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      Genetically predicted 486 blood metabolites in relation to risk of colorectal cancer: A Mendelian randomization study

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          Abstract

          Background

          Metabolic disorders are a hallmark feature of cancer. However, the evidence for the causality of circulating metabolites to promote or prevent colorectal cancer (CRC) is still lacking. We performed a two‐sample Mendelian randomization (MR) analysis to assess the causality from genetically proxied 486 blood metabolites to CRC.

          Methods

          Genome‐wide association study (GWAS) data for exposures were extracted from 7824 Europeans GWAS on metabolite levels. GWAS data for CRC from the GWAS catalog database GCST012879 were used for the preliminary analysis. The random inverse variance weighted (IVW) is the primary analysis for causality analysis while MR‐Egger and weighted median as complementary analyses. Cochran Q test, MR‐Egger intercept test, MR‐PRESSO, Radial MR, and leave‐one‐out analysis were used for sensitivity analyses. For significant associations, additional independent CRC GWAS data GCST012880 were used for replication analysis and meta‐analysis. For the final identification of metabolites, Steiger test, linkage disequilibrium score regression, and colocalization analysis were performed for further evaluation. Multivariable MR was performed to assess the direct effect of metabolites on CRC.

          Results

          The results of this study indicated significant associations between six metabolites pyruvate (odds ratio [OR]: 0.49, 95% confidence interval [CI]: 0.32–0.77, p = 0.002), 1,6‐anhydroglucose (OR: 1.33, 95% CI: 1.11–1.59, p = 0.002), nonadecanoate (19:0) (OR: 0.40, 95% C I:0.4–0.68, p = 0.0008), 1‐linoleoylglycerophosphoethanolamine (OR: 0.47, 95% CI: 0.30–0.75, p = 0.001), 2‐hydroxystearate (OR: 0.39, 95% CI: 0.23–0.67, p = 0.0007), gamma‐glutamylthreonine (OR: 2.14, 95% CI: 1.02–4.50, p = 0.040) and CRC. MVMR analysis revealed that genetically predicted pyruvate, 1‐linoleoylglycerophosphoethanolamine and gamma‐glutamylthreonine can directly influence CRC independently of other metabolites.

          Conclusion

          The current work provides evidence to support the causality of the six circulating metabolites on CRC and a new perspective on the exploration of the biological mechanisms of CRC by combining genomics and metabolomics. These findings contribute to the screening, prevention and treatment of CRC.

          Abstract

          Due to unavoidable study design weaknesses, previous studies have made it difficult to assess the causality from circulating metabolites to colorectal cancer. In this work, the authors used the most comprehensive blood metabolite genome‐wide association study data to assess the causality between metabolites and colorectal cancer based on a Mendelian randomization study. They found that genetic liability for higher levels of pyruvate, nonadecanoate (19:0), 1‐linoleoylglycerophosphoethanolamine, and 2‐hydroxystearate associated with lower colorectal cancer risk while higher levels of 1,6‐anhydroglucose and gamma‐glutamylthreonine increased risk of colorectal cancer.

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          Most cited references70

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          Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

          This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.
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            Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries

            This article provides a status report on the global burden of cancer worldwide using the GLOBOCAN 2018 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer, with a focus on geographic variability across 20 world regions. There will be an estimated 18.1 million new cancer cases (17.0 million excluding nonmelanoma skin cancer) and 9.6 million cancer deaths (9.5 million excluding nonmelanoma skin cancer) in 2018. In both sexes combined, lung cancer is the most commonly diagnosed cancer (11.6% of the total cases) and the leading cause of cancer death (18.4% of the total cancer deaths), closely followed by female breast cancer (11.6%), prostate cancer (7.1%), and colorectal cancer (6.1%) for incidence and colorectal cancer (9.2%), stomach cancer (8.2%), and liver cancer (8.2%) for mortality. Lung cancer is the most frequent cancer and the leading cause of cancer death among males, followed by prostate and colorectal cancer (for incidence) and liver and stomach cancer (for mortality). Among females, breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death, followed by colorectal and lung cancer (for incidence), and vice versa (for mortality); cervical cancer ranks fourth for both incidence and mortality. The most frequently diagnosed cancer and the leading cause of cancer death, however, substantially vary across countries and within each country depending on the degree of economic development and associated social and life style factors. It is noteworthy that high-quality cancer registry data, the basis for planning and implementing evidence-based cancer control programs, are not available in most low- and middle-income countries. The Global Initiative for Cancer Registry Development is an international partnership that supports better estimation, as well as the collection and use of local data, to prioritize and evaluate national cancer control efforts. CA: A Cancer Journal for Clinicians 2018;0:1-31. © 2018 American Cancer Society.
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              Detection of widespread horizontal pleiotropy in causal relationships inferred from Mendelian randomization between complex traits and diseases

              Horizontal pleiotropy occurs when the variant has an effect on disease outside of its effect on the exposure in Mendelian randomization (MR). Violation of the ‘no horizontal pleiotropy’ assumption can cause severe bias in MR. We developed the Mendelian Randomization Pleiotropy RESidual Sum and Outlier (MR-PRESSO) test to identify horizontal pleiotropic outliers in multi-instrument summary-level MR testing. We showed using simulations that MR-PRESSO is best suited when horizontal pleiotropy occurs in <50% of instruments. Next, we applied MR-PRESSO, along with several other MR tests to complex traits and diseases, and found that horizontal pleiotropy: (i) was detectable in over 48% of significant causal relationships in MR; (ii) introduced distortions in the causal estimates in MR that ranged on average from −131% to 201%; (iii) induced false positive causal relationships in up to 10% of relationships; and (iv) can be corrected in some but not all instances.
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                Author and article information

                Contributors
                drdong@tom.com
                houli1203@126.com
                Journal
                Cancer Med
                Cancer Med
                10.1002/(ISSN)2045-7634
                CAM4
                Cancer Medicine
                John Wiley and Sons Inc. (Hoboken )
                2045-7634
                03 May 2023
                June 2023
                : 12
                : 12 ( doiID: 10.1002/cam4.v12.12 )
                : 13784-13799
                Affiliations
                [ 1 ] Dongzhimen Hospital Beijing University of Chinese Medicine (BUCM) Beijing China
                [ 2 ] Department of Oncology and Hematology, Dongzhimen Hospital Beijing University of Chinese Medicine (BUCM) Beijing China
                Author notes
                [*] [* ] Correspondence

                Qing Dong and Li Hou,

                Department of Oncology and Hematology, Dongzhimen Hospital, Beijing University of Chinese Medicine, 5 Haiyun Cang, Beijing 100700, People's Republic of China.

                Email: drdong@ 123456tom.com and houli1203@ 123456126.com

                Author information
                https://orcid.org/0000-0002-3422-9140
                https://orcid.org/0000-0001-7246-147X
                https://orcid.org/0000-0003-2921-0821
                Article
                CAM46022 CAM4-2022-11-5313.R2
                10.1002/cam4.6022
                10315807
                37132247
                ebab2e9e-338f-4f94-ad34-dc0d2e9c2a79
                © 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 16 March 2023
                : 30 November 2022
                : 18 April 2023
                Page count
                Figures: 6, Tables: 1, Pages: 16, Words: 8473
                Funding
                Funded by: National Natural Science Foundation of China Grant Program
                Award ID: 81573959
                Funded by: the Capital Health Development Research Fund
                Award ID: 2020‐2‐4193
                Award ID: 2022‐1‐4171
                Categories
                Research Article
                RESEARCH ARTICLES
                Cancer Prevention
                Custom metadata
                2.0
                June 2023
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.3.0 mode:remove_FC converted:03.07.2023

                Oncology & Radiotherapy
                blood metabolites,causality,colocalization analysis,colorectal cancer,mendelian randomization

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