Bener Abdulbari, Ozturk Ahmet Emin, Ustundag Unsal Veli, Barisik Cem Cahit, Agan Ahmet F, Day Andrew S
Department of Biostatistics and Public Health, School of Medicine, Istanbul Medipol University, Istanbul, Turkey.
Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, The University of Manchester, Manchester, UK.
J Clin Med Res. 2024 Oct;16(10):483-490. doi: 10.14740/jocmr5296. Epub 2024 Oct 18.
The aim of this study is to investigate whether vitamin D, calcium, ferritin, and uric acids play a beneficial biomarker role in the prevention of colorectal cancer (CRC) risk.
The case-control design was employed, including 650 CRC cases and 650 controls aged 35 to 70 years, comprising both men and women. The study encompasses sociodemographic data, clinical information, radiological diagnoses, and biochemical measurements.
Statistically significant differences were observed between CRC and controls in terms of age, diagnostic radiology, tomography, positron emission tomography/computed tomography (PET/CT), colonoscopy, CRC awareness, risk factors, age, genetics, exposure to chemicals, inadequate nutrition, smoking, hookah and alcohol use. Significant differences were also identified in intestinal inflammations, obesity, processed foods (P < 0.001), abdominal pain and cramps, diarrhea, constipation, blood in stool, bloating (gas), irritable bowel, nausea/vomiting, anemia, stress, fatigue, weakness, and weight loss. Regarding biochemical parameters, statistically significant differences were found between CRC and controls in terms of hemoglobin, glycated hemoglobin (HbA1c), fasting blood glucose (FBG), vitamin D, neutrophil level, red blood cell (RBC), white blood cell (WBC), platelet level, platelet count, hematocrit, potassium, sodium (Na), calcium, creatinine, cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), bilirubin, uric acid, iron (Fe), ferritin, C-reactive protein (CRP), total protein, systolic blood pressure (SBP), and diastolic blood pressure (DBP) parameters (P < 0.001). Multivariate stepwise regression analysis was performed to find the best risk factors for the diagnosis of CRC as the dependent variable. As a result of the analysis, intestinal inflammation (P < 0.001), nausea/vomiting (P < 0.001), stomach pain (P = 0.003), hookah-smoking (P = 0.034), uric acid (P < 0.001), bilirubin (P < 0.001), cigarette smoke exposure (P = 0.033), processed food consumption (P = 0.002), calcium levels (P = 0.029), vitamin D deficiency (P < 0.001), and ferritin (P < 0.001) levels were identified as significant determinants for CRC.
The current study demonstrated that vitamin D, calcium, ferritin, and uric acids play a beneficial biomarker role in reducing the risk of CRC prevention. The increase in CRC rates may be associated with lifestyle, environmental and hereditary factors, nutrition, alcohol consumption, hookah use, and cigarette smoking.
本研究的目的是调查维生素D、钙、铁蛋白和尿酸在预防结直肠癌（CRC）风险方面是否发挥有益的生物标志物作用。
采用病例对照设计，纳入650例年龄在35至70岁之间的结直肠癌病例和650例对照，包括男性和女性。该研究涵盖社会人口统计学数据、临床信息、放射学诊断和生化测量。
在年龄、诊断放射学、断层扫描、正电子发射断层扫描/计算机断层扫描（PET/CT）、结肠镜检查、结直肠癌知晓情况、危险因素、年龄、遗传学、化学物质暴露、营养不足、吸烟、水烟和酒精使用方面，结直肠癌病例与对照组之间存在统计学显著差异。在肠道炎症、肥胖、加工食品（P < 0.001）、腹痛和痉挛、腹泻、便秘、便血、腹胀（气体）、肠易激综合征、恶心/呕吐、贫血、压力、疲劳、虚弱和体重减轻方面也发现了显著差异。关于生化参数，在血红蛋白、糖化血红蛋白（HbA1c）、空腹血糖（FBG）、维生素D、中性粒细胞水平、红细胞（RBC）、白细胞（WBC）、血小板水平、血小板计数、血细胞比容、钾、钠（Na）、钙、肌酐、胆固醇、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、胆红素、尿酸、铁（Fe）、铁蛋白、C反应蛋白（CRP）、总蛋白、收缩压（SBP）和舒张压（DBP）参数方面，结直肠癌病例与对照组之间存在统计学显著差异（P < 0.001）。进行多变量逐步回归分析以找出作为因变量的结直肠癌诊断的最佳危险因素。分析结果显示，肠道炎症（P < 0.001）、恶心/呕吐（P < 0.001）、胃痛（P = 0.003）、水烟吸食（P = 0.034）、尿酸（P < 0.001）、胆红素（P < 0.001）、香烟烟雾暴露（P = 0.033）、加工食品消费（P = 0.002）、钙水平（P = 0.029）、维生素D缺乏（P < 0.001）和铁蛋白（P < 0.001）水平被确定为结直肠癌的重要决定因素。
当前研究表明，维生素D、钙、铁蛋白和尿酸在降低结直肠癌预防风险方面发挥有益的生物标志物作用。结直肠癌发病率的增加可能与生活方式、环境和遗传因素、营养、酒精消费、水烟使用和吸烟有关。
