1
|
Leiby JS, Lee ME, Shivakumar M, Choe EK, Kim D. Deep learning imaging phenotype can classify metabolic syndrome and is predictive of cardiometabolic disorders. J Transl Med 2024; 22:434. [PMID: 38720370 PMCID: PMC11077781 DOI: 10.1186/s12967-024-05163-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 04/04/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Cardiometabolic disorders pose significant health risks globally. Metabolic syndrome, characterized by a cluster of potentially reversible metabolic abnormalities, is a known risk factor for these disorders. Early detection and intervention for individuals with metabolic abnormalities can help mitigate the risk of developing more serious cardiometabolic conditions. This study aimed to develop an image-derived phenotype (IDP) for metabolic abnormality from unenhanced abdominal computed tomography (CT) scans using deep learning. We used this IDP to classify individuals with metabolic syndrome and predict future occurrence of cardiometabolic disorders. METHODS A multi-stage deep learning approach was used to extract the IDP from the liver region of unenhanced abdominal CT scans. In a cohort of over 2,000 individuals the IDP was used to classify individuals with metabolic syndrome. In a subset of over 1,300 individuals, the IDP was used to predict future occurrence of hypertension, type II diabetes, and fatty liver disease. RESULTS For metabolic syndrome (MetS) classification, we compared the performance of the proposed IDP to liver attenuation and visceral adipose tissue area (VAT). The proposed IDP showed the strongest performance (AUC 0.82) compared to attenuation (AUC 0.70) and VAT (AUC 0.80). For disease prediction, we compared the performance of the IDP to baseline MetS diagnosis. The models including the IDP outperformed MetS for type II diabetes (AUCs 0.91 and 0.90) and fatty liver disease (AUCs 0.67 and 0.62) prediction and performed comparably for hypertension prediction (AUCs of 0.77). CONCLUSIONS This study demonstrated the superior performance of a deep learning IDP compared to traditional radiomic features to classify individuals with metabolic syndrome. Additionally, the IDP outperformed the clinical definition of metabolic syndrome in predicting future morbidities. Our findings underscore the utility of data-driven imaging phenotypes as valuable tools in the assessment and management of metabolic syndrome and cardiometabolic disorders.
Collapse
Affiliation(s)
- Jacob S Leiby
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, 19104, Philadelphia, PA, USA
| | - Matthew E Lee
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, 19104, Philadelphia, PA, USA
| | - Manu Shivakumar
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, 19104, Philadelphia, PA, USA
| | - Eun Kyung Choe
- Department of Surgery, Seoul National University Hospital Healthcare System Gangnam Center, 06236, Seoul, South Korea.
| | - Dokyoon Kim
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, 19104, Philadelphia, PA, USA.
- Institute for Biomedical Informatics, Perelman School of Medicine, University of Pennsylvania, 19104, Philadelphia, PA, USA.
| |
Collapse
|
2
|
Ma W, Zhu H, Yu X, Zhai X, Li S, Huang N, Liu K, Shirai K, Sheerah HA, Cao J. Association between android fat mass, gynoid fat mass and cardiovascular and all-cause mortality in adults: NHANES 2003-2007. Front Cardiovasc Med 2023; 10:1055223. [PMID: 37273879 PMCID: PMC10233278 DOI: 10.3389/fcvm.2023.1055223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 04/14/2023] [Indexed: 06/06/2023] Open
Abstract
Objectives Evidence of the relationship between android fat mass and gynoid fat mass with the mortality prediction is still limited. Current study analyzed the NHANES database to investigate the relationship between android fat mass, gynoid fat mass and CVD, with all-cause mortality. Method The study subjects were NHANES participants over 20 years old, two indicators of regional body composition, android fat and gynoid fat were measured by Dual Energy x-ray Absorptiometry (DEXA). The other various covariates data obtained from the NHANES questionnaire and laboratory measurements, including age, gender, education, race/ethnicity, uric acid, total serum cholesterol, albumin, Vitamin C, folate, alcohol drinking, smoking status, history of diabetes, and hypertension. Mortality status was ascertained from a linked mortality file prepared by the National Center for Health Statistics. The study population was divided quartiles based on the distribution of android fat mass and gynoid fat mass. The relationship between these two indicators with cardiovascular and all-cause mortality was investigated by using Cox regression. The covariates age, gender, smoking status, drinking status, history of diabetes, and history of hypertension were stratified. Results In the fully adjusted model, Q3 had the lowest HR in android fat mass and gynoid fat mass. When examining the relationship between android fat mass and CVD mortality, current smokers and drinkers had the lowest CVD risk in Q2 [smoking: 0.21 (0.08, 0.52), drinking: 0.14 (0.04, 0.50)]. In diabetic patients, compared with Q1, other groups with increased android fat mass can significantly reduce the risk of CVD [Q4: 0.17 (0.04, 0.75), Q3: 0.18 (0.03, 1.09), Q2: 0.27 (0.09, 0.83)]. In ≥60 years old and female, the greater the gynoid fat mass, the smaller the HR of all-cause mortality [Q4 for ≥60 years old: 0.57 (0.33, 0.96), Q4 for female: 0.37 (0.23, 0.58)]. People <60 years old had a lower risk of all-cause mortality with gynoid fat mass in Q3 than those ≥60 years old [<60 years: 0.50 (0.27, 0.91), ≥60 years: 0.65 (0.45, 0.95)]. Among subjects without hypertension, the group with the largest android fat mass had the lowest risk of CVD mortality, and the group with the largest gynoid fat mass had the lowest risk of all-cause mortality [Android fat mass: 0.36 (0.16, 0.81), gynoid fat mass: 0.57 (0.39, 0.85)]. Conclusion Moderate android fat mass and gynoid fat mass (Q3) had the most protective effect. Smokers and drinkers need to control their body fat. Being too thin is harmful to people with diabetes. Increased gynoid fat mass is a protective factor for all-cause mortality in older adults and females. Young people's gynoid fat mass is more protective in the moderate range than older people's. If no high blood pressure exists, people with more android and gynoid fat mass have a lower risk of CVD or all-cause mortality.
Collapse
Affiliation(s)
- Wenzhi Ma
- School of Public Health, Wuhan University, Wuhan, China
| | - Huiping Zhu
- School of Public Health, Capital Medical University, Beijing, China
| | - Xinyi Yu
- School of Public Health, Capital Medical University, Beijing, China
| | - Xiaobing Zhai
- Center for Artificial Intelligence Driven Drug Discovery, Faculty of Applied Sciences, Macao Polytechnic University, Macao, China
| | - Shiyang Li
- School of Public Health, Wuhan University, Wuhan, China
| | - Nian Huang
- School of Public Health, Wuhan University, Wuhan, China
| | - Keyang Liu
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita-shi, Japan
| | - Kokoro Shirai
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita-shi, Japan
| | - Haytham A. Sheerah
- Assistant Deputyship for International Collaborations, Ministry of Health, Riyadh, Saudi Arabia
| | - Jinhong Cao
- School of Management, Hubei University of Chinese Medicine, Wuhan, China
- Research Center for the Development of Chinese Medicine, Hubei Province Project of Key Research Institute of Humanities and Social Sciences at Universities, Wuhan, China
| |
Collapse
|
3
|
Han J, Liu X, Tang M, Yang F, Ding Z, Wu G. Abdominal fat and muscle distributions in different stages of colorectal cancer. BMC Cancer 2023; 23:279. [PMID: 36978044 PMCID: PMC10044362 DOI: 10.1186/s12885-023-10736-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 03/13/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND The purpose of this study is to explore the difference of abdominal fat and muscle composition, especially subcutaneous and visceral adipose tissue, in different stages of colorectal cancer (CRC). MATERIALS AND METHODS Patients were divided into 4 groups: healthy controls (patients without colorectal polyp), polyp group (patients with colorectal polyp), cancer group (CRC patients without cachexia), and cachexia group (CRC patients with cachexia). Skeletal muscle (SM), subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and intermuscular adipose tissue (IMAT) were assessed at the third lumbar level on computed tomography images obtained within 30 days before colonoscopy or surgery. One-way ANOVA and linear regression were used to analyze the difference of abdominal fat and muscle composition in different stages of CRC. RESULTS A total of 1513 patients were divided into healthy controls, polyp group, cancer group, and cachexia group, respectively. In the development of CRC from normal mucosa to polyp and cancer, the VAT area of the polyp group was significantly higher than that of the healthy controls both in male (156.32 ± 69.71 cm2 vs. 141.97 ± 79.40 cm2, P = 0.014) and female patients (108.69 ± 53.95 cm2 vs. 96.28 ± 46.70 cm2, P = 0.044). However, no significant differences were observed of SAT area between polyp group and healthy controls in both sexes. SAT area decreased significantly in the male cancer group compared with the polyp group (111.16 ± 46.98 cm2 vs. 126.40 ± 43.52 cm2, P = 0.001), while no such change was observed in female patients. When compared with healthy controls, the SM, IMAT, SAT, and VAT areas of cachexia group was significantly decreased by 9.25 cm2 (95% CI: 5.39-13.11 cm2, P < 0.001), 1.93 cm2 (95% CI: 0.54-3.32 cm2, P = 0.001), 28.84 cm2 (95% CI: 17.84-39.83 cm2, P < 0.001), and 31.31 cm2 (95% CI: 18.12-44.51 cm2, P < 0.001) after adjusting for age and gender. CONCLUSION Abdominal fat and muscle composition, especially SAT and VAT, was differently distributed in different stages of CRC. It is necessary to pay attention to the different roles of subcutaneous and visceral adipose tissue in the development of CRC.
Collapse
Affiliation(s)
- Jun Han
- Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
- Shanghai Clinical Nutrition Research Center, Shanghai, China
| | - Xinyang Liu
- Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Min Tang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Fan Yang
- Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Zuoyou Ding
- Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Guohao Wu
- Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
- Shanghai Clinical Nutrition Research Center, Shanghai, China.
| |
Collapse
|
4
|
Role of Perirectal Fat in the Carcinogenesis and Development of Early-Onset Rectal Cancer. JOURNAL OF ONCOLOGY 2022; 2022:4061142. [PMID: 35368890 PMCID: PMC8965599 DOI: 10.1155/2022/4061142] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 02/24/2022] [Accepted: 03/05/2022] [Indexed: 11/17/2022]
Abstract
Purpose The incidence of early-onset rectal cancer (EORC) has been increasing since the past decade, while its underlying cause remained unknown. This study was aimed at clarifying the relationship between perirectal fat area (PFA) and EORC. Patients and Methods. All patients with rectal cancer who received radical excision between January 2016 and December 2017 at our hospital were included. The fat series images of pelvic magnetic resonance imaging scans were obtained and PFA at the ischial spine level was calculated using the ImageJ software. Results A total of 303 patients were finally included and divided into two groups according to the median PFA: Group 1 (<20.2 cm2, n = 151) and Group 2 (≥20.2 cm2, n = 152). PFA positively correlated with body weight and body mass index. PFA increased with invasion depth, lymph node metastasis, TNM stage, tumor deposits, and vascular invasion. Patients with EORC had higher PFA than those with late-onset rectal cancer (LORC; P = 0.009). Among patients with stage I–III rectal cancers, those in Group 2 had significantly shorter disease-free survival (P = 0.010) and overall survival (P = 0.034) than those in Group 1, and PFA was an independent predictor of disease-free survival (OR: 1.683 [1.126-3.015], P = 0.035) and overall survival (OR: 1.678 [1.022-2.639], P = 0.046). Conclusions Patients with EORC had significantly higher PFA than those with LORC. PFA is positively correlated with T stage, N stage, TNM stage, tumor deposit, and vascular invasion and is an independent predictor of disease-free survival and overall survival. Therefore, perirectal fat may be involved in the carcinogenesis and development of EORC.
Collapse
|
5
|
Izquierdo AG, Boughanem H, Diaz-Lagares A, Arranz-Salas I, Esteller M, Tinahones FJ, Casanueva FF, Macias-Gonzalez M, Crujeiras AB. DNA methylome in visceral adipose tissue can discriminate patients with and without colorectal cancer. Epigenetics 2021; 17:665-676. [PMID: 34311674 DOI: 10.1080/15592294.2021.1950991] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Adipose tissue dysfunction, particularly the visceral (VAT) compartment, has been proposed to play a relevant role in colorectal cancer (CRC) development and progression. Epigenetic mechanisms could be involved in this association. The current study aimed to evaluate if specific epigenetic marks in VAT are associated with colorectal cancer (CRC) to identify epigenetic hallmarks of adipose tissue-related CRC. Epigenome-wide DNA methylation was evaluated in VAT from 25 healthy participants and 29 CRC patients, using the Infinium HumanMethylation450K BeadChip. The epigenome-wide methylation analysis identified 170,184 sites able to perfectly separate the CRC and healthy samples. The differentially methylated CpG sites (DMCpGs) showed a global trend for increased methylated levels in CRC with respect to healthy group. Most of the genes encoded by the DMCpGs belonged to metabolic pathways and cell cycle, insulin resistance, and adipocytokine signalling, as well as tumoural transformation processes. In gene-specific analyses, involved genes biologically relevant for the development of CRC include PTPRN2, MAD1L1, TNXB, DIP2C, INPP5A, HDCA4, PRDM16, RPTOR, ATP11A, TBCD, PABPC3, and IER2. The methylation level of some of them showed a discriminatory capacity for detecting CRC higher than 90%, showing IER2 to have the highest capacity. This study reveals that a specific methylation pattern of VAT is associated with CRC. Some of the epigenetic marks identified could provide useful tools for the prediction and personalized treatment of CRC connected to excess adiposity.
Collapse
Affiliation(s)
- Andrea G Izquierdo
- Epigenomics in Endocrinology and Nutrition Group, Epigenomics Unit, Instituto De Investigacion Sanitaria De Santiago De Compostela (IDIS), Complejo Hospitalario Universitario De Santiago De Compostela (CHUS/SERGAS), and Centro De Investigacion Biomedica En Red Fisiopatologia De La Obesidad Y Nutricion (Ciberobn), Spain
| | - Hatim Boughanem
- Department of Endocrinology and Nutrition, Virgen De La Victoria University Hospital, University of Malaga (IBIMA), Spain and Centro De Investigacion Biomedica En Red Physiopathology of Obesity and Nutrition (Ciberobn), Málaga, Spain
| | - Angel Diaz-Lagares
- Cancer Epigenetics, Translational Medical Oncology (Oncomet), Instituto De Investigacion Sanitaria De Santiago De Compostela (IDIS), Complejo Hospitalario Universitario De Santiago De Compostela (CHUS/SERGAS), and Centro De Investigacion Biomedica En Red Oncología (CIBERONC), Spain
| | - Isabel Arranz-Salas
- Unit of Anatomical Pathology, Virgen de la Victoria University Hospital, Málaga, Spain
| | - Manel Esteller
- Josep Carreras Leukemia Research Institute (IJC), Badalona, Barcelona, Catalonia, Spain; Centro De Investigacion Biomedica En Red Oncologia (CIBERONC), Madrid, Spain; Institucio Catalana De Recerca I Estudis Avançats (ICREA), Barcelona, Catalonia, Spain; Physiological Sciences Department, School of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, Catalonia, Spain
| | - Francisco J Tinahones
- Department of Endocrinology and Nutrition, Virgen De La Victoria University Hospital, University of Malaga (IBIMA), Spain and Centro De Investigacion Biomedica En Red Physiopathology of Obesity and Nutrition (Ciberobn), Málaga, Spain
| | - Felipe F Casanueva
- Molecular and Cellular Endocrinology Group. Instituto De Investigacion Sanitaria De Santiago De Compostela (IDIS), Complejo Hospitalario Universitario De Santiago De Compostela (CHUS), Santiago De Compostela University (USC) and Centro De Investigacion Biomedica En Red Fisiopatologia De La Obesidad Y Nutricion (Ciberobn), Spain
| | - Manuel Macias-Gonzalez
- Department of Endocrinology and Nutrition, Virgen De La Victoria University Hospital, University of Malaga (IBIMA), Spain and Centro De Investigacion Biomedica En Red Physiopathology of Obesity and Nutrition (Ciberobn), Málaga, Spain
| | - Ana B Crujeiras
- Epigenomics in Endocrinology and Nutrition Group, Epigenomics Unit, Instituto De Investigacion Sanitaria De Santiago De Compostela (IDIS), Complejo Hospitalario Universitario De Santiago De Compostela (CHUS/SERGAS), and Centro De Investigacion Biomedica En Red Fisiopatologia De La Obesidad Y Nutricion (Ciberobn), Spain
| |
Collapse
|
6
|
The Relationship Between Colorectal Cancer and Abdominal Adipose Tissue Distribution. JOURNAL OF CONTEMPORARY MEDICINE 2021. [DOI: 10.16899/jcm.879490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
7
|
Bader J, Carson M, Enos R, Velazquez K, Sougiannis A, Singh U, Becker W, Nagarkatti M, Fan D, Murphy A. High-fat diet-fed ovariectomized mice are susceptible to accelerated subcutaneous tumor growth potentially through adipose tissue inflammation, local insulin-like growth factor release, and tumor associated macrophages. Oncotarget 2020; 11:4554-4569. [PMID: 33346251 PMCID: PMC7733624 DOI: 10.18632/oncotarget.27832] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 11/03/2020] [Indexed: 12/20/2022] Open
Abstract
Background: The association between obesity and colorectal cancer (CRC) risk has been well established. This relationship appears to be more significant in men than in women, which may be attributable to sex hormones. However, controlled animal studies to substantiate these claims and the mechanisms involved are lacking. Materials and Methods: MC38 murine colon adenocarcinoma cells were injected subcutaneously into high-fat diet (HFD) fed male, female and ovariectomized (OVX) female C57BL/6 mice. Results: HFD increased tumor growth (main effect) that was consistent with metabolic perturbations (P < 0.01). HFD OVX mice exhibited the most significant tumor growth compared to HFD male and female mice (p < 0.05) and this was associated with increased subcutaneous adipose tissue (p < 0.05). Further, the subcutaneous adipose tissue depots within HFD OVX mice exhibited more severe macrophage associated inflammation compared to female (P < 0.01), but not male mice. Conditioned media from subcutaneous adipose tissue of HFD OVX contained higher IGF-1 levels compared to male (P < 0.01), but not female mice. Finally, HFD OVX mice had increased M2-like gene expression in their tumor-associated macrophages (TAMs) compared to female mice (P < 0.01). Conclusions: This work provides evidences suggesting adiposity, adipose specific IGF-1, macrophage associated adipose inflammation, and TAMs as potential mechanisms driving obesity-enhanced CRC in females lacking ovarian hormones.
Collapse
Affiliation(s)
- Jackie Bader
- Department of Pathology, Microbiology, & Immunology, School of Medicine, University of South Carolina, Columbia, SC 29209, USA
| | - Meredith Carson
- Department of Pathology, Microbiology, & Immunology, School of Medicine, University of South Carolina, Columbia, SC 29209, USA
| | - Reilly Enos
- Department of Pathology, Microbiology, & Immunology, School of Medicine, University of South Carolina, Columbia, SC 29209, USA
| | - Kandy Velazquez
- Department of Pathology, Microbiology, & Immunology, School of Medicine, University of South Carolina, Columbia, SC 29209, USA
| | - Alexander Sougiannis
- Department of Pathology, Microbiology, & Immunology, School of Medicine, University of South Carolina, Columbia, SC 29209, USA
| | - Udai Singh
- Department of Medicine, University of Virginia Health Systems, Charlottesville, VA 22908, USA
| | - William Becker
- Department of Pathology, Microbiology, & Immunology, School of Medicine, University of South Carolina, Columbia, SC 29209, USA
| | - Mitzi Nagarkatti
- Department of Pathology, Microbiology, & Immunology, School of Medicine, University of South Carolina, Columbia, SC 29209, USA
| | - Daping Fan
- Department of Cell Biology and Anatomy, School of Medicine, University of South Carolina, Columbia, SC 29209, USA
| | - Angela Murphy
- Department of Pathology, Microbiology, & Immunology, School of Medicine, University of South Carolina, Columbia, SC 29209, USA
| |
Collapse
|
8
|
Ose J, Holowatyj AN, Nattenmüller J, Gigic B, Lin T, Himbert C, Habermann N, Achaintre D, Scalbert A, Keski-Rahkonen P, Böhm J, Schrotz-King P, Schneider M, Ulrich A, Kampman E, Weijenberg M, Gsur A, Ueland PM, Kauczor HU, Ulrich CM. Metabolomics profiling of visceral and abdominal subcutaneous adipose tissue in colorectal cancer patients: results from the ColoCare study. Cancer Causes Control 2020; 31:723-735. [PMID: 32430684 PMCID: PMC7425810 DOI: 10.1007/s10552-020-01312-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 05/04/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Underlying mechanisms of the relationship between body fatness and colorectal cancer remain unclear. This study investigated associations of circulating metabolites with visceral (VFA), abdominal subcutaneous (SFA), and total fat area (TFA) in colorectal cancer patients. METHODS Pre-surgery plasma samples from 212 patients (stage I-IV) from the ColoCare Study were used to perform targeted metabolomics. VFA, SFA, and TFA were quantified by computed tomography scans. Partial correlation and linear regression analyses of VFA, SFA, and TFA with metabolites were computed and corrected for multiple testing. Cox proportional hazards were used to assess 2-year survival. RESULTS In patients with metastatic tumors, SFA and TFA were statistically significantly inversely associated with 16 glycerophospholipids (SFA: pFDR range 0.017-0.049; TFA: pFDR range 0.029-0.048), while VFA was not. Doubling of ten of the aforementioned glycerophospholipids was associated with increased risk of death in patients with metastatic tumors, but not in patients with non-metastatic tumors (phet range: 0.00044-0.049). Doubling of PC ae C34:0 was associated with ninefold increased risk of death in metastatic tumors (Hazard Ratio [HR], 9.05; 95% confidence interval [CI] 2.17-37.80); an inverse association was observed in non-metastatic tumors (HR 0.17; 95% CI 0.04-0.87; phet = 0.00044). CONCLUSION These data provide initial evidence that glycerophospholipids in metastatic colorectal cancer are uniquely associated with subcutaneous adiposity, and may impact overall survival.
Collapse
Affiliation(s)
- Jennifer Ose
- Huntsman Cancer Institute, Salt Lake City, UT, USA.
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.
| | - Andreana N Holowatyj
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Johanna Nattenmüller
- Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
| | - Biljana Gigic
- Department of General, Visceral and Transplantation Surgery, University Hospital of Heidelberg, Heidelberg, Germany
| | - Tengda Lin
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Caroline Himbert
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Nina Habermann
- Genome Biology Unit, European Molecular Biology Laboratory, Heidelberg, Germany
| | - David Achaintre
- International Agency Research on Cancer (IARC), Lyon, France
| | | | | | - Jürgen Böhm
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Petra Schrotz-King
- Division of Preventive Oncology, German Cancer Research Center (DKFZ), National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Martin Schneider
- Department of General, Visceral and Transplantation Surgery, University Hospital of Heidelberg, Heidelberg, Germany
| | - Alexis Ulrich
- Department of General, Visceral and Transplantation Surgery, University Hospital of Heidelberg, Heidelberg, Germany
| | - Ellen Kampman
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Matty Weijenberg
- Department of Epidemiology, GROW - School of Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Andrea Gsur
- Institute of Cancer Research, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | | | - Hans-Ulrich Kauczor
- Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
| | - Cornelia M Ulrich
- Huntsman Cancer Institute, Salt Lake City, UT, USA.
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.
| |
Collapse
|
9
|
Ng ZQ, Wijesuriya R, Misur P, Tan JH, Moe KS, Theophilus M. Opportunistic use of radiological measures of visceral adiposity for assessment of risk of colorectal adenoma. ANZ J Surg 2020; 90:2298-2303. [PMID: 32501646 DOI: 10.1111/ans.16063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 05/09/2020] [Accepted: 05/19/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Recent evidence suggested that radiological measures of visceral adiposity are a better tool for risk assessment of colorectal adenomas. The aim of this study was to investigate the association of visceral adiposity with the development of colorectal adenomas. METHODS A retrospective review of all cases of computed tomography-confirmed acute diverticulitis from November 2015 to April 2018 was performed. Data collated included basic demographics, computed tomography scan results (uncomplicated versus complicated diverticulitis), treatment modality (conservative versus intervention), outcomes and follow-up colonoscopy results within 12 months of presentation. The patients were divided into no adenoma (A) and adenoma (B) groups. Visceral fat area (VFA), subcutaneous fat area (SFA) and VFA/SFA ratio (V/S) were measured at L4/L5 level. Statistical analysis was performed to evaluation the association of VFA, SFA, V/S and different thresholds with the risk of adenoma formation. RESULTS A total of 169 patients were included in this study (A:B = 123:46). The mean ± standard deviation for VFA was higher in group B (201 ± 87 cm2 versus 176 ± 79 cm2 ) with a trend towards statistical significance (P = 0.08). There was no difference in SFA and V/S in both groups. When the VFA >200 cm2 was analysed, it was associated with a threefold risk of adenoma formation (odds ratio 2.7, 95% confidence interval 1.35-5.50, P = 0.006). Subgroup analysis of gender with VFA, SFA and V/S found that males have a significantly higher VFA in group B (220.0 ± 95.2 cm2 versus 187.3 ± 69.2 cm2 ; P = 0.05). CONCLUSIONS The radiological measurement of visceral adiposity is a useful tool for opportunistic assessment of risk of colorectal adenoma.
Collapse
Affiliation(s)
- Zi Qin Ng
- Department of General Surgery, St John of God Midland Hospital, Perth, Western Australia, Australia
| | - Ruwan Wijesuriya
- Department of General Surgery, St John of God Midland Hospital, Perth, Western Australia, Australia.,School of Medicine, University of Notre Dame, Fremantle, Western Australia, Australia
| | - Philip Misur
- Perth Radiological Clinic, St John of God Midland Hospital, Perth, Western Australia, Australia
| | - Jih Huei Tan
- Department of General Surgery, Hospital Sultanah Aminah, Johor Bahru, Malaysia
| | - Kyaw Soe Moe
- Department of General Surgery, St John of God Midland Hospital, Perth, Western Australia, Australia
| | - Mary Theophilus
- Department of General Surgery, St John of God Midland Hospital, Perth, Western Australia, Australia.,Curtin Medical School, Curtin University, Perth, Western Australia, Australia
| |
Collapse
|
10
|
Akay S, Urkan M, Balyemez U, Erşen M, Taşar M. Is visceral obesity associated with colorectal cancer? The first volumetric study using all CT slices. ACTA ACUST UNITED AC 2020; 25:338-345. [PMID: 31287430 DOI: 10.5152/dir.2019.18350] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE We aimed to examine the possible relationship between abdominal adiposity parameters and the presence of colorectal cancer (CRC) and between these adiposity parameters and various histopathologic findings of the tumor. METHODS A total of 60 control subjects and 111 CRC patients, 63 with early-stage and 48 with advanced-stage disease, were enrolled. Medical data and abdominopelvic computed tomography (CT) examinations of each study group were retrospectively reviewed. Abdominal adiposity parameters, including visceral adipose tissue (VAT) volume, subcutaneous adipose tissue (SAT) volume, and total adipose tissue (TAT) volume, were calculated on all slices of the CT examinations with specialized software, and results for each study group were compared. Adiposity parameters were also compared with tumor histopathologic findings. RESULTS We found lower VAT and higher SAT volumes in advanced-stage CRC patients, compared with the early-stage group. However, this relationship was not statistically significant (P = 0.721 for VAT and P = 0.432 for SAT volumes). We detected significantly lower VAT and SAT volumes in the early-stage CRC group compared with the control group (P = 0.014 for both). There was no significant relationship between TAT volumes and the study groups (P = 0.06). No statistically significant relationship was detected between adipose tissue parameters and histopathologic features of the CRC group (P > 0.05). CONCLUSION We found statistically significant lower VAT and SAT volumes in patients with early-stage CRC compared with the control group. Volumetric adipose tissue measurements may be more accurate than area measurements and can easily be performed on abdominopelvic CT examination, which is the routine imaging modality for CRC patients.
Collapse
Affiliation(s)
- Sinan Akay
- Department of Radiology, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Murat Urkan
- Department of General Surgery, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Uğurcan Balyemez
- Department of Radiology, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Mehmet Erşen
- Department of Radiology, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Mustafa Taşar
- Department of Radiology, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
11
|
Spychalski P, Kobiela J, Wieszczy P, Kamiński MF, Reguła J. Clinical stages of colorectal cancer diagnosed in obese and overweight individuals in the Polish Colonoscopy Screening Program. United European Gastroenterol J 2019; 7:790-797. [PMID: 31316783 DOI: 10.1177/2050640619840451] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 03/07/2019] [Indexed: 12/14/2022] Open
Abstract
Background Obesity is a known risk factor of colorectal cancer (CRC). However, precise interconnections between excessive body fat and CRC are still vague. Therefore, the aim of this study was to assess whether stage of CRC detected in overweight and obese individuals differs from individuals with normal body mass index (BMI). A secondary aim of this study was to elucidate whether overweight and obesity influence the overall survival in CRC. Methods This study was a cross-sectional analysis of 163,129 individuals who underwent screening colonoscopy performed on data from a prospectively maintained database of the Polish Colonoscopy Screening Program. Results Overweight and obese individuals present with a less advanced CRC in screening setting (p = 0.014). This trend is the most pronounced in males (p = 0.001). Univariable and multivariable analyses revealed that obesity was a negative predictor of detection of advanced CRC with odds ratio 0.72 (95% confidence interval 0.52-1.00; p = 0.047). Furthermore, overweight and obesity were not statistically significant predictors of risk of death (p = 0.614 and p = 0.446, respectively). Conclusions Obese screenees present with a less advanced disease in comparison to non-obese. Moreover, survival stratified by clinical stage seems to not be influenced by BMI category. Therefore, a higher proportion of early diagnosed cancers can potentially create a survival benefit in this group.
Collapse
Affiliation(s)
- Piotr Spychalski
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland
| | - Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland.,Department of Cancer Prevention, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Paulina Wieszczy
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland.,Department of Cancer Prevention, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Michał F Kamiński
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland.,Department of Oncological Gastroenterology, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland.,Institute of Health and Society, University of Oslo, Oslo, Norway.,Department of Cancer Prevention, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Jarosław Reguła
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland.,Department of Cancer Prevention, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| |
Collapse
|
12
|
Jung IS, Shin CM, Park SJ, Park YS, Yoon H, Jo HJ, Kim N, Lee DH. Association of visceral adiposity and insulin resistance with colorectal adenoma and colorectal cancer. Intest Res 2018; 17:404-412. [PMID: 30419640 PMCID: PMC6667358 DOI: 10.5217/ir.2018.00072] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 10/01/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND/AIMS To examine whether visceral adiposity serves as a risk factor for colorectal cancer (CRC) and colorectal adenomas. METHODS Two hundred healthy subjects, 200 patients with colorectal adenoma, and 151 patients with CRC (46 with early-stage and 105 with advanced-stage cancers) were enrolled at a tertiary referral hospital. All subjects underwent colonoscopy, and had laboratory data, and computed tomography (CT) scan available for abdominal fat measurement. An abdominal CT scan taken 1 to 4 years (mean interval, 20.6 months) before the diagnosis of CRC was also available in the 42 CRC patients. RESULTS The mean areas of visceral adipose tissue (VAT) areas in the control, adenoma, early- and advanced-stage CRC groups were 94.6, 116.8, 110.4, and 99.7 cm2 , respectively (P<0.001). The risk of adenoma positively correlated with VAT area and the visceral-to-total fat ratio (P for trend <0.01), but the risk of CRC did not (P>0.05). The risk of both adenoma and CRC positively correlated with fasting plasma glucose levels (P for trend <0.05). In patients with early-stage cancer (n=17), VAT area decreased when the CT scan at diagnosis was compared with that taken before the diagnosis of CRC, but superficial adipose tissue area did not, so visceral-to-total fat ratio significantly decreased (46.6% vs. 50.7%, respectively, P=0.018). CONCLUSIONS VAT area is related to the risk of colorectal adenoma. However, VAT decreases from the early stages of CRC. Impaired fasting glucose has a role in colorectal carcinogenesis.
Collapse
Affiliation(s)
- In Sub Jung
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Cheol Min Shin
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sung Jae Park
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Young Soo Park
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyuk Yoon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyun Jin Jo
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Health Promotion Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Nayoung Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Dong Ho Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| |
Collapse
|
13
|
Grizzi F, Basso G, Borroni EM, Cavalleri T, Bianchi P, Stifter S, Chiriva-Internati M, Malesci A, Laghi L. Evolving notions on immune response in colorectal cancer and their implications for biomarker development. Inflamm Res 2018; 67:375-389. [PMID: 29322204 DOI: 10.1007/s00011-017-1128-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 12/27/2017] [Accepted: 12/29/2017] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Colorectal cancer (CRC) still represents the third most commonly diagnosed type of cancer in men and women worldwide. CRC is acknowledged as a heterogeneous disease that develops through a multi-step sequence of events driven by clonal selections; this observation is sustained by the fact that histologically similar tumors may have completely different outcomes, including a varied response to therapy. METHODS In "early" and "intermediate" stage of CRC (stages II and III, respectively) there is a compelling need for new biomarkers fit to assess the metastatic potential of their disease, selecting patients with aggressive disease that might benefit from adjuvant and targeted therapies. Therefore, we review the actual notions on immune response in colorectal cancer and their implications for biomarker development. RESULTS The recognition of the key role of immune cells in human cancer progression has recently drawn attention on the tumor immune microenvironment, as a source of new indicators of tumor outcome and response to therapy. Thus, beside consolidated histopathological biomarkers, immune endpoints are now emerging as potential biomarkers. CONCLUSIONS The introduction of immune signatures and cellular and molecular components of the immune system as biomarkers is particularly important considering the increasing use of immune-based cancer therapies as therapeutic strategies for cancer patients.
Collapse
Affiliation(s)
- Fabio Grizzi
- Department of Immunology and Inflammation, Humanitas Clinical and Research Center, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
| | - Gianluca Basso
- Laboratory of Molecular Gastroenterology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Elena Monica Borroni
- Department of Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Tommaso Cavalleri
- Laboratory of Molecular Gastroenterology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Paolo Bianchi
- Laboratory of Molecular Gastroenterology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Sanja Stifter
- Department of Pathology, School of Medicine, University of Rijeka, Rijeka, Croatia
| | | | - Alberto Malesci
- Laboratory of Molecular Gastroenterology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
- Department of Gastroenterology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
- Department of Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Luigi Laghi
- Laboratory of Molecular Gastroenterology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
- Department of Gastroenterology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
- Hereditary Cancer Genetics Clinic, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| |
Collapse
|
14
|
Wong MCS, Chan CH, Cheung W, Fung DH, Liang M, Huang JLW, Wang YH, Jiang JY, Yu CP, Wang HH, Wu JCY, Chan FKL, Sung JJY. Association between investigator-measured body-mass index and colorectal adenoma: a systematic review and meta-analysis of 168,201 subjects. Eur J Epidemiol 2017; 33:15-26. [PMID: 29288474 PMCID: PMC5803281 DOI: 10.1007/s10654-017-0336-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 11/23/2017] [Indexed: 12/11/2022]
Abstract
The objective of this meta-analysis is to evaluate the odds of colorectal adenoma (CRA) in colorectal cancer screening participants with different body mass index (BMI) levels, and examine if this association was different according to gender and ethnicity. The EMBASE and MEDLINE were searched to enroll high quality observational studies that examined the association between investigator-measured BMI and colonoscopy-diagnosed CRA. Data were independently extracted by two reviewers. A random-effects meta-analysis was conducted to estimate the summary odds ratio (SOR) for the association between BMI and CRA. The Cochran’s Q statistic and I2 analyses were used to assess the heterogeneity. A total of 17 studies (168,201 subjects) were included. When compared with subjects having BMI < 25, individuals with BMI 25–30 had significantly higher risk of CRA (SOR 1.44, 95% CI 1.30–1.61; I2 = 43.0%). Subjects with BMI ≥ 30 had similarly higher risk of CRA (SOR 1.42, 95% CI 1.24–1.63; I2 = 18.5%). The heterogeneity was mild to moderate among studies. The associations were significantly higher than estimates by previous meta-analyses. There was no publication bias detected (Egger’s regression test, p = 0.584). Subgroup analysis showed that the magnitude of association was significantly higher in female than male subjects (SOR 1.43, 95% CI 1.30–1.58 vs. SOR 1.16, 95% CI 1.07–1.24; different among different ethnic groups (SOR 1.72, 1.44 and 0.88 in White, Asians and Africans, respectively) being insignificant in Africans; and no difference exists among different study designs. In summary, the risk conferred by BMI for CRA was significantly higher than that reported previously. These findings bear implications in CRA risk estimation.
Collapse
Affiliation(s)
- Martin Chi-Sang Wong
- Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China.,School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China
| | - Chun-Hei Chan
- School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China
| | - Wilson Cheung
- School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China
| | - Din-Hei Fung
- School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China
| | - Miaoyin Liang
- School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China
| | - Jason Li-Wen Huang
- School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China
| | - Yan-Hong Wang
- School of Basic Medicine, Peking Union Medical College and Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, 100050, China
| | - Johnny Yu Jiang
- Peking Union School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100050, China
| | - Chun-Pong Yu
- Li Ping Medical Library, Chinese University of Hong Kong, Shatin, HKSAR, China
| | - Harry Haoxiang Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Justin Che-Yuen Wu
- Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China.,Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China.,State Key Laboratory of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China
| | - Francis Ka-Leung Chan
- Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China.,Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China.,State Key Laboratory of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China
| | - Joseph Jao-Yiu Sung
- Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China. .,Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China. .,State Key Laboratory of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China.
| |
Collapse
|
15
|
Incidence of cancer in outpatients with chronic obstructive pulmonary disease. Rev Clin Esp 2017. [DOI: 10.1016/j.rceng.2017.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
16
|
Incidencia de cáncer en pacientes ambulatorios con enfermedad pulmonar obstructiva crónica. Rev Clin Esp 2017; 217:387-393. [DOI: 10.1016/j.rce.2017.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 06/09/2017] [Accepted: 06/14/2017] [Indexed: 11/20/2022]
|
17
|
Comparison of exenatide and acarbose on intra-abdominal fat content in patients with obesity and type-2 diabetes: A randomized controlled trial. Obes Res Clin Pract 2017; 11:607-615. [DOI: 10.1016/j.orcp.2017.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 12/19/2016] [Accepted: 01/11/2017] [Indexed: 11/20/2022]
|
18
|
Gomez-Perez SL, Chaudhry V, Mar W, Patel B, Fantuzzi G, Freels S, Braunschweig CA. Impact of Abdominal Adipose Depots and Race on Risk for Colorectal Cancer: A Case-Control Study. Nutr Cancer 2017; 69:573-579. [PMID: 28323443 DOI: 10.1080/01635581.2017.1296964] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Visceral adipose tissue (VAT) but not subcutaneous adipose tissue (SAT) is associated with obesity-related diseases including colorectal cancer (CRC). Superficial SAT (SSAT) and deep SAT (DSAT), components of SAT, also appear to independently influence disease risk. These abdominal adipose tissues (AATs) are not extensively studied in connection with CRC and have not been explored in the United States despite known racial variations in body composition. We conducted a case-control study that compared associations between AAT with CRC risk and race of African-American (AA) and non-Hispanic white (NHW) men with incident CRC matched by age, body mass index, and race (N = 158, 79/group). Cross-sectional computed tomography images were used for assessment of AAT. Overall cases and controls had similar VAT areas (140 ± 192 vs 149 ± 152 cm2, P-value = 0.93); however, cases had lower SSAT than controls (88 ± 39 vs 112 ± 65 cm2, P < 0.01). Among controls, AA had significantly lower VAT (114 ± 168 vs 180 ± 167, P < 0.01) than NHW. Conditional logistic regression revealed that AA men with greater SSAT had lower odds for CRC (odds ratio [OR]: 0.24, 95% confidence interval [CI] 0.07-0.85). Our findings indicate that VAT does vary between cases and controls by race; however, this variation is not a risk factor for CRC. The negative association between CRC and SSAT in AA men warrants further investigation.
Collapse
Affiliation(s)
- Sandra L Gomez-Perez
- a Department of Clinical Nutrition , Rush University Medical Center , Chicago , Illinois , USA
| | - Vivek Chaudhry
- b Division of Colon and Rectal Surgery , John H. Stroger Hospital , Chicago , Illinois , USA
| | - Winnie Mar
- c Department of Radiology , University of Illinois Hospital and Health Sciences System , Chicago , Illinois , USA
| | - Bimal Patel
- d Department of Radiology , John H. Stroger Hospital , Chicago , Illinois , USA
| | - Giamila Fantuzzi
- e Department of Kinesiology and Nutrition , University of Illinois at Chicago , Chicago , Illinois , USA
| | - Sally Freels
- f Division of Epidemiology and Biostatistics , University of Illinois at Chicago , Chicago , Illinois , USA
| | - Carol A Braunschweig
- g Department of Kinesiology and Nutrition , University of Illinois at Chicago , Chicago , Illinois , USA
| |
Collapse
|
19
|
Xu H, Zhang Y, Dong H, Pei F, Li G, Wu D. To assess the association between vertebral marrow fat content and colorectal adenoma in postmenopausal women using magnetic resonance spectroscopy. Acta Radiol 2016; 57:1033-9. [PMID: 26567964 DOI: 10.1177/0284185115616292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 10/18/2015] [Indexed: 12/26/2022]
Abstract
BACKGROUND Although lower bone mineral density (BMD) is considered to have an increased risk for colorectal adenoma, no association between marrow fat content and colorectal adenoma has been elucidated yet. PURPOSE To evaluate the relationship between marrow fat fraction (MFF) and the presence of colorectal adenoma in postmenopausal women using magnetic resonance spectroscopy (MRS). MATERIAL AND METHODS We performed a cross-sectional observational study on 152 postmenopausal patients with colorectal adenoma and 100 matched control subjects who underwent screening colonoscopy, biochemical measurements, dual-energy X-ray absorptiometry, and MRS. Logistic regression models were performed to assess the relationships among BMD, MFF, and colorectal adenoma. RESULTS With univariate analysis, marrow fat accumulation was higher and BMD values were lower in patients with colorectal adenoma compared with those in controls. After adjustment for potential confounders including demographics, health history, blood lipid levels, indexes of glucose metabolism, and validated measures of diet and physical activity, MFF was significantly positively associated with colorectal adenoma (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.10-2.46; P = 0.008). Vertebral BMD, but not total hip and femoral neck BMD, was inversely related with colorectal adenoma (OR, 0.62; 95% CI, 0.14-0.89; P = 0.027). Additionally, MFF was associated with adenoma number, size, and high-risk adenoma (all P < 0.01). MFF was found to be an independent risk factor of a high-risk colorectal adenoma (OR, 2.08; 95% CI, 1.24-3.60; P = 0.019). CONCLUSION Marrow fat accumulation is highly associated with colorectal adenoma, particularly high-risk adenoma, in postmenopausal women.
Collapse
Affiliation(s)
- Haidong Xu
- Department of Radiology, Ningbo Medical Treatment Center Lihuili Hospital, Zhejiang, PR China
| | - Yuqin Zhang
- Department of Radiology, Ningbo Medical Treatment Center Lihuili Hospital, Zhejiang, PR China
| | - Haibo Dong
- Department of Radiology, Ningbo Medical Treatment Center Lihuili Hospital, Zhejiang, PR China
| | - Feng Pei
- Department of Anus-intestines, Ningbo Medical Treatment Center Lihuili Hospital, Zhejiang, PR China
| | - Guanwu Li
- Department of Radiology, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, PR China
| | - Dongmei Wu
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, PR China
| |
Collapse
|
20
|
Xu BB, Zhao XL, Xu GP. Clinical study of anesthetization by dezocine combined with propofol for indolent colonoscopy. World J Gastroenterol 2016; 22:5609-5615. [PMID: 27350739 PMCID: PMC4917621 DOI: 10.3748/wjg.v22.i24.5609] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Revised: 04/12/2016] [Accepted: 05/23/2016] [Indexed: 02/06/2023] Open
Abstract
AIM: To assess the use of dezocine combined with propofol for the anesthetization of patients undergoing indolent colonoscopy.
METHODS: A cross-sectional survey of patients undergoing indolent colonoscopy in the Xinjiang People’s Hospital was conducted from April 1 to April 30, 2015. The survey collected patient general information and anesthesia data, including overall medical experience and pain management. Thirty minutes after colonoscopy surgery, samples of venous blood were collected and the biochemical indicators of gastrointestinal function were analyzed.
RESULTS: There were 98 female and 62 male respondents. Indolent colonoscopy was found to be more suitable for mid to older-aged patients. The necessary conditions for the diagnosis of digestive diseases were required in 65 of the 73 inpatients. Adverse reactions to the intraoperative process included two cases of body movement and two cases of respiratory depression. Gastrin and vasoactive intestinal peptide levels were slightly increased. However, somatostatin and endothelin levels were slightly decreased.
CONCLUSION: This study revealed that dezocine combined with propofol can be successfully used for the anesthetization of indolent colonoscopy patients without pain and should be widely used.
Collapse
|
21
|
The impact of BMI on early colorectal neoplastic lesions and the role of endoscopic diagnosis:. An Italian observational study. Int J Surg 2016; 33 Suppl 1:S71-5. [PMID: 27250694 DOI: 10.1016/j.ijsu.2016.05.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION CRC often arises from polyps: an early detection and resection are effective in decreasing both incidence and mortality rate. Relation between risk factors, adenomas and CRC have been showed, but there is little evidence for overweight association with preneoplastic lesions. This study analyzed the correlation between body mass index (BMI) and primitive site of polyps. METHODS We performed a retrospective study, in a period between January 2010 and October 2014. Subjects aged 50 years and older who underwent their first-time screening colonoscopy were included. Reports regarding characteristic of the polyps were collected. RESULTS 142 patients were enrolled and they were divided into two groups: group I - patients with left sided colonic polyps, and group II - patients who right sided colonic polyps. The ANOVA test-one way, documents a difference between the BMI and the colon localization of polyps. CONCLUSIONS Patients with overweight had a higher risk to develop lesions in the left colon compared to patients with normal weight. Despite the fact that Italian epidemiological studies have found a prevalence of polyps of 44-53% in rectal-sigmoid segment, 32-36% in transverse segment and of 14-20% in right segment, we showed an incidence of 26.05% for right sided polyps, which maybe related with the eating habits of the territory.
Collapse
|
22
|
Lu Y, Ness-Jensen E, Martling A, Hveem K. Anthropometry-based Obesity Phenotypes and Risk of Colorectal Adenocarcinoma: A Large Prospective Cohort Study in Norway. Epidemiology 2016; 27:423-432. [PMID: 26808598 DOI: 10.1097/ede.0000000000000447] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND It is unclear whether obesity phenotypes measured by different anthropometric indices are associated with a risk of colorectal adenocarcinoma by anatomical location. METHODS We compiled harmonized population-based cohort studies (Cohort of Norway, CONOR) with 143,477 participants that were conducted between 1994 and 2010. General, abdominal, and gluteofemoral obesity were assessed by body mass index (BMI, kg/m(2)), waist circumference (cm), and hip circumference (cm). Other measures examined were waist to hip ratio, waist to height ratio, and body adiposity index. We performed Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of obesity relative to a risk of colorectal adenocarcinoma. RESULTS In total, 2,044 incident cases of colorectal adenocarcinoma were identified. We observed a positive association between waist circumference (high versus low) and adenocarcinoma in the proximal colon (HR = 1.9, 95% CI = 1.5, 2.5) and distal colon (HR = 1.7, 95% CI = 1.3, 2.3) when adjusted for BMI. The association with waist circumference was especially strong in men. BMI was not associated with adenocarcinoma in the colon or rectum after adjusting for waist circumference. We found no association between hip circumference and colorectal adenocarcinoma. When adjusted for BMI plus waist circumference, body adiposity index was negatively associated with adenocarcinoma in the proximal or distal colon. CONCLUSION Abdominal obesity, but not general or gluteofemoral obesity, was associated with an increased risk of adenocarcinoma in the proximal and the distal colon, especially in men. Muscularity may be negatively associated with risk of colon adenocarcinoma.
Collapse
Affiliation(s)
- Yunxia Lu
- From the aDepartment of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; bDepartment of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom; and cHUNT Research Centre, Department of Public Healthand General Practice, Norwegian University of Science and Technology, Levanger, Norway
| | | | | | | |
Collapse
|
23
|
Passarelli MN, Newcomb PA. Blood Lipid Concentrations and Colorectal Adenomas: A Systematic Review and Meta-Analysis of Colonoscopy Studies in Asia, 2000-2014. Am J Epidemiol 2016; 183:691-700. [PMID: 27013025 DOI: 10.1093/aje/kwv294] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 10/19/2015] [Indexed: 12/19/2022] Open
Abstract
It is unclear whether dyslipidemia is associated with risk of colorectal neoplasia. The incidence of both conditions is increasing in Asia, motivating a number of new studies from this region. We performed a systematic literature search of Asian colonoscopy-based studies that collected blood lipid concentrations at the time of endoscopy. Persons found to have colorectal adenoma were considered cases, and those found to be adenoma-free were considered controls. Seventeen studies published between 2000 and 2014 met inclusion criteria, collectively enrolling 17,387 cases and 30,427 controls. Mean differences and adjusted odds ratios were summarized with random-effects meta-analyses. Compared with controls, cases had higher total cholesterol (mean difference (MD) = 2.4 mg/dL, 95% confidence interval (CI): 0.2, 4.6), higher low-density lipoprotein cholesterol (MD = 1.3 mg/dL, 95% CI: 0.1, 2.6), higher triglyceride (MD = 16.4 mg/dL, 95% CI: 11.2, 21.5), and lower high-density lipoprotein (HDL) cholesterol (MD = -2.1 mg/dL, 95% CI: -2.7, -1.6) concentrations. Based on adjusted odds ratios, associations for 40-mg/dL-higher triglyceride levels (odds ratio = 1.13, 95% CI: 1.05, 1.21) and 10-mg/dL-higher HDL cholesterol levels (odds ratio = 0.96, 95% CI: 0.92, 1.00) achieved statistical significance. Persons with adenoma were more likely to have unfavorable cholesterol profiles at the time of colonoscopy than those without adenoma. The most convincing evidence for an association between dyslipidemia and colorectal neoplasia was observed for hypertriglyceridemia.
Collapse
|
24
|
Pietrzyk L, Torres A, Maciejewski R, Torres K. Obesity and Obese-related Chronic Low-grade Inflammation in Promotion of Colorectal Cancer Development. Asian Pac J Cancer Prev 2016; 16:4161-8. [PMID: 26028066 DOI: 10.7314/apjcp.2015.16.10.4161] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Colorectal cancer (CRC) is a worldwide health problem, being the third most commonly detected cancer in males and the second in females. Rising CRC incidence trends are mainly regarded as a part of the rapid 'Westernization' of life-style and are associated with calorically excessive high-fat/low-fibre diet, consumption of refined products, lack of physical activity, and obesity. Most recent epidemiological and clinical investigations have consistently evidenced a significant relationship between obesity-driven inflammation in particular steps of colorectal cancer development, including initiation, promotion, progression, and metastasis. Inflammation in obesity occurs by several mechanisms. Roles of imbalanced metabolism (MetS), distinct immune cells, cytokines, and other immune mediators have been suggested in the inflammatory processes. Critical mechanisms are accounted to proinflammatory cytokines (e.g. IL-1, IL-6, IL-8) and tumor necrosis factor-α (TNF-α). These molecules are secreted by macrophages and are considered as major agents in the transition between acute and chronic inflammation and inflammation-related CRC. The second factor promoting the CRC development in obese individuals is altered adipokine concentrations (leptin and adiponectin). The role of leptin and adiponectin in cancer cell proliferation, invasion, and metastasis is attributable to the activation of several signal transduction pathways (JAK/STAT, mitogen-activated protein kinase (MAPK), phosphatidylinositol 3 kinase (PI3K), mTOR, and 5'AMPK signaling pathways) and multiple dysregulation (COX-2 downregulation, mRNA expression).
Collapse
Affiliation(s)
- Lukasz Pietrzyk
- Laboratory of Biostructure, Department of Human Anatomy, Medical University of Lublin, Military Clinical Hospital, Lublin, Poland E-mail :
| | | | | | | |
Collapse
|
25
|
Martinez-Useros J, Garcia-Foncillas J. Obesity and colorectal cancer: molecular features of adipose tissue. J Transl Med 2016; 14:21. [PMID: 26801617 PMCID: PMC4722674 DOI: 10.1186/s12967-016-0772-5] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 01/05/2016] [Indexed: 02/06/2023] Open
Abstract
The huge part of population in developed countries is overweight or obese. Obesity is often determined by body mass index (BMI) but new accurate methods and ratios have recently appeared to measure body fat or fat located in the intestines. Early diagnosis of obesity is crucial since it is considered an increasing colorectal cancer risk factor. On the one hand, colorectal cancer has been strongly associated with lifestyle factors. A diet rich in red and processed meats may increase colorectal cancer risk; however, high-fiber diets (grains, cereals and fruits) have been associated with a decreased risk of colorectal cancer. Other life-style factors associated with obesity that also increase colorectal cancer risk are physical inactivity, smoking and high alcohol intake. Cutting-edge studies reported that high-risk transformation ability of adipose tissue is due to production of different pro-inflammatory cytokines like IL-8, IL-6 or IL-2 and other enzymes like lactate dehydrogenase (LDH) and tumour necrosis factor alpha (TNFα). Furthermore, oxidative stress produces fatty-acid peroxidation whose metabolites possess very high toxicities and mutagenic properties. 4-hydroxy-2-nonenal (4-HNE) is an active compounds that upregulates prostaglandin E2 which is directly associated with high proliferative colorectal cancer. Moreover, 4-HNE deregulates cell proliferation, cell survival, differentiation, autophagy, senescence, apoptosis and necrosis via mitogen-activated protein kinase (MAPK), phosphoinositide 3-kinase (PIK3CA)—AKT and protein kinase C pathways. Other product of lipid peroxidation is malondialdehyde (MDA) being able to regulate insulin through WNT-pathway as well as having demonstrated its mutagenic capability. Accumulation of point mutation enables genomic evolution of colorectal cancer described in the model of Fearon and Vogelstein. In this review, we will summarize different determination methods and techniques to assess a truthfully diagnosis and we will explain some of the capabilities that performs adipocytes as the largest endocrine organ.
Collapse
Affiliation(s)
- Javier Martinez-Useros
- Translational Oncology Division, Oncohealth Institute, FIIS-Fundacion Jimenez Diaz, Av. Reyes Catolicos 2, 28040, Madrid, Spain.
| | - Jesus Garcia-Foncillas
- Translational Oncology Division, Oncohealth Institute, FIIS-Fundacion Jimenez Diaz, Av. Reyes Catolicos 2, 28040, Madrid, Spain.
| |
Collapse
|
26
|
Zhu QC, Gao RY, Wu W, Guo BM, Peng JY, Qin HL. Effect of a high-fat diet in development of colonic adenoma in an animal model. World J Gastroenterol 2014; 20:8119-8129. [PMID: 25009384 PMCID: PMC4081683 DOI: 10.3748/wjg.v20.i25.8119] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Revised: 03/10/2014] [Accepted: 04/09/2014] [Indexed: 02/07/2023] Open
Abstract
AIM: To investigate the effect of a high-fat diet in the formation of the precursors of colorectal cancer using an animal model.
METHODS: Wistar rats were divided into two groups that were fed either a high-fat diet (HFD) or a normal-fat diet (ND), and 1,2-dimethylhydrazine was administered at a dose of 40 mg/kg for 10 wk. The body weight/liver weight/epididymal fat weight were recorded after rats were sacrificed, and the formation of colonic adenoma was also observed. The levels of insulin, leptin, tumor necrosis factor (TNF)-α, insulin-like growth factor (IGF)-1 and triglycerides were determined by enzyme-linked immunosorbent assay in order to compare the altered levels of biochemical indices and inflammatory cytokines in the serum between rats fed an ND and HFD. Cell proliferation activity (Ki-67) was determined by immunohistochemical analysis. Western blot and immunofluorescence staining were used to examine the expression of proliferating cell nuclear antigen (PCNA), cyclooxygenase (COX)-2, cyclin D1, β-catenin and nuclear factor (NF)-κB proteins in the adenoma and comparative control tissues.
RESULTS: The number of colonic adenomas and the colonic epithelial Ki-67 were significantly higher in the HFD group than in the ND group. The HFD group also had increased body weight, liver weight and epididymal fat weight, which were associated with increased levels of serum insulin, leptin, TNF-α, IGF-1 and triglycerides. HFD induced upregulation of PCNA, COX-2, cyclin D1, β-catenin and NF-κB proteins, as revealed by Western blot and immunofluorescence staining.
CONCLUSION: HFD promotes the formation of colonic adenoma through inflammation, metabolic abnormalities, and increases cell cycle progression.
Collapse
|