Abstract

Insulin resistance (IR) is an established risk factor for colorectal cancer (CRC). Given that CRC and IR physiologically overlap and the calpain-10 gene (CAPN10) is a candidate for IR, we explored the association between CAPN10 and CRC risk. Blood samples of 400 case-control pairs were genotyped, and the lifestyle and dietary habits of these pairs were recorded and collected. Unconditional logistic regression (LR) was used to assess the effects of CAPN10 SNP43 and SNP19, and environmental factors. Both generalized multifactor dimensionality reduction (GMDR) and the classification and regression tree (CART) were used to test gene-environment interactions for CRC risk. The GA+AA genotype of SNP43 and the Del/Ins+Ins/Ins genotype of SNP19 were marginally related to CRC risk (GA+AA: OR = 1.35, 95% CI = 0.92-1.99; Del/Ins+Ins/ Ins: OR = 1.31, 95% CI = 0.84-2.04). Notably, a high-order interaction was consistently identified by GMDR and CART analyses. In GMDR, the four-factor interaction model of SNP43, SNP19, red meat consumption, and smoked meat consumption was the best model, with a maximum cross-validation consistency of 10/10 and testing balance accuracy of 0.61 (P < 0.01). In LR, subjects with high red and smoked meat consumption and two risk genotypes had a 6.17-fold CRC risk (95% CI = 2.44-15.6) relative to that of subjects with low red and smoked meat consumption and null risk genotypes. In CART, individuals with high smoked and red meat consumption, SNP19 Del/Ins+Ins/Ins, and SNP43 GA+AA had higher CRC risk (OR = 4.56, 95%CI = 1.94-10.75) than those with low smoked and red meat consumption. Though the single loci of CAPN10 SNP43 and SNP19 are not enough to significantly increase the CRC susceptibility, the combination of SNP43, SNP19, red meat consumption, and smoked meat consumption is associated with elevated risk.

Highlights

  • As the second most common cancer and fourth leading cause of cancer deaths in the world (Ferlay et al, 2010), colorectal cancer (CRC) is an important health issue

  • The GA+AA genotype of SNP43 and the Del/Ins+Ins/Ins genotype of SNP19 were marginally related to CRC risk (GA+AA: OR = 1.35, 95% CI = 0.92-1.99; Del/Ins+Ins/ Ins: OR = 1.31, 95% CI = 0.84-2.04)

  • Individuals with obesity and type 2 diabetes mellitus (T2DM) have high incidence and mortality rates of CRC compared with health people (Basen-Engquist and Chang, 2011; Noto et al, 2011), whereas both obesity and T2DM are associated with insulin resistance (IR) (Wilkin, 2009; Zeyda and Stulnig, 2009)

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Summary

Introduction

As the second most common cancer and fourth leading cause of cancer deaths in the world (Ferlay et al, 2010), colorectal cancer (CRC) is an important health issue. Individuals with obesity and type 2 diabetes mellitus (T2DM) have high incidence and mortality rates of CRC compared with health people (Basen-Engquist and Chang, 2011; Noto et al, 2011), whereas both obesity and T2DM are associated with insulin resistance (IR) (Wilkin, 2009; Zeyda and Stulnig, 2009). Hyperinsulinemia and a high insulin-like growth factor-1 (IGF-1) level, which are caused by increased insulin, promote cell proliferation and inhibit apoptosis through activating the protein kinase B (Akt) and mitogenactivated protein kinase signaling networks in neoplastic tissues (Pollak, 2008; Leng et al, 2001). IR is associated with inhibition of the liver kinase B1 (LKB1)adenosine 5’-monophosphate (AMP)-activated protein kinase (LKB1-AMPK) pathway which promotes energy storage and obesity.

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