cancer and 121 700 (38·4%) of 317 000 cases of endometrial cancer were attributable to these risk factors. In the conservative scenario, about 4·5% (626 900 new cases) of all incident cancers assessed were attributable to diabetes and high BMI combined. Individually, high BMI (544 300 cases) was responsible for twice as many cancer cases as diabetes (280 100 cases). 26·1% of diabetes-related cancers (equating to 77 000 new cases) and 31·9% of high BMI-related cancers (174 040 new cases) were attributable to increases in the prevalence of these risk factors from 1980 to 2002. INTERPRETATION A substantial number of cancer cases are attributable to diabetes and high BMI. As the prevalence of these cancer risk factors increases, clinical and public health efforts should focus on identifying optimal preventive and screening measures for whole populations and individual patients. FUNDING NIHR and Wellcome Trust.
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Affiliation(s)
- Jonathan Pearson-Stuttard
- School of Public Health, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
| | - Bin Zhou
- School of Public Health, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Vasilis Kontis
- School of Public Health, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - James Bentham
- School of Public Health, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK; School of Mathematics, Statistics and Actuarial Science (SMSAS), University of Kent, Canterbury, UK
| | - Marc J Gunter
- Nutrition and Metabolism Section, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Majid Ezzati
- School of Public Health, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK; WHO Collaborating Centre on NCD Surveillance and Epidemiology, Imperial College London, London, UK
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20
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Djuric Z, Turgeon DK, Sen A, Ren J, Herman K, Ramaswamy D, Zhao L, Ruffin MT, Normolle DP, Smith WL, Brenner DE. The Anti-inflammatory Effect of Personalized Omega-3 Fatty Acid Dosing for Reducing Prostaglandin E 2 in the Colonic Mucosa Is Attenuated in Obesity. Cancer Prev Res (Phila) 2017; 10:729-737. [PMID: 29133307 DOI: 10.1158/1940-6207.capr-17-0091] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 07/12/2017] [Accepted: 10/02/2017] [Indexed: 12/20/2022]
Abstract
This clinical trial developed a personalized dosing model for reducing prostaglandin E2 (PGE2) in colonic mucosa using ω-3 fatty acid supplementation. The model utilized serum eicosapentaenoic acid (EPA, ω-3):arachidonic acid (AA, ω-6) ratios as biomarkers of colonic mucosal PGE2 concentration. Normal human volunteers were given low and high ω-3 fatty acid test doses for 2 weeks. This established a slope and intercept of the line for dose versus serum EPA:AA ratio in each individual. The slope and intercept was utilized to calculate a personalized target dose that was given for 12 weeks. This target dose was calculated on the basis of a model, initially derived from lean rodents, showing a log-linear relationship between serum EPA:AA ratios and colonic mucosal PGE2 reduction. Bayesian methods allowed addition of human data to the rodent model as the trial progressed. The dosing model aimed to achieve a serum EPA:AA ratio that is associated with a 50% reduction in colonic PGE2 Mean colonic mucosal PGE2 concentrations were 6.55 ng/mg protein (SD, 5.78) before any supplementation and 3.59 ng/mg protein (SD, 3.29) after 12 weeks of target dosing. In secondary analyses, the decreases in PGE2 were significantly attenuated in overweight and obese participants. This occurred despite a higher target dose for the obese versus normal weight participants, as generated by the pharmacodynamic predictive model. Large decreases also were observed in 12-hydroxyicosatetraenoic acids, and PGE3 increased substantially. Future biomarker-driven dosing models for cancer prevention therefore should consider energy balance as well as overall eicosanoid homeostasis in normal tissue. Cancer Prev Res; 10(12); 729-37. ©2017 AACR.
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Affiliation(s)
- Zora Djuric
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan.
| | - D Kim Turgeon
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | - Ananda Sen
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan.,Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Jianwei Ren
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | - Kirk Herman
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | - Devon Ramaswamy
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | - Lili Zhao
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Mack T Ruffin
- Department of Family and Community Medicine, Penn State Hershey Medical Center, Hershey, Pennsylvania
| | - Daniel P Normolle
- Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - William L Smith
- Department of Biological Chemistry, University of Michigan Medical School, Ann Arbor, Michigan
| | - Dean E Brenner
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan.,Department of Pharmacology, University of Michigan Medical School, Ann Arbor, Michigan
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21
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Thomson CA, Crane TE, Garcia DO, Wertheim BC, Hingle M, Snetselaar L, Datta M, Rohan T, LeBlanc E, Chlebowski RT, Qi L. Association between Dietary Energy Density and Obesity-Associated Cancer: Results from the Women's Health Initiative. J Acad Nutr Diet 2017; 118:617-626. [PMID: 28826845 DOI: 10.1016/j.jand.2017.06.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 06/11/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Dietary energy density (DED) is the ratio of energy (kilocalories or kilojoules) intake to food weight (grams) and is a measure of diet quality. Consumption of foods high in DED has been associated with weight gain in adults. OBJECTIVE To investigate the association between baseline DED and incident obesity-associated cancers in the Women's Health Initiative. DESIGN Prospective cohort study of clinical trial and observational study participants. PARTICIPANTS/SETTING Postmenopausal women aged 50 to 79 years (N=92,295) enrolled in the observational study or the calcium and vitamin D trial and hormone replacement therapy trials of the Women's Health Initiative. MAIN OUTCOME MEASURES Incident, medical record-adjudicated, obesity-related cancers during follow-up. Exposure variable was DED (kilocalories per gram for the total diet) from self-reported dietary intake at baseline using a food frequency questionnaire. STATISTICAL ANALYSES The associations between DED and each incident cancer, or any obesity-related cancer, were examined using competing-risks regression models, with death as a competing risk. Body mass index-stratified models were generated to investigate body mass index as a potential modifying factor. RESULTS DED was associated with higher body mass index (28.9±6.0 vs 26.3±4.9) and waist circumference (89.3±14.2 vs 82.4±12.4 cm) for DED quintiles 5 vs 1, respectively. DED was associated with a 10% increased risk of any obesity-related cancer (subhazard ratioQ5 vs Q1: 1.1, 95% CI 1.03 to 1.2; P=0.004). This increased risk appeared limited to women who were normal weight at enrollment. CONCLUSIONS Higher DED may be a contributing factor for obesity-related cancers, especially among normal-weight postmenopausal women and, as such, could serve as a modifiable behavior for dietary interventions to reduce obesity-associated cancer risk.
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