Inflammation Is a Mediating Factor in the Association between Lifestyle and Fatigue in Colorectal Cancer Patients
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 th...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-12-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/12/12/3701 |
| _version_ | 1797545231223095296 |
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| author | Evertine Wesselink Harm van Baar Moniek van Zutphen Meilissa Tibosch Ewout A. Kouwenhoven Eric T.P. Keulen Dieuwertje E. Kok Henk K. van Halteren Stephanie O. Breukink Johannes H. W. de Wilt Matty P. Weijenberg Marlou-Floor Kenkhuis Michiel G. J. Balvers Renger F. Witkamp Fränzel J. B. van Duijnhoven Ellen Kampman Sandra Beijer Martijn J. L. Bours Renate M. Winkels |
| author_facet | Evertine Wesselink Harm van Baar Moniek van Zutphen Meilissa Tibosch Ewout A. Kouwenhoven Eric T.P. Keulen Dieuwertje E. Kok Henk K. van Halteren Stephanie O. Breukink Johannes H. W. de Wilt Matty P. Weijenberg Marlou-Floor Kenkhuis Michiel G. J. Balvers Renger F. Witkamp Fränzel J. B. van Duijnhoven Ellen Kampman Sandra Beijer Martijn J. L. Bours Renate M. Winkels |
| author_sort | Evertine Wesselink |
| collection | DOAJ |
| description | 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, TNFα, 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 (<i>n</i> = 1417, β −2.22, 95%CI −3.65; −0.78). In the population of analysis for the mediation analyses (<i>n</i> = 551), the total association between lifestyle and fatigue was (β −2.17, 95% CI −4.60; 0.25). A statistically significant indirect association via inflammation was observed (β −0.97, 95% CI −1.92; −0.21), explaining 45% of the total association between lifestyle and fatigue (−0.97/−2.17 × 100). Thus, inflammation is probably one of the underlying mechanisms linking lifestyle to fatigue. |
| first_indexed | 2024-03-10T14:12:33Z |
| format | Article |
| id | doaj.art-4c04f23799f9434caeb96d580ae5f642 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T14:12:33Z |
| publishDate | 2020-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-4c04f23799f9434caeb96d580ae5f6422023-11-21T00:03:26ZengMDPI AGCancers2072-66942020-12-011212370110.3390/cancers12123701Inflammation Is a Mediating Factor in the Association between Lifestyle and Fatigue in Colorectal Cancer PatientsEvertine Wesselink0Harm van Baar1Moniek van Zutphen2Meilissa Tibosch3Ewout A. Kouwenhoven4Eric T.P. Keulen5Dieuwertje E. Kok6Henk K. van Halteren7Stephanie O. Breukink8Johannes H. W. de Wilt9Matty P. Weijenberg10Marlou-Floor Kenkhuis11Michiel G. J. Balvers12Renger F. Witkamp13Fränzel J. B. van Duijnhoven14Ellen Kampman15Sandra Beijer16Martijn J. L. Bours17Renate M. Winkels18Division of Human Nutrition and Health, Wageningen University, Wageningen, 6708 WE, The NetherlandsDivision of Human Nutrition and Health, Wageningen University, Wageningen, 6708 WE, The NetherlandsDivision of Human Nutrition and Health, Wageningen University, Wageningen, 6708 WE, The NetherlandsDivision of Human Nutrition and Health, Wageningen University, Wageningen, 6708 WE, The NetherlandsZiekenhuis Groep Twente, Department of Surgery, Almelo, 7600 SZ, The NetherlandsZuyderland Medical Centre, Department of Gastroenterology, Sittard-Geleen, 6162 BG, The NetherlandsDivision of Human Nutrition and Health, Wageningen University, Wageningen, 6708 WE, The NetherlandsDepartment of Internal Medicine, Admiraal de Ruyter Ziekenhuis, Goes, 4462 RA, The NetherlandsMedical Center, Department of Surgery, Maastricht University, Maastricht, 6229 HX, The NetherlandsMedical Centre, Department of Surgery, Radboud University, Nijmegen, 6500 HB, The NetherlandsDepartment of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, 6200 MD, The NetherlandsDepartment of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, 6200 MD, The NetherlandsDivision of Human Nutrition and Health, Wageningen University, Wageningen, 6708 WE, The NetherlandsDivision of Human Nutrition and Health, Wageningen University, Wageningen, 6708 WE, The NetherlandsDivision of Human Nutrition and Health, Wageningen University, Wageningen, 6708 WE, The NetherlandsDivision of Human Nutrition and Health, Wageningen University, Wageningen, 6708 WE, The NetherlandsDepartment of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, 3511 DT, The NetherlandsDepartment of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, 6200 MD, The NetherlandsDivision of Human Nutrition and Health, Wageningen University, Wageningen, 6708 WE, The NetherlandsFatigue 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, TNFα, 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 (<i>n</i> = 1417, β −2.22, 95%CI −3.65; −0.78). In the population of analysis for the mediation analyses (<i>n</i> = 551), the total association between lifestyle and fatigue was (β −2.17, 95% CI −4.60; 0.25). A statistically significant indirect association via inflammation was observed (β −0.97, 95% CI −1.92; −0.21), explaining 45% of the total association between lifestyle and fatigue (−0.97/−2.17 × 100). Thus, inflammation is probably one of the underlying mechanisms linking lifestyle to fatigue.https://www.mdpi.com/2072-6694/12/12/3701fatiguecolorectal cancerinflammation markerslifestylemediation analyses |
| spellingShingle | Evertine Wesselink Harm van Baar Moniek van Zutphen Meilissa Tibosch Ewout A. Kouwenhoven Eric T.P. Keulen Dieuwertje E. Kok Henk K. van Halteren Stephanie O. Breukink Johannes H. W. de Wilt Matty P. Weijenberg Marlou-Floor Kenkhuis Michiel G. J. Balvers Renger F. Witkamp Fränzel J. B. van Duijnhoven Ellen Kampman Sandra Beijer Martijn J. L. Bours Renate M. Winkels Inflammation Is a Mediating Factor in the Association between Lifestyle and Fatigue in Colorectal Cancer Patients Cancers fatigue colorectal cancer inflammation markers lifestyle mediation analyses |
| title | Inflammation Is a Mediating Factor in the Association between Lifestyle and Fatigue in Colorectal Cancer Patients |
| title_full | Inflammation Is a Mediating Factor in the Association between Lifestyle and Fatigue in Colorectal Cancer Patients |
| title_fullStr | Inflammation Is a Mediating Factor in the Association between Lifestyle and Fatigue in Colorectal Cancer Patients |
| title_full_unstemmed | Inflammation Is a Mediating Factor in the Association between Lifestyle and Fatigue in Colorectal Cancer Patients |
| title_short | Inflammation Is a Mediating Factor in the Association between Lifestyle and Fatigue in Colorectal Cancer Patients |
| title_sort | inflammation is a mediating factor in the association between lifestyle and fatigue in colorectal cancer patients |
| topic | fatigue colorectal cancer inflammation markers lifestyle mediation analyses |
| url | https://www.mdpi.com/2072-6694/12/12/3701 |
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