Poullis Andrew, Foster Russell, Shetty Ajeya, Fagerhol Magne K, Mendall Michael A
Mayday University Hospital, Thornton Heath, Surrey, United Kingdom.
Cancer Epidemiol Biomarkers Prev. 2004 Feb;13(2):279-84. doi: 10.1158/1055-9965.epi-03-0160.
The mechanisms by which the lifestyle risk factors obesity, physical inactivity, and low fiber intake predispose to colorectal cancer (CRC) are unclear. Chronic bowel inflammation predisposes to malignancy in cases of inflammatory bowel disease. Many lifestyle risk factors for CRC are associated with evidence of systemic inflammation as indicated by circulating levels of C-reactive protein (CRP), but it is unknown how this relates to inflammation at tissue level. Little is known about the degree of bowel inflammation in general population and the factors that affect it. Therefore, we aimed to assess the relation of levels of bowel inflammation in the general population and lifestyle risk factors for CRC, and to additionally assess whether these associations, if present, were attenuated by controlling for evidence of systemic inflammation. Average CRC risk subjects (320) of either sex aged 50-70 were recruited in South London. A stool sample was provided for calprotectin measurement (a marker of bowel inflammation), serum for CRP, and a detailed dietary and lifestyle questionnaire completed. There was a significant positive relationship between fecal calprotectin and increasing age (P = 0.002), obesity (P = 0.04), physical inactivity (P = 0.01), and an inverse relationship with fiber intake (P = 0.02) and vegetable consumption (P = 0.04). The relationship with obesity was attenuated by controlling for serum CRP. Fecal calprotectin levels are associated with lifestyle risk factors for colorectal cancer. Low-level asymptomatic bowel inflammation may be the link between lifestyle and the pathogenesis of CRC, and circulating proinflammatory cytokines may be part of the mechanism for this link.
肥胖、缺乏身体活动和膳食纤维摄入量低等生活方式风险因素致使患结直肠癌（CRC）的机制尚不清楚。在炎症性肠病病例中，慢性肠道炎症易引发恶性肿瘤。许多结直肠癌的生活方式风险因素与全身性炎症证据相关，如C反应蛋白（CRP）的循环水平所示，但尚不清楚这与组织水平的炎症有何关联。对于一般人群肠道炎症的程度及其影响因素知之甚少。因此，我们旨在评估一般人群肠道炎症水平与结直肠癌生活方式风险因素之间的关系，并进一步评估如果存在这些关联，控制全身性炎症证据后是否会减弱。在伦敦南部招募了年龄在50 - 70岁之间的320名平均结直肠癌风险受试者（男女不限）。提供粪便样本用于测量钙卫蛋白（肠道炎症标志物），提供血清用于检测CRP，并完成详细的饮食和生活方式问卷。粪便钙卫蛋白与年龄增长（P = 0.002）、肥胖（P = 0.04）、缺乏身体活动（P = 0.01）呈显著正相关，与膳食纤维摄入量（P = 0.02）和蔬菜摄入量（P = 0.04）呈负相关。通过控制血清CRP，与肥胖的关系减弱。粪便钙卫蛋白水平与结直肠癌的生活方式风险因素相关。低水平无症状肠道炎症可能是生活方式与结直肠癌发病机制之间的联系，循环促炎细胞因子可能是这种联系机制的一部分。
