Prediagnostic serum calcium concentrations and risk of colorectal cancer development in 2 large European prospective cohorts

Zinc, copper, copper-to-zinc ratio, and other biometals in blood serum and tumor tissue of patients with colorectal cancer

The objective of the present study was to assess serum and cancerous tissue biometal levels in colorectal cancer (CRC) patients, and its relation to disease severity. A total of 90 CRC patients and 97 controls were involved in the present study. The level of biometals in blood serum and colon tissues (only in CRC cases) was evaluated by inductively-coupled plasma mass-spectrometry. CRC patients are characterized by lower serum Ca, Fe, Se, and Zn, as well as higher serum Co, Cu, Mg, V, and Cu/Zn ratio compared to healthy controls. The lowest serum Zn levels and the highest Cu concentration and Cu/Zn ratio were observed in patients with the largest tumor size. Regression analysis demonstrated that tumor size is a significant negative predictor of serum Se levels, being positively associated with serum Cu/Zn values. The degree of metastasis to regional lymph nodes was inversely associated with circulating Ca, Co, Mg, Zn, and Mn levels. Serum Mg and Mn levels were positively associated with the stage of the disease and tumor location, respectively. Cancerous tissue Ca and Mo levels were lower, while Mg content was higher compared to healthy adjacent tissues. In cancerous tissues a constant but non-significant trend to elevation of tissue Zn content with increasing tumor size was observed. In addition, serum Cu, Zn, and Cu/Zn values positively correlated with the respective tumor values. These findings demonstrate that altered biometal metabolism is associated with CRC, while systemic Cu/Zn ratio may be indicative of Cu and Zn imbalance in cancerous tissue.

Predictive value of serum calcium ion level in patients with colorectal cancer: A retrospective cohort study

BACKGROUND

Serum calcium ion (Ca2+) is an economical and readily available indicator as a routine screening test for hospitalized patients. There are no studies related to serum Ca2+ level and digestive tract malignancy.

AIM

To evaluate the effectiveness of serum Ca2+ level in predicting the prognosis of patients with colorectal cancer (CRC).

METHODS

We retrospectively collected the data of 280 patients diagnosed with CRC who underwent radical surgery at the Affiliated Cancer Hospital of Xinjiang Medical University. By analyzing the clinicopathological features, differences between serum Ca2+ concentrations on the first day after surgery were determined. We used the receiver operating characteristic curve to assess the predictive ability of serum Ca2+ for survival. Survival analyses were performed using the Kaplan-Meier method, and multivariate Cox proportional risk regression was used to determine association between calibration serum Ca2+ levels and CRC survival outcomes.

RESULTS

By receiver operating characteristic curve analysis, the ideal threshold value for Ca2+ the first postoperative day and delta serum calcium (δCa2+) value were 1.975 and 0.245, respectively. Overall survival (OS) and progression-free survival (PFS) were better in both the high Ca2+ group and high δCa2+ group on the first postoperative day. The variables identified through univariate analysis were incorporated into multivariate analysis and showed that tumor differentiation (P = 0.047), T stage (P = 0.019), N stage (P < 0.001), nerve vascular invasion (P = 0.037), carcinoembryonic antigen (P = 0.039), baseline serum Ca2+ level (P = 0.011), and serum Ca2+ level on the first day (P = 0.006) were independent predictors of prognosis for patients undergoing feasible radical CRC surgery. Using the findings from the multifactorial analysis, we developed a nomogram and the calibration showed a good predictive ability.

CONCLUSION

Low serum Ca2+ level on the first postoperative day is an independent risk factor for OS and PFS in CRC.

Rb1 restores palmitic acid-induced reduction of Ca2+ influx by activating PLC in EA cells and PLD in MOVAS cells

Recent interest has focused on the role of Ca2+ in regulating health problems, including cardiovascular disease and colorectal cancer. The inverse correlation between colon cancer and serum Ca2+ underlines the importance of understanding intracellular Ca2+ dynamics. Studies are also evaluating the contributions of abnormalities in Ca²⁺ homeostasis and intracellular dysfunction to the pathogenesis of metabolic syndrome as a precursor of cardiovascular disease. In this study, we investigated the changes of Ca2+ dynamics and ginsenoside Rb1 (Rb1)-induced recovery in two vascular cell lines exposed to palmitic acid (PA), the most abundant active ingredient in palm oil. The mechanism underlying the Rb1-induced recovery was examined in a store operated Ca2+ entry model by Ca2+ store depletion. PA reduced the Ca2+ influx in both EA.hy926 (EA) and MOVAS cells, and this change was restored by Rb1. In EA cells, the Rb1-induced restoration was abolished by U73122 or 2-APB. In MOVAS cells, meanwhile, the effect of Rb1 was abolished by FIPI, U73122 and U73343. Under normal conditions, Rb1 itself altered phospholipid signaling (PLC in EA cells and PLD in MOVAS cells), but did not affect Ca2+ homeostasis. These differences resulted in differences in downstream actions, as KB-R7943 and nifedipine inhibited Rb1-mediated Ca2+ influx recovery only in MOVAS cells. In conclusion, Rb1 rescues the PA-induced Ca2+ influx by appropriately activating PLC in EA cells and PLD in MOVAS cells. This demonstrates that Ca2+ dynamics are elaborately regulated via intracellular Ca2+ signaling networks, suggesting a potential strategy for maintaining vascular Ca2+ homeostasis in hyperlipidemic environments.

Evolving landscape of colorectal cancer: Global and regional burden, risk factor dynamics, and future scenarios (the Global Burden of Disease 1990-2050)

BACKGROUND

Presently, colorectal cancer (CRC) is the second leading cause of cancer-related deaths worldwide. We provided global, regional, and national estimates of the burden of CRC and their attributable risks from 1990 to 2021, aiming to guide screening, early detection, and treatment strategies, optimize healthcare resource allocation, and facilitate the rational management of burden of CRC.

METHODS

Using data derived from the Global Burden of Disease database, we estimated the incidence, mortality, and disability-adjusted life years (DALYs) of CRC. The temporal trends of the age-standardized rate of CRC were quantified by calculating the estimated annual percentage changes (EAPC). Deaths from CRC attributable to each risk factor that had evidence of causation with CRC were estimated. CRC's deaths and DALYs was forecast through 2050 by logistic regression with Socio-Demographic Index as a predictor, then multiplying by projected population estimates.

RESULTS

Globally, between 1990 and 2021, the incident cases, death cases, and DALYs attributed to CRC have doubled, the age-standardized incidence rate (ASIR) presented a slightly upward tendency, while the age-standardized death rate (ASMR) and the age-standardized DALYs rate (ASDR) exhibited a decreasing trend. From 1990-2021, the ASIR for males has an increased trend, while females presented a downward trend. The ASIR and ASDR of CRC were higher in high and high-middle sociodemographic index (SDI) countries. The ASIR of CRC in 165 countries and territories showed escalating trend. Globally, for males and both sexes combined, diet low in whole grains was the leading risk factor for age-standardized deaths from CRC in 2021. However, among females, diet low in milk was the leading risk factor. We forecast that 2.18 million (1.53-2.94) individuals will death for CRC worldwide by 2050, and the DALYs achieve 41.7 million (29.9-55.4) by 2050.

CONCLUSION

The doubling of incidence counts and mortality cases and the rising ASIR in most countries indicates a significant burden of CRC. Authorities should devise suitable measures to address the increasing burdens, such as optimizing screening programs, enhancing awareness and screening efforts for males, and reducing exposure to modifiable risk factors.

Diet-wide analyses for risk of colorectal cancer: prospective study of 12,251 incident cases among 542,778 women in the UK

Uncertainty remains regarding the role of diet in colorectal cancer development. We examined associations of 97 dietary factors with colorectal cancer risk in 542,778 Million Women Study participants (12,251 incident cases over 16.6 years), and conducted a targeted genetic analysis in the ColoRectal Transdisciplinary Study, Colon Cancer Family Registry, and Genetics and Epidemiology of Colorectal Cancer Consortium (GECCO). Alcohol (relative risk per 20 g/day=1.15, 95% confidence interval 1.09-1.20) and calcium (per 300 mg/day=0.83, 0.77-0.89) intakes had the strongest associations, followed by six dairy-related factors associated with calcium. We showed a positive association with red and processed meat intake and weaker inverse associations with breakfast cereal, fruit, wholegrains, carbohydrates, fibre, total sugars, folate, and vitamin C. Genetically predicted milk consumption was inversely associated with risk of colorectal, colon, and rectal cancers. We conclude that dairy products help protect against colorectal cancer, and that this is driven largely or wholly by calcium.

Exploring the Chemopreventive Effect of Medication on Gene Expression Linked to Colorectal Cancer: An Observational and Mendelian Randomization Analysis in Healthy Colon Mucosa

Gene expression appears altered in apparently normal tissue surrounding tumor tissue. The observed biological alterations in the tumor microenvironment play a crucial role in cancer development and are named the cancer field effect (FE). A robust set of overexpressed FE genes in tissue surrounding colorectal cancer (CRC) tumor were identified in previous studies. Our study aimed to investigate the influence of common medication intake and modifiable risk factors on FE gene expression using a colonic mucosa sample dataset of healthy individuals (BarcUVa-Seq). We applied expression enrichment analysis of the FE genes for each studied medication and factor. Both observational and instrumental (Mendelian randomization) analysis were conducted, and the results were validated using independent datasets. The findings from the observational and instrumental analyses consistently showed that medication intake, especially metformin, considerably downregulated the FE genes. Chemopreventive effects were also noted for antihypertensive drugs targeting the renin-angiotensin system. Conversely, benzodiazepines usage might upregulate FE genes, thus fostering a tumor-promoting microenvironment. In contrast, the findings from the observational and instrumental analyses on modifiable risk factors showed some discrepancies. The instrumental results indicated that obesity and smoking might promote a tumor-favorable microenvironment. These findings offer insights into the biological mechanisms through which risk factors might influence CRC development and highlight the potential chemopreventive roles of metformin and antihypertensive drugs in CRC risk.

Epidemiology of Colorectal Cancer in Saudi Arabia: A Review

Colorectal cancer (CRC) is the second leading cause of cancer death in the world, originating from the glandular epithelial cells of the large intestine and the rectum. This article aims to review the epidemiology of CRC in Saudi Arabia, focusing on prevalence, incidence, risk factors, preventive measures, and outcomes. This narrative review utilized the PubMed database for data extraction, including freely accessible studies published in the last 15 years. Sixteen articles from different study designs were included, while awareness and non-English language studies were excluded. In 2020, the incidence and mortality rate of CRC in Saudi Arabia were 14.6% and 1.48% among all cancers, respectively. From 2006 to 2016, the number of colon cancer and rectal cancer cases increased by 8% and 7%, respectively. Risk factors for CRC in Saudi Arabia include low education level, unemployment, physical inactivity, excess weight, poor knowledge of foods rich in fiber, cigarette smoking, reduced serum vitamin D and calcium levels, and certain gene mutations. National guidelines in Saudi Arabia recommend CRC screening for all individuals above 45 years using colonoscopy, flexible sigmoidoscopy, or fecal occult blood test. The 10-year survival rate for CRC in Saudi Arabia is 44.6%. The overall 5-year survival rate for the Ministry of National Guard-Health Affairs is 52.0%. To lower the incidence and mortality of CRC, primary, secondary, and tertiary prevention are all very important. The most crucial aspect is to concentrate on primary prevention, which may involve raising public awareness of CRC risk factors and strategies for reducing or eliminating them.

Identification of phenomic data in the pathogenesis of cancers of the gastrointestinal (GI) tract in the UK biobank

Gastrointestinal (GI) cancers account for a significant incidence and mortality rates of cancers globally. Utilization of a phenomic data approach allows researchers to reveal the mechanisms and molecular pathogenesis of these conditions. We aimed to investigate the association between the phenomic features and GI cancers in a large cohort study. We included 502,369 subjects aged 37-73 years in the UK Biobank recruited since 2006, followed until the date of the first cancer diagnosis, date of death, or the end of follow-up on December 31st, 2016, whichever occurred first. Socio-demographic factors, blood chemistry, anthropometric measurements and lifestyle factors of participants collected at baseline assessment were analysed. Unvariable and multivariable logistic regression were conducted to determine the significant risk factors for the outcomes of interest, based on the odds ratio (OR) and 95% confidence intervals (CI). The analysis included a total of 441,141 participants, of which 7952 (1.8%) were incident GI cancer cases and 433,189 were healthy controls. A marker, cystatin C was associated with total and each gastrointestinal cancer (adjusted OR 2.43; 95% CI 2.23-2.64). In this cohort, compared to Asians, the Whites appeared to have a higher risk of developing gastrointestinal cancers. Several other factors were associated with distinct GI cancers. Cystatin C and race appear to be important features in GI cancers, suggesting some overlap in the molecular pathogenesis of GI cancers. Given the small proportion of Asians within the UK Biobank, the association between race and GI cancers requires further confirmation.

Are Twin Pregnancies at Higher Risk for Iron and Calcium Deficiency than Singleton Pregnancies?

The aim of this study was to compare the iron and calcium status in singleton and twin pregnancies and to assess whether there is an increased risk for iron and calcium deficiency in twin gestation. The study included 105 singleton and 9 twin pregnancies at or above 35 weeks of gestation. Information on prenatal supplementation with iron or calcium was acquired, and adverse perinatal outcomes were recorded. Biosamples from all 114 mothers and 73 newborns (61 singleton and 12 twin newborns) were finally analyzed. Total iron and calcium concentrations in serum were measured through total reflection X-ray fluorescence analysis. The results indicated no significant differences in maternal serum iron and calcium concentrations between singleton and twin pregnancies. Similarly, iron and calcium concentrations in newborn umbilical cord serum samples were not different between singleton and twin pregnancies. The comparison of total iron and calcium between mothers and umbilical cord serum indicated significantly lower concentrations in the mothers, with the differences being not homogenous but rather pair-specific. A significant positive correlation between maternal serum and umbilical cord serum calcium concentration was noticed. Prenatal iron supplementation was associated with higher iron concentrations in both mothers and newborns, supporting the efficiency of supplementation and the quality of the study methods. Collectively, the data indicate no significant differences in serum iron and calcium concentrations with regard to singleton or twin pregnancies and the efficiency of iron supplementation during pregnancy for increasing iron status.

Determination of Calcium in Meat Products by Automatic Titration with 1,2-Diaminocyclohexane-N,N,N',N'-tetraacetic Acid

Mechanically separated meat (MSM) is a by-product of the poultry industry that requires routine quality assessment. Calcium content is an indirect indicator of bone debris in MSM but is difficult to determine by EDTA titration due to the poor solubility of calcium phosphate. Therefore, 1,2-diaminocyclohexane-N,N,N',N'-tetraacetic acid was used instead, which has two orders of magnitude higher affinity for calcium ions. In addition, the auxiliary complexing agents triethanolamine and Arsenazo III, an indicator that is sensitive to low calcium concentrations, were used. Automatic titration endpoint detection was performed using an immersion probe at 660 nm. It has been shown that the color change in Arsenazo III can also be read with an RGB camera. The CDTA titration procedure has been tested on commercial Bologna-type sausages and the results were in line with AAS and ICP reference data. The content of calcium in sausages turned out to be very diverse and weakly correlated with the content of MSM. The tested MSM samples had a wide range of calcium content: from 62 to 2833 ppm. Calcium-rich poultry by-products include fat and skin (115 to 412 ppm), articular cartilage (1069 to 1704 ppm), and tendons (532 to 34,539 ppm). The CDTA titration procedure is fully suitable for small meat processing plants due to its simplicity of use and low cost.