Inflammation Is a Mediating Factor in the Association between Lifestyle and Fatigue in Colorectal Cancer Patients

被引：17

作者：

Wesselink, Evertine ^{[1
]}

van Baar, Harm ^{[1
]}

van Zutphen, Moniek ^{[1
]}

Tibosch, Meilissa ^{[1
]}

Kouwenhoven, Ewout A. ^{[2
]}

Keulen, Eric T. P. ^{[3
]}

Kok, Dieuwertje E. ^{[1
]}

van Halteren, Henk K. ^{[4
]}

Breukink, Stephanie O. ^{[5
,6
]}

de Wilt, Johannes H. W. ^{[7
]}

Weijenberg, Matty P. ^{[6
]}

Kenkhuis, Marlou-Floor ^{[6
]}

Balvers, Michiel G. J. ^{[1
]}

Witkamp, Renger F. ^{[1
]}

van Duijnhoven, Franzel J. B. ^{[1
]}

Kampman, Ellen ^{[1
]}

Beijer, Sandra ^{[8
]}

Bours, Martijn J. L. ^{[6
]}

Winkels, Renate M. ^{[1
]}

机构：

[1] Wageningen Univ, Div Human Nutr & Hlth, NL-6708 WE Wageningen, Netherlands

[2] Ziekenhuis Grp Twente, Dept Surg, NL-7600 SZ Almelo, Netherlands

[3] Zuyderland Med Ctr, Dept Gastroenterol, NL-6162 BG Sittard Geleen, Netherlands

[4] Admiraal de Ruyter Ziekenhuis, Dept Internal Med, NL-4462 RA Goes, Netherlands

[5] Maastricht Univ, Med Ctr, Dept Surg, NL-6229 HX Maastricht, Netherlands

[6] Maastricht Univ, GROW Sch Oncol & Dev Biol, Dept Epidemiol, NL-6200 MD Maastricht, Netherlands

[7] Radboud Univ Nijmegen, Med Ctr, Dept Surg, NL-6500 HB Nijmegen, Netherlands

[8] Netherlands Comprehens Canc Org IKNL, Dept Res & Dev, NL-3511 DT Utrecht, Netherlands

来源：

CANCERS | 2020年 / 12卷 / 12期

关键词：

fatigue; colorectal cancer; inflammation markers; lifestyle; mediation analyses; QUALITY-OF-LIFE; LOW-GRADE INFLAMMATION; SURVIVORS; EXERCISE; HEALTH; REPRODUCIBILITY; QUESTIONNAIRE; IMPACT; DIET;

D O I：

10.3390/cancers12123701

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Simple Summary Fatigue is common among colorectal cancer patients. A healthier lifestyle may beneficially affect fatigue, although data are sparse. A healthier lifestyle may result in lower levels of inflammation, which is one of the suggested mechanisms by which lifestyle could influence fatigue. In an observational study, we investigated 1) whether a healthier lifestyle was associated with less fatigue among colorectal cancer patients, and 2) whether this association could be explained by inflammation. We showed that a healthier lifestyle was associated with less fatigue, and that inflammation levels mediated this association. Future intervention studies should investigate whether improving lifestyle after cancer diagnosis results in lowering of inflammation markers and subsequent fatigue. Fatigue is very common among colorectal cancer (CRC) patients. We examined the association between adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) lifestyle recommendations and fatigue among stage I-III CRC patients, and whether inflammation mediated this association. Data from two prospective cohort studies were used. Adherence to the WCRF/AICR recommendations was expressed as a score ranging from 0-7, and assessed shortly after diagnosis. Six months post-diagnosis, fatigue was assessed with the European Organization for Research and Treatment of Cancer quality of life questionnaire C30 (EORTC QLQ-C30), and in a subpopulation, the plasma levels of inflammation markers (IL6, IL8, TNF alpha, and hsCRP) were assessed. Multiple linear regression analyses were performed to investigate the association between adherence to the WCRF/AICR recommendations and fatigue. To test mediation by inflammation, the PROCESS analytic tool developed by Hayes was used. A higher WCRF/AICR adherence score was associated with less fatigue six months after diagnosis (n = 1417, beta -2.22, 95%CI -3.65; -0.78). In the population of analysis for the mediation analyses (n = 551), the total association between lifestyle and fatigue was (beta -2.17, 95% CI -4.60; 0.25). A statistically significant indirect association via inflammation was observed (beta -0.97, 95% CI -1.92; -0.21), explaining 45% of the total association between lifestyle and fatigue (-0.97/-2.17 x 100). Thus, inflammation is probably one of the underlying mechanisms linking lifestyle to fatigue.

引用

页码：1 / 13

页数：13

共 45 条

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