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An S, Gunathilake M, Lee J, Kim M, Oh JH, Chang HJ, Sohn DK, Shin A, Kim J. Relationship Between Aspirin Use and Site-Specific Colorectal Cancer Risk Among Individuals With Metabolic Comorbidity. J Korean Med Sci 2024; 39:e199. [PMID: 38978486 PMCID: PMC11231443 DOI: 10.3346/jkms.2024.39.e199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 05/22/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND The relationship between aspirin usage and the risk of colorectal cancer (CRC) among individuals with both hypertension (HTN) and diabetes mellitus (DM) remains unclear. This study aims to explore the impact of aspirin use on the site-specific CRC risk in patients with metabolic comorbidity. METHODS A case-control study was conducted among 1,331 CRC patients and 2,771 controls recruited from the Nation Cancer Center in Korea. Multinomial logistic regression analyses were used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for the association between aspirin use, metabolic disease status, and site-specific CRC risk. RESULTS Among the 4,102 participants, 1,191 individuals had neither HTN nor DM, 2,044 were diagnosed with HTN, 203 with DM, and 664 presented with HTN and DM comorbidity. An increasing number of HTN and DM was associated with an increased risk of overall CRC (HTN or DM: OR, 1.70; 95% CI, 1.39-2.07; HTN and DM: OR, 8.43; 95% CI, 6.37-11.16), while aspirin use was associated with a decreased risk of overall CRC (OR, 0.31; 95% CI, 0.21-0.46). These results remained consistent across anatomical sites. Among individuals with HTN and DM comorbidity, aspirin use notably associated with lower risk of overall CRC (OR, 0.39; 95% CI, 0.21-0.72), proximal colon (OR, 0.32; 95% CI, 0.13-0.71) and rectal cancer (OR, 0.27; 95% CI, 0.08-0.97), but not distal colon cancer (OR, 0.58; 95% CI, 0.27-1.24). CONCLUSION This study showed that aspirin use is negatively associated with overall and site-specific CRC, even among individuals with HTN and DM comorbidity.
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Affiliation(s)
- Seokyung An
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Madhawa Gunathilake
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Jeonghee Lee
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Minji Kim
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Jae Hwan Oh
- Center for Colorectal Cancer, National Cancer Center Hospital, National Cancer Center, Goyang, Korea
| | - Hee Jin Chang
- Center for Colorectal Cancer, National Cancer Center Hospital, National Cancer Center, Goyang, Korea
| | - Dae Kyung Sohn
- Center for Colorectal Cancer, National Cancer Center Hospital, National Cancer Center, Goyang, Korea
| | - Aesun Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jeongseon Kim
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.
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The interaction between glycemic index, glycemic load, and the genetic variant ADIPOQ T45G (rs2241766) in the risk of colorectal cancer: a case-control study in a Korean population. Eur J Nutr 2022; 61:2601-2614. [PMID: 35243553 DOI: 10.1007/s00394-022-02845-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 02/16/2022] [Indexed: 11/04/2022]
Abstract
PURPOSE The glycemic index (GI), glycemic load (GL), and adiponectin level contribute to glycemic response and insulin sensitivity in the body. Studies have shown that tumor development is related to glycemic disorders; however, the results are contradictory. We aimed to investigate the association of GI and GL with colorectal cancer (CRC) risk in a Korean population and their possible interactions with the genetic variant ADIPOQ T45G. METHODS AND RESULTS A case-control study including 2096 participants with 695 CRC cases was conducted. The results showed that diets with high GI or GL were significantly associated with an increased risk of CRC [odds ratio (OR) = 5.44, 95% confidence interval (CI) 3.85-7.68; OR = 4.43, 95% CI 3.18-6.15, respectively; all p-trends < 0.001]. Moreover, even with a low-GI and low-GL diet, G/G genotype carriers may have 2.93-fold and 3.77-fold higher risk of rectal cancer compared to carriers of other genotypes (T/T + T/G), (OR = 2.93, 95% CI 1.01-8.59, p-interaction = 0.011 for GI; OR = 3.77, 95% CI 1.46-9.77, p-interaction = 0.025 for GL). CONCLUSIONS Overall, our study suggests positive associations of GI and GL with CRC risk. Moreover, the associations of GI and GL with rectal cancer risk could be modified by ADIPOQ T45G in a Korean population. Further studies with larger sample sizes are needed to confirm our findings.
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Yu D, An G, Yao J. Lymphocyte-to-monocyte ratio combined with CA19-9 for predicting postoperative recurrence of colorectal cancer in patients with diabetes. J Clin Lab Anal 2021; 35:e23944. [PMID: 34418175 PMCID: PMC8418504 DOI: 10.1002/jcla.23944] [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: 04/12/2021] [Revised: 06/21/2021] [Accepted: 07/26/2021] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To investigate the significance of lymphocyte-to-monocyte ratio (LMR) combined with carbohydrate antigen (CA) 19-9 for predicting postoperative recurrence of colorectal cancer (CRC) in patients with type II diabetes. METHODS We conducted a retrospective analysis of 106 postoperative patients with stage II-III CRC and with type II diabetes. Their clinical indexes such as LMR and CA19-9 were collected, and the patients were followed up for 5 years. RESULTS The CA19-9 level was 119.7 U/ml at baseline in the relapsed group, while this was 24.81 U/ml in non-relapsed group (p = 0.001). On the contrary, the LMR level was 5.10 and 2.57 for non-relapsed and relapsed group (p < 0.001), respectively. Kaplan-Meier survival curves stratified by CA19-9 and LMR suggested that patients with lower CA19-9 had higher survival probability (p < 0.001), while patients with high LMR level had higher survival probability (p < 0.001). The multivariable Cox proportional hazard regression analysis with CA19-9 and LMR indicated that although the baseline CA19-9 is significantly associated with increasing risk of disease recurrence, the HR (HR = 1.0, 95% CI 1.00-1.01) was small and close to 1, whereas the high baseline LMR (HR = 0.44, 95% CI 0.32-0.61) was associated with decrease in disease recurrence. Model with continuous CA19-9 and LMR was able to better predict (AUC 73.17%) the disease recurrence. CONCLUSION LMR combined with CA19-9 may become a new index for predicting postoperative recurrence of CRC in patients with diabetes.
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Affiliation(s)
- Dan Yu
- Department of Oncology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Guangyu An
- Department of Oncology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Jiannan Yao
- Department of Oncology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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Zhao M, Wang H, Chen J, Xi Y, Wang F, Huo C, Li W, Chu Y, Xu P, Huang Q, Bu S. Expression of long non-coding RNA H19 in colorectal cancer patients with type 2 diabetes. Arch Physiol Biochem 2021; 127:228-234. [PMID: 31232113 DOI: 10.1080/13813455.2019.1628068] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 05/31/2019] [Indexed: 12/24/2022]
Abstract
The aim of this study was to explore the lncRNAs expression in colorectal cancer (CRC) patients with type 2 diabetes (T2DM) and evaluate the diagnostic value of lncRNAs expression in CRC patients with T2DM. The present study was conducted on two cohorts with CRC patients. The tissues levels of lncRNAs were measured by real-time PCR analysis. The results showed that H19 and MALAT1 expression were higher in CRC tissues than in normal colorectal mucosa (p = 1.59 × 10-6 and p = 6.95 × 10-9, respectively), whereas lincRNA-p21 showed lower expression in CRC tissues (p = 1.10 × 10-4). Logistic regression analysis results indicated that the expression of H19 was significantly lower in CRC patients with T2DM compared with CRC patients without T2DM (p = .032). H19 expression in CRC group without T2DM was significantly associated with hypertension (p = .040). Additionally, the area under the receiver operating characteristic curve of H19 was 0.672 of the group CRC with T2DM, which suggests that H19 could be a useful biomarker and predictive targets for diagnosis of T2DM in CRC patients.
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Affiliation(s)
- Ming Zhao
- Department of Medical Services, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
| | - Hantao Wang
- Department of Colorectal Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Jingbo Chen
- Department of Endocrinology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Yang Xi
- Diabetes Research Center, Medical School, Ningbo University, Ningbo, China
| | - Fuyan Wang
- Diabetes Research Center, Medical School, Ningbo University, Ningbo, China
| | - Cuilan Huo
- Department of Endocrinology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Wenwen Li
- Department of Endocrinology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Yudong Chu
- Department of Nephrology, Ningbo Medical Center Lihuili Eastern Hospital, Ningbo, China
- The Second Section within Ninghai Second Hospital, Ningbo, China
| | - Pengjie Xu
- Department of Nephrology, Ningbo Medical Center Lihuili Eastern Hospital, Ningbo, China
- The Second Section within Ninghai Second Hospital, Ningbo, China
| | - Qin Huang
- Department of Endocrinology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Shizhong Bu
- Diabetes Research Center, Medical School, Ningbo University, Ningbo, China
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Colorectal Cancer Risks According to Sex Differences in Patients With Type II Diabetes Mellitus: A Korean Nationwide Population-Based Cohort Study. Clin Transl Gastroenterol 2020; 10:e00090. [PMID: 31651449 PMCID: PMC6884353 DOI: 10.14309/ctg.0000000000000090] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION: Developing colorectal cancer (CRC) poses challenges for patients with type II diabetes mellitus (T2DM). We investigated CRC risk factors in patients with T2DM. METHODS: We retrospectively collected data from the National Health Insurance Corporation database, comprising approximately 97% of the Korean population. T2DM and CRC were defined according to International Classification of Disease codes (10th Revision) and claims data. Obesity was defined using body mass index (BMI); abdominal obesity was defined according to waist circumference. Other variables were defined using demographic, anthropometric, and laboratory data. RESULTS: Overall, 2,591,149 patients with T2DM were analyzed. During the follow-up period (median, 5.4 years), 24,236 CRC cases were identified. Aging (≥70 years), male sex, smoking, alcohol consumption, hypertension, and insulin and/or sulfonylurea use were significant risk factors for CRC. In males, smoking and alcohol consumption were more likely to lead to CRC, whereas a BMI increase was a more significant risk factor in females. Females with a BMI ≥ 25 kg/m2 and abdominal obesity were associated with an 18% increased risk of CRC compared with patients with normal weight and normal waist circumference (hazard ratio = 1.184, 95% confidence interval 1.123–1.25), whereas male patients with a BMI ≥ 25 kg/m2 and abdominal obesity were associated with an 8% increased risk (hazard ratio = 1.087, 95% confidence interval 1.049–1.127). DISCUSSION: Patients had CRC risk factors that differed according to sex. Smoking and heavy alcohol consumption were risks of CRC in males. Female patients with a BMI ≥ 25 kg/m2 and abdominal obesity were at a higher risk of developing CRC than males.
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Guo J, Wang B, Hou W, Ma K. Risk factors for elevated serum colorectal cancer markers in patients with type 2 diabetes mellitus. Open Life Sci 2020; 15:267-273. [PMID: 33817215 PMCID: PMC7874651 DOI: 10.1515/biol-2020-0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 02/16/2020] [Accepted: 03/11/2020] [Indexed: 11/23/2022] Open
Abstract
The study aims to examine the risk factors for increased colorectal cancer (CRC) markers in patients with type 2 diabetes mellitus (T2DM). The 229 patients retrospectively reviewed were categorized into two groups: CRC tumor marker-positive and -negative groups. Patients who tested positive for all three of the following CRC markers were included in the CRC tumor marker-positive group: serum carcinoembryonic antigen, carbohydrate antigen 19-9 and septin9 methylation. Univariate analysis revealed that most CRC marker-positive patients had higher age, a family history of CRC, history of smoking and alcohol intake, high body mass index (BMI; overweight), longer history of T2DM, worse diabetes control (with high glycated hemoglobin A1c [HbA1c]), lower level of serum vitamin D (VD), high-density lipoprotein cholesterol and higher level of total cholesterol and triglyceride (TG). Logistic regression analysis showed that BMI, VD, HbA1c and TG were independent predictors of CRC marker-positive status (OR, 95% confidence intervals and P values were 1.912 [1.346–2.716], <0.001; 0.773 [0.633–0.943], 0.011; 9.082 [3.52–23.433], <0.001; and 11.597 [3.267–41.164], <0.001, respectively). In this retrospective study, high BMI, HbA1c and TG as well as low level of VD were correlated with CRC tumor marker-positive status in T2DM patients. Patients with these risk factors may benefit from more frequent screening for CRC tumor markers.
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Affiliation(s)
- Jingjing Guo
- Department of Health, Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan 250013, China
| | - Bin Wang
- Department of Health, Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan 250013, China
| | - Weikai Hou
- Department of Endocrinology, Qilu Hospital of Shandong University, No. 105, Jiefang Road, Jinan 250012, China
| | - Kun Ma
- Department of Pediatrics, The First Affiliated Hospital of Shandong First Medical University, No. 16766, Jing Shi Road, Jinan 250014, China
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Zhu P, Liu J, Lu M, Wu G, Lin X, Cai L, Zhang X. Influence and mechanism of miR-99a suppressing development of colorectal cancer (CRC) with diabetes mellitus (DM). Onco Targets Ther 2019; 12:10311-10321. [PMID: 31819515 PMCID: PMC6885593 DOI: 10.2147/ott.s190998] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 07/18/2019] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE This study aimed to identify the changes of miRNAs in colorectal cancer (CRC) complicated with diabetes mellitus (DM) (CRC + DM) tissues and their potential effects. METHODS The changes of miRNAs in CRC + DM tissues were determined by miRNA microarray. The expression levels of miR-99a in 40 clinical specimens and 6 CRC cell lines were determined by qRT-PCR. The capacity for miR-99a to induce cell proliferation and invasion was examined with miR-99a-overexpressing HCT-116 cells. The relative mTOR mRNA and protein levels were determined by qRT-PCR and Western blotting, respectively, in HCT-116 cells transfected with miR-99a. The dual luciferase assay was performed to confirm the direct regulation of miR-99a on mTOR 3'-UTR. The HCT-116 cells were treated with 100 mg/L advanced glycation end products (AGEs); then, the mTOR expression levels were determined by qRT-PCR, Western blotting, and immunohistochemistry. RESULTS Seventeen miRNAs were found to be differentially expressed among normal tissue, CRC tissue, and CRC with DM tissue, including 15 upregulated and 2 downregulated with fold changs of more than 2 times. qRT-PCR confirmed that miR-99a was downregulated in CRC and CRC + DM tissues. In addition, miR-99a overexpression remarkably impaired CRC cell proliferation and metastasis, and negatively regulated mTOR signaling through direct binding to the 3'-UTR of mTOR. AGEs could suppress miR-99a and stimulate mTOR signaling in CRC cells. Increased mTOR was also identified in CRC with DM tissues. CONCLUSION Our findings indicate that miR-99a is a potential marker and therapeutic target of CRC complicated with DM, and that AGEs impair miR-99a-overactivated mTOR signaling in CRC with DM patients, which promotes CRC development.
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Affiliation(s)
- Peixuan Zhu
- The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Jiahao Liu
- Cancer Center, Traditional Chinese Medicine-Integrated Hospital, Southern Medical University, Guangzhou, People’s Republic of China
| | - Meijuan Lu
- The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Gongfa Wu
- Department of Pathology, Zengcheng District People’s Hospital of Guangzhou City, Guangzhou, People’s Republic of China
| | - Xutao Lin
- The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Longmei Cai
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
| | - Xiaona Zhang
- The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China
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Metabolic Syndrome and Risk of Colorectal Cancer: A Case-Control Study. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2019. [DOI: 10.5812/ijcm.84627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Sex- and site-specific differences in colorectal cancer risk among people with type 2 diabetes. Int J Colorectal Dis 2019; 34:269-276. [PMID: 30421309 PMCID: PMC6331739 DOI: 10.1007/s00384-018-3191-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/05/2018] [Indexed: 02/04/2023]
Abstract
PURPOSE The prevalence of colorectal cancer is higher among patients with type 2 diabetes mellitus (T2D) than among patients without diabetes. Furthermore, men are at higher risk for developing colorectal cancer than women in the general population and also subsite-specific risks differ per sex. The aim was to evaluate the impact of T2D on these associations. METHODS A population-based matched cohort study was performed using data from the PHARMO Database Network. Patients with T2D were selected and matched (1:4) to diabetes free controls. Cox proportional hazards models were used to estimate hazard ratios (HRs) for CRC and its subsites. HRs were determined per sex and adjusted for age and socioeconomic status. The ratio of distal versus proximal colon cancer was calculated for people with T2D and controls per sex and stratified by age. RESULTS Over 55,000 people with T2D were matched to > 215,000 diabetes free controls. Men and women with T2D were 1.3 times more likely to develop colorectal cancer compared to controls. Men with T2D were at higher risk to develop distal colon cancer (hazard ratio (95% confidence interval), 1.42 (1.08-1.88)), and women with T2D were at higher risk for developing proximal colon cancer (hazard ratio (95% confidence interval), 1.58 (1.13-2.19)). For rectal cancer, no statistically significant risk was observed for both men and women. CONCLUSIONS Sex-specific screening strategies and prevention protocols should be considered for people with T2D. More tailored screening strategies may optimize the effectiveness of colorectal cancer screening in terms of reducing incidence and mortality.
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Khoja A, Aljawadi M, Al-Shammari SA, Bokhari NN, Aldarwish AA, Mardini WK, Khoja TA. Utilization of Colorectal Cancer Screening among Saudi Elderly Population: A Study from the Saudi National Survey for Elderly Health. Asian Pac J Cancer Prev 2018; 19:3401-3407. [PMID: 30583346 PMCID: PMC6428552 DOI: 10.31557/apjcp.2018.19.12.3401] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 11/05/2018] [Indexed: 02/07/2023] Open
Abstract
Objective: The goal of this study was to measure colorectal cancer screening (CRCS) utilization in Saudi Arabia ’s elderly population and to assess the factors associated with CRCS. Methods: The Saudi National Survey for Elderly Health was used to examine CRCS utilization. It is a nationally representative population-based cross-sectional survey that was conducted between 2006-2007. Utilization of CRCS was defined as any colonoscopy during the last five years or fecal occult blood test (FOBT) during the twelve months before the interview. Multivariable logistic regression was used to assess patients’ demographics, co-morbidities, number of visits to primary health clinics, and hospital availability and accessibility impact on CRCS. Results: The prevalence of CRCS utilization among Saudi elderly population was 5.64%. The fecal occult blood test was done in 4.4% of subjects while scope use was performed in 0.55%. In addition, 0.69% of patients have gone through both FOBT and scope use. Having blood in stools (OR=2.80; 95%CI: 1.3-6.00), Self-drivers (OR= 2.52) private driver (OR=2.1; 95%CI: 1.15-3.7) having 4 or more visits to primary care centers 1.81 (95%CI: 1.14-2.86) were positively associated with CRCS utilization. On the other hand, being single was negatively associated with CRCS utilization. Conclusion: In this nationally representative sample CRCS prevalence was very low. According to our findings and in the context of the burden of colorectal cancer on the population, we recommend developing national evidence-based policies and programs that take in consideration easiness of transportation and the availability of primary care centers near to Saudi elderly population.
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Affiliation(s)
- Abdullah Khoja
- Department of Public Health and Family Medicine, College of Medicine, Al Imam Mohammad ibn Saud Islamic University (IMSIU), Riyadh, Kingdom of Saudi Arabia.
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Niederseer D, Bracher I, Stadlmayr A, Huber-Schönauer U, Plöderl M, Obeid S, Schmied C, Hammerl S, Stickel F, Lederer D, Patsch W, Aigner E, Datz C. Association between Cardiovascular Risk and Diabetes with Colorectal Neoplasia: A Site-Specific Analysis. J Clin Med 2018; 7:jcm7120484. [PMID: 30486335 PMCID: PMC6306807 DOI: 10.3390/jcm7120484] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 11/21/2018] [Accepted: 11/22/2018] [Indexed: 12/14/2022] Open
Abstract
Several studies have shown site-specific differences in colorectal cancer (CRC) with respect to the risk factors. CRC was shown to be associated with cardiovascular risk (CVR) factors, but site-specific variations have not been investigated so far. This study aimed to assess the associations between the prevalence and subsite-specific differences of colorectal neoplasia and established CVR scores or known coronary artery disease (CAD) in a large asymptomatic European screening cohort (N = 2098). Participants underwent simultaneous screening colonoscopy and CVR evaluation, using the Framingham Risk Score and Heart Score. Lesions found in the colonoscopy were classified by location (proximal/distal colon or rectum). More neoplasias were found in the proximal versus the distal colon (p < 0.001). The Framingham Risk Score and Heart Score showed incremental risk for colorectal adenoma, across the tertiles in the proximal and the distal colon (p < 0.001). The prevalence of adenomas in the rectum was much lower, but also here, incremental risk could be shown for the Framingham Risk but not the Heart Risk Score tertiles. Prevalence of adenomas in the proximal colon was higher in subjects with type 2 diabetes (T2DM) (p = 0.006), but no association was found between adenomas and T2DM in the distal colon (p = 0.618) and the rectum (p = 0.071). Males had a higher CVR and more findings, in the screening colonoscopy, as compared to females, however, no site-specific differences were noted. Patients with known CAD and high CVR have an increased risk of colorectal neoplasia in both the proximal and distal colon. Patients with T2DM have a higher risk for neoplasia in the proximal colon.
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Affiliation(s)
- David Niederseer
- Department of Internal Medicine, General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical University Salzburg, 5110 Oberndorf, Austria.
- Department of Cardiology, University Heart Centre, University Hospital Zurich, 8091 Zürich, Switzerland.
| | - Isabelle Bracher
- Department of Cardiology, University Heart Centre, University Hospital Zurich, 8091 Zürich, Switzerland.
| | - Andreas Stadlmayr
- Department of Internal Medicine, General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical University Salzburg, 5110 Oberndorf, Austria.
| | - Ursula Huber-Schönauer
- Department of Internal Medicine, General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical University Salzburg, 5110 Oberndorf, Austria.
| | - Martin Plöderl
- Suicide Prevention Research Program, Paracelsus Medical University, 5020 Salzburg, Austria.
- Department of Suicide Prevention, University Clinic of Psychiatry and Psychotherapy I, Christian Doppler Clinic, 5020 Salzburg, Austria.
- University Institute of Clinical Psychology, Christian Doppler Clinic, 5020 Salzburg, Austria.
| | - Slayman Obeid
- Department of Cardiology, University Heart Centre, University Hospital Zurich, 8091 Zürich, Switzerland.
| | - Christian Schmied
- Department of Cardiology, University Heart Centre, University Hospital Zurich, 8091 Zürich, Switzerland.
| | - Sabrina Hammerl
- Department of Internal Medicine, General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical University Salzburg, 5110 Oberndorf, Austria.
| | - Felix Stickel
- Department of Gastroenterology and Hepatology, University Hospital of Zürich, 8091 Zürich, Switzerland.
| | - Dieter Lederer
- Department of Internal Medicine, General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical University Salzburg, 5110 Oberndorf, Austria.
| | - Wolfgang Patsch
- Institute of Pharmacology and Toxicology, Paracelsus Medical University Salzburg, 5020 Austria.
| | - Elmar Aigner
- Department of Internal Medicine I, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria.
- Obesity Research Group, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria.
| | - Christian Datz
- Department of Internal Medicine, General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical University Salzburg, 5110 Oberndorf, Austria.
- Obesity Research Group, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria.
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Song N, Shin A, Jung HS, Oh JH, Kim J. Effects of interactions between common genetic variants and smoking on colorectal cancer. BMC Cancer 2017; 17:869. [PMID: 29258461 PMCID: PMC5737484 DOI: 10.1186/s12885-017-3886-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 12/08/2017] [Indexed: 12/17/2022] Open
Abstract
Background Although genome-wide association studies (GWAS) have identified variants in approximately 40 susceptibility loci for colorectal cancer (CRC), there are few studies on the interactions between identified single-nucleotide polymorphisms (SNPs) and lifestyle risk factors. We evaluated whether smoking could modify associations between these genetic variants and CRC risk. Methods A total of 703 CRC patients and 1406 healthy controls were included in this case-control study from the National Cancer Center in Korea. Thirty CRC susceptibility SNPs identified in previous GWAS were genotyped. A logistic regression model was used to examine associations between the SNPs and smoking behaviors by sex. The interaction was estimated by including an additional interaction term in the model. Results In men, an increased CRC risk was observed for longer durations (OR>28 vs. ≤28years = 1.49 (95% CI = 1.11–1.98)), greater quantities (OR≥20 vs. <20cigarettes/day = 2.12 (1.61–2.79)), and longer pack-years of smoking (OR≥21 vs. <21pack-years = 1.78 (1.35–2.35)). In women, longer pack-years of smoking significantly increased CRC risk (OR≥5 vs. <5pack-years = 6.11 (1.10–34.00)). Moreover, there were significant interactions between smoking status and the polymorphisms rs1957636 at 14q22.3 (Pinteraction = 5.5 × 10−4) and rs4813802 at 20p12.3 (Pinteraction = 0.04) in men. Interactions between smoking status and the rs6687758 at 1q41 (Pinteraction = 0.03), duration and the rs174537 at 11q12.2 (Pinteraction = 0.05), and pack-years and the rs4813802 (Pinteraction = 0.04) were also found in women. Conclusions Associations between susceptibility SNPs and CRC risk may be modified by smoking behaviors, supporting the existence of gene-smoking interactions. Electronic supplementary material The online version of this article (10.1186/s12885-017-3886-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nan Song
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Aesun Shin
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea. .,Department of Preventive Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea. .,Molecular Epidemiology Branch, National Cancer Center, Goyang, South Korea.
| | - Hye Soo Jung
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Jae Hwan Oh
- Center for Colorectal Cancer, National Cancer Center, Goyang, South Korea
| | - Jeongseon Kim
- Molecular Epidemiology Branch, National Cancer Center, Goyang, South Korea. .,Molecular Epidemiology Branch, Division of Cancer Epidemiology and Prevention, Research Institute, National Cancer Center, 323 Ilsan-ro, Insandong-gu, Goyang-si, Gyeonggi-do, 10408, South Korea.
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13
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de Jong R, Burden A, de Kort S, van Herk-Sukel M, Vissers P, Janssen P, Haak H, Masclee A, de Vries F, Janssen-Heijnen M. Impact of detection bias on the risk of gastrointestinal cancer and its subsites in type 2 diabetes mellitus. Eur J Cancer 2017; 79:61-71. [DOI: 10.1016/j.ejca.2017.03.039] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 03/25/2017] [Accepted: 03/29/2017] [Indexed: 01/23/2023]
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14
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Zhao M, Liao D, Zhao J. Diabetes-induced mechanophysiological changes in the small intestine and colon. World J Diabetes 2017; 8:249-269. [PMID: 28694926 PMCID: PMC5483424 DOI: 10.4239/wjd.v8.i6.249] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 04/05/2017] [Accepted: 05/05/2017] [Indexed: 02/05/2023] Open
Abstract
The disorders of gastrointestinal (GI) tract including intestine and colon are common in the patients with diabetes mellitus (DM). DM induced intestinal and colonic structural and biomechanical remodeling in animals and humans. The remodeling is closely related to motor-sensory abnormalities of the intestine and colon which are associated with the symptoms frequently encountered in patients with DM such as diarrhea and constipation. In this review, firstly we review DM-induced histomorphological and biomechanical remodeling of intestine and colon. Secondly we review motor-sensory dysfunction and how they relate to intestinal and colonic abnormalities. Finally the clinical consequences of DM-induced changes in the intestine and colon including diarrhea, constipation, gut microbiota change and colon cancer are discussed. The final goal is to increase the understanding of DM-induced changes in the gut and the subsequent clinical consequences in order to provide the clinicians with a better understanding of the GI disorders in diabetic patients and facilitates treatments tailored to these patients.
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15
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The association between plasma C-peptide concentration and the risk of prostate cancer: a nested case-control study within a Japanese population-based prospective study. Eur J Cancer Prev 2017; 27:461-467. [PMID: 28362652 DOI: 10.1097/cej.0000000000000363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The association between plasma C-peptide concentration and prostate cancer is unclear. Inconsistency of results from previous studies motivates this study. Using the Japan Public Health Center-based Prospective study, 201 prostate cancer cases and 402 controls were matched by age, public health center area, residence, date and time of blood collection, and fasting duration before blood collection. Odds ratios (OR) and 95% confidence intervals (CIs) were estimated by conditional logistic regression models. Out of 201 cases, 144 were localized and 48 were advanced. The overall association between median plasma C-peptide concentration and prostate cancer was not significant (OR for the highest tertile=0.81, 95% CI: 0.43-1.56, P-trend=0.54). Although stratification of prostate cancer by stage indicated different effects of plasma C-peptide on localized and advanced cases, there was no association between plasma C-peptide concentration and advanced prostate cancer (OR=2.82, 95% CI: 0.30-26.36 for the highest category, P-trend=0.37) and localized cases (OR=0.49, 95% CI: 0.23-1.04 for the highest category, P-trend=0.06) for patients fasting at the time of blood collection. The association between plasma C-peptide concentration and prostate cancer risk differed by cancer stage. Differentiation of localized and advanced prostate cancer cases is crucial when investigating the association between plasma C-peptide concentration and the risk of prostate cancer.
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Lee SJ, Kim JH, Park SJ, Ock SY, Kwon SK, Choi YS, Kim BK. Optimal glycemic target level for colon cancer patients with diabetes. Diabetes Res Clin Pract 2017; 124:66-71. [PMID: 28107755 DOI: 10.1016/j.diabres.2016.12.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 11/30/2016] [Accepted: 12/08/2016] [Indexed: 01/27/2023]
Abstract
AIMS The aim of this study was to evaluate the differences in mortality among colon cancer patients with or without diabetes and to determine optimal glycemic target level for colon cancer patients with diabetes. METHODS A total of 741 patients with colon cancer between April 1999 and December 2010 were reviewed. The non-diabetes group had a fasting plasma glucose <126mg/dL, and the diabetes group had a fasting plasma glucose ⩾126mg/dL. Patients with diabetes were further divided based on glycemic control into either the uncontrolled subgroup (HbA1c ⩾8%) or the well-controlled subgroup (HbA1c <8%). RESULTS Patients with diabetes had significantly shorter overall survival and median survival than non-diabetes patients. Uncontrolled diabetes patients had significantly shorter overall survival and median survival than well-controlled diabetes patients. The relative risk of mortality for diabetes patients was higher than non-diabetes patients (relative risk 1.17). The relative risk of mortality in uncontrolled diabetes patients was significantly higher than in well-controlled diabetes patients (relative risk 4.58). The area under the curve for mortality and HbA1c level was 0.73. The cut off HbA1c level was 7.75%. CONCLUSIONS A optimal glycemic control level for colon cancer patients with diabetes should be recommended as an HbA1c of 7.8% or below.
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Affiliation(s)
- Shin Jun Lee
- Department of Internal Medicine, Kosin University College of Medicine, Gamcheonro 262, Seogu, Busan, South Korea
| | - Jae Hyun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Gamcheonro 262, Seogu, Busan, South Korea
| | - Seun Ja Park
- Department of Internal Medicine, Kosin University College of Medicine, Gamcheonro 262, Seogu, Busan, South Korea
| | - So Young Ock
- Department of Internal Medicine, Kosin University College of Medicine, Gamcheonro 262, Seogu, Busan, South Korea
| | - Su Kyoung Kwon
- Department of Internal Medicine, Kosin University College of Medicine, Gamcheonro 262, Seogu, Busan, South Korea
| | - Young Sik Choi
- Department of Internal Medicine, Kosin University College of Medicine, Gamcheonro 262, Seogu, Busan, South Korea
| | - Bu Kyung Kim
- Department of Internal Medicine, Kosin University College of Medicine, Gamcheonro 262, Seogu, Busan, South Korea.
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