Association between Long-term Energy Balance-Related Factors and Survival in Colorectal Cancer Overall and by Metabolic Warburg-Subtypes.

IF 3.7 3区 医学 Q2 ONCOLOGY Cancer Epidemiology Biomarkers & Prevention Pub Date : 2024-10-02 DOI:10.1158/1055-9965.EPI-24-0199
Kelly Offermans, Josien C A Jenniskens, Colinda C J M Simons, Iryna Samarska, Gregorio E Fazzi, Kim M Smits, Leo J Schouten, Matty P Weijenberg, Heike I Grabsch, Piet A van den Brandt
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Abstract

Background: Long-term energy balance-related factors (i.e., lifestyle and physiologic factors that influence the equilibrium between energy intake and energy expenditure over an extended period) such as body mass index (BMI) are linked to colorectal cancer risk, but their impact on colorectal cancer survival is unclear. We explored associations between these long-term energy balance-related factors and survival and examined potential differences across metabolic Warburg-subtypes.

Methods: Associations between long-term energy balance-related factors and survival in the total series of patients with colorectal cancer (n = 2,347) obtained from the prospective Netherlands Cohort Study, as well as according to Warburg-subtype (Warburg-low: n = 652, Warburg-moderate: n = 802, Warburg-high: n = 797), were investigated using Cox regression analysis.

Results: Among the long-term energy balance-related factors studied, only increasing prediagnostic BMI was associated with a borderline significant poorer overall survival in patients with colorectal cancer [HR5kg/m2, 1.07; 95% confidence interval (CI), 0.99-1.15]. Stratified analyses showed that prediagnostic weight gain (HR5kg, 1.04; 95% CI, 0.99-1.09) and potentially increased height (HR5cm, 1.04; 95% CI, 0.98-1.11) were associated with poor overall survival only in patients with Warburg-high colorectal cancer. Increasing prediagnostic BMI was associated with poor survival only in patients with Warburg-moderate colorectal cancer (colorectal cancer-specific: HR5kg/m2, 1.12; 95% CI, 0.96-1.32; overall: HR5kg/m2, 1.20; 95% CI, 1.05-1.36). No consistent patterns were observed across energy restriction proxies.

Conclusions: Maintaining a healthy prediagnostic BMI may be beneficial for colorectal cancer survival. Moreover, associations between prediagnostic BMI, weight change, early-life energy restriction, height, and colorectal cancer survival differed according to Warburg-subtypes.

Impact: Understanding the biologic pathways involved in associations between energy balance-related factors and colorectal cancer survival could help refine prevention strategies in the future.

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结直肠癌总体及沃伯格代谢亚型的长期能量平衡相关因素与存活率之间的关系。
背景:身体质量指数(BMI)等长期能量平衡相关因素(即影响长期能量摄入和能量消耗平衡的生活方式和生理因素)与结直肠癌(CRC)风险有关,但它们对CRC存活率的影响尚不清楚。我们探讨了这些长期能量平衡相关因素与生存之间的关系,并研究了不同代谢沃伯格亚型之间的潜在差异:方法:我们使用 Cox 回归分析法研究了前瞻性荷兰队列研究中所有 CRC 患者(2347 人)的长期能量平衡相关因素与生存率之间的关系,并根据沃伯格亚型(沃伯格-低:652 人,沃伯格-中:802 人,沃伯格-高:797 人)对长期能量平衡相关因素与生存率之间的关系进行了研究:结果:在所研究的长期能量平衡相关因素中,只有诊断前体重指数(BMI)的升高与 CRC 患者较差的总生存率(HR5kg/m2:1.07;95%CI:0.99-1.15)有边缘显著相关性。分层分析显示,诊断前体重增加(HR5kg 1.06;95%CI 1.00-1.12)和潜在身高增加(HR5cm 1.04;95%CI 0.98-1.11)仅与沃伯格高CRC患者总生存率较低有关。诊断前体重指数的增加仅与沃伯格中度 CRC 患者生存率低有关(CRC 特异性:HR5kg/m2 1.12;95%CI 0.96-1.32;总体:HR5kg/m2 1.20;95%CI 1.05-1.36)。在能量限制代用指标中未观察到一致的模式:结论:保持诊断前健康的 BMI 可能有利于 CRC 的生存。此外,诊断前体重指数、体重变化、生命早期能量限制、身高与 CRC 存活率之间的关系因沃伯格亚型而异:影响:了解能量平衡相关因素与 CRC 存活率之间关系的生物学途径有助于完善未来的预防策略。
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来源期刊
Cancer Epidemiology Biomarkers & Prevention
Cancer Epidemiology Biomarkers & Prevention 医学-公共卫生、环境卫生与职业卫生
CiteScore
6.50
自引率
2.60%
发文量
538
审稿时长
1.6 months
期刊介绍: Cancer Epidemiology, Biomarkers & Prevention publishes original peer-reviewed, population-based research on cancer etiology, prevention, surveillance, and survivorship. The following topics are of special interest: descriptive, analytical, and molecular epidemiology; biomarkers including assay development, validation, and application; chemoprevention and other types of prevention research in the context of descriptive and observational studies; the role of behavioral factors in cancer etiology and prevention; survivorship studies; risk factors; implementation science and cancer care delivery; and the science of cancer health disparities. Besides welcoming manuscripts that address individual subjects in any of the relevant disciplines, CEBP editors encourage the submission of manuscripts with a transdisciplinary approach.
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