University of Utah, Salt Lake City, Utah.
Huntsman Cancer Institute, Salt Lake City, Utah.
Cancer Epidemiol Biomarkers Prev. 2022 Dec 5;31(12):2148-2156. doi: 10.1158/1055-9965.EPI-22-0681.
Physical activity and obesity are well-established factors of colorectal cancer risk and prognosis. Here, we investigate associations of individual and combined physical activity and body mass index (BMI) groups with proinflammatory biomarkers in colorectal cancer patients.
Self-reported physical activity levels were classified as "active" (≥8.75 MET-hours/week) versus "inactive" (<8.75 MET-hours/week) in n = 579 stage I-IV colorectal cancer patients enrolled in the ColoCare Study. BMI [normal weight (≥18.5-<25 kg/m2), overweight (≥25-<30 kg/m2), and obese (≥30 kg/m2)] was abstracted from medical records. Patients were classified into four combinations of physical activity levels and BMI. Biomarkers [C-reactive protein (CRP), SAA, IL6, IL8, and TNFα] in presurgery serum samples were measured using the Mesoscale Discovery Platform. Regression models were used to compute relative percent differences in biomarker levels by physical activity and BMI groups.
"Inactive" patients had non-statistically significant higher IL6 levels compared with "active" patients (+36%, P = 0.10). "Obese" patients had 88% and 17% higher CRP and TNFα levels compared with "normal weight" patients (P = 0.03 and 0.02, respectively). Highest CRP levels were observed among "overweight or obese/inactive" compared with "normal weight/active" patients (P = 0.03).
We provide evidence of associations between individual and combined physical activity and BMI groups with proinflammatory biomarkers. Although BMI was identified as the key driver of inflammation, biomarker levels were higher among "inactive" patients across BMI groups.
This is the largest study in colorectal cancer patients investigating associations of energy balance components with inflammatory biomarkers. Our results suggest that physical activity may reduce obesity-induced inflammation in colorectal cancer patients and support the design of randomized controlled trials testing this hypothesis.
体力活动和肥胖是结直肠癌风险和预后的既定因素。在这里，我们研究了个体和联合体力活动和身体质量指数（BMI）组与结直肠癌患者促炎生物标志物的关联。
在 ColoCare 研究中，共纳入了 579 例 I-IV 期结直肠癌患者，根据自我报告的体力活动水平将其分为“活跃”（≥8.75MET-hours/week）与“不活跃”（<8.75MET-hours/week）组。从病历中提取 BMI[正常体重（≥18.5-<25kg/m2）、超重（≥25-<30kg/m2）和肥胖（≥30kg/m2）]。将患者分为体力活动水平和 BMI 四个组合组。使用 Mesoscale Discovery Platform 测量术前血清样本中的生物标志物[C 反应蛋白（CRP）、SAA、IL6、IL8 和 TNFα]。使用回归模型计算生物标志物水平的体力活动和 BMI 组的相对百分比差异。
与“活跃”患者相比，“不活跃”患者的 IL6 水平高出非统计学显著的 36%（P=0.10）。与“正常体重”患者相比，“肥胖”患者的 CRP 和 TNFα 水平分别高出 88%和 17%（P=0.03 和 0.02）。与“正常体重/活跃”患者相比，“超重或肥胖/不活跃”患者的 CRP 水平最高（P=0.03）。
我们提供了个体和联合体力活动和 BMI 组与促炎生物标志物之间关联的证据。虽然 BMI 被确定为炎症的关键驱动因素，但在 BMI 组中，“不活跃”患者的生物标志物水平更高。
这是在结直肠癌患者中进行的最大规模的研究，旨在调查能量平衡成分与炎症生物标志物的关联。我们的结果表明，体力活动可能会降低结直肠癌患者肥胖引起的炎症，并支持设计测试这一假设的随机对照试验。
