Circulating bilirubin levels and risk of colorectal cancer: Serological and Mendelian randomization analyses

Background Bilirubin, a byproduct of hemoglobin breakdown and purported anti-oxidant, is thought to be cancer preventive. We conducted complementary serological and Mendelian randomization (MR) analyses to investigate whether alterations in circulating levels of bilirubin are associated with risk of...

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Main Authors: Seyed Khoei, Nazlisadat, Jenab, Mazda, Murphy, Neil, Banbury, Barbara L., Carreras-Torres, Robert, Viallon, Vivian, Kuehn, Tilman, Bueno-de-Mesquita, Bas, Aleksandrova, Krasimira, Cross, Amanda J., Weiderpass, Elisabete, Stepien, Magdalena, Bulmer, Andrew, Tjonneland, Anne, Boutron-Ruault, Marie-Christine, Severi, Gianluca, Carbonnel, Franck, Katzke, Verena, Boeing, Heiner, Bergmann, Manuela M., Trichopoulou, Antonia, Karakatsani, Anna, Martimianaki, Georgia, Palli, Domenico, Tagliabue, Giovanna, Panico, Salvatore, Tumino, Rosario, Sacerdote, Carlotta, Skeie, Guri, Merino, Susana, Bonet, Catalina, Rodriguez-Barranco, Miguel, Gil, Leire, Chirlaque, Maria-Dolores, Ardanaz, Eva, Myte, Robin, Hultdin, Johan, Perez-Cornago, Aurora, Aune, Dagfinn, Tsilidis, Konstantinos, Albanes, -, Baron, John A., Berndt, Sonja I., Bezieau, Stephane, Brenner, Hermann, Campbell, Peter T., Casey, Graham, Chan, Andrew T., Chang-Claude, Jenny, Chanock, Stephen J., Cotterchio, Michelle, Gallinger, Steven, Gruber, Stephen B., Haile, Robert W., Hampe, Jochen, Hoffmeister, Michael, Hopper, John L., Hsu, Li, Huyghe, Jeroen R., Jenkins, Mark A., Joshi, Amit D., Kampman, Ellen, Larsson, Susanna C., Le Marchand, Loic, Li, Christopher I., Li, Li, Lindblom, Annika, Lindor, Noralane M., Martin, Vicente, Moreno, Victor, Newcomb, Polly A., Offit, Kenneth, Ogino, Shuji, Parfrey, Patrick S., Pharoah, Paul D. P., Rennert, Gad, Sakoda, Lori C., Schafmayer, Clemens, Schmit, Stephanie L., Schoen, Robert E., Slattery, Martha L., Thibodeau, Stephen N., Ulrich, Cornelia M., van Duijnhoven, Franzel J. B., Weigl, Korbinian, Weinstein, Stephanie J., White, Emily, Wolk, Alicja, Woods, Michael O., Wu, Anna H., Zhang, Xuehong, Ferrari, Pietro, Anton, Gabriele, Peters, Annette, Peters, Ulrike, Gunter, Marc J., Wagner, Karl-Heinz, Freisling, Heinz
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Published: BioMed Central Ltd 2020
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Online Access:http://eprints.um.edu.my/36409/
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content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
topic R Medicine (General)
spellingShingle R Medicine (General)
Seyed Khoei, Nazlisadat
Jenab, Mazda
Murphy, Neil
Banbury, Barbara L.
Carreras-Torres, Robert
Viallon, Vivian
Kuehn, Tilman
Bueno-de-Mesquita, Bas
Aleksandrova, Krasimira
Cross, Amanda J.
Weiderpass, Elisabete
Stepien, Magdalena
Bulmer, Andrew
Tjonneland, Anne
Boutron-Ruault, Marie-Christine
Severi, Gianluca
Carbonnel, Franck
Katzke, Verena
Boeing, Heiner
Bergmann, Manuela M.
Trichopoulou, Antonia
Karakatsani, Anna
Martimianaki, Georgia
Palli, Domenico
Tagliabue, Giovanna
Panico, Salvatore
Tumino, Rosario
Sacerdote, Carlotta
Skeie, Guri
Merino, Susana
Bonet, Catalina
Rodriguez-Barranco, Miguel
Gil, Leire
Chirlaque, Maria-Dolores
Ardanaz, Eva
Myte, Robin
Hultdin, Johan
Perez-Cornago, Aurora
Aune, Dagfinn
Tsilidis, Konstantinos
Albanes, -
Baron, John A.
Berndt, Sonja I.
Bezieau, Stephane
Brenner, Hermann
Campbell, Peter T.
Casey, Graham
Chan, Andrew T.
Chang-Claude, Jenny
Chanock, Stephen J.
Cotterchio, Michelle
Gallinger, Steven
Gruber, Stephen B.
Haile, Robert W.
Hampe, Jochen
Hoffmeister, Michael
Hopper, John L.
Hsu, Li
Huyghe, Jeroen R.
Jenkins, Mark A.
Joshi, Amit D.
Kampman, Ellen
Larsson, Susanna C.
Le Marchand, Loic
Li, Christopher I.
Li, Li
Lindblom, Annika
Lindor, Noralane M.
Martin, Vicente
Moreno, Victor
Newcomb, Polly A.
Offit, Kenneth
Ogino, Shuji
Parfrey, Patrick S.
Pharoah, Paul D. P.
Rennert, Gad
Sakoda, Lori C.
Schafmayer, Clemens
Schmit, Stephanie L.
Schoen, Robert E.
Slattery, Martha L.
Thibodeau, Stephen N.
Ulrich, Cornelia M.
van Duijnhoven, Franzel J. B.
Weigl, Korbinian
Weinstein, Stephanie J.
White, Emily
Wolk, Alicja
Woods, Michael O.
Wu, Anna H.
Zhang, Xuehong
Ferrari, Pietro
Anton, Gabriele
Peters, Annette
Peters, Ulrike
Gunter, Marc J.
Wagner, Karl-Heinz
Freisling, Heinz
Circulating bilirubin levels and risk of colorectal cancer: Serological and Mendelian randomization analyses
description Background Bilirubin, a byproduct of hemoglobin breakdown and purported anti-oxidant, is thought to be cancer preventive. We conducted complementary serological and Mendelian randomization (MR) analyses to investigate whether alterations in circulating levels of bilirubin are associated with risk of colorectal cancer (CRC). We decided a priori to perform analyses separately in men and women based on suggestive evidence that associations may differ by sex. Methods In a case-control study nested in the European Prospective Investigation into Cancer and Nutrition (EPIC), pre-diagnostic unconjugated bilirubin (UCB, the main component of total bilirubin) concentrations were measured by high-performance liquid chromatography in plasma samples of 1386 CRC cases and their individually matched controls. Additionally, 115 single-nucleotide polymorphisms (SNPs) robustly associated (P < 5 x 10(-8)) with circulating total bilirubin were instrumented in a 2-sample MR to test for a potential causal effect of bilirubin on CRC risk in 52,775 CRC cases and 45,940 matched controls in the Genetics and Epidemiology of Colorectal Cancer Consortium (GECCO), the Colon Cancer Family Registry (CCFR), and the Colorectal Transdisciplinary (CORECT) study. Results The associations between circulating UCB levels and CRC risk differed by sex (P-heterogeneity = 0.008). Among men, higher levels of UCB were positively associated with CRC risk (odds ratio OR] = 1.19, 95% confidence interval CI] = 1.04-1.36; per 1-SD increment of log-UCB). In women, an inverse association was observed (OR = 0.86 (0.76-0.97)). In the MR analysis of the mainUGT1A1SNP (rs6431625), genetically predicted higher levels of total bilirubin were associated with a 7% increase in CRC risk in men (OR = 1.07 (1.02-1.12);P = 0.006; per 1-SD increment of total bilirubin), while there was no association in women (OR = 1.01 (0.96-1.06);P = 0.73). Raised bilirubin levels, predicted by instrumental variables excluding rs6431625, were suggestive of an inverse association with CRC in men, but not in women. These differences by sex did not reach formal statistical significance (P-heterogeneity >= 0.2). Conclusions Additional insight into the relationship between circulating bilirubin and CRC is needed in order to conclude on a potential causal role of bilirubin in CRC development.
format Article
author Seyed Khoei, Nazlisadat
Jenab, Mazda
Murphy, Neil
Banbury, Barbara L.
Carreras-Torres, Robert
Viallon, Vivian
Kuehn, Tilman
Bueno-de-Mesquita, Bas
Aleksandrova, Krasimira
Cross, Amanda J.
Weiderpass, Elisabete
Stepien, Magdalena
Bulmer, Andrew
Tjonneland, Anne
Boutron-Ruault, Marie-Christine
Severi, Gianluca
Carbonnel, Franck
Katzke, Verena
Boeing, Heiner
Bergmann, Manuela M.
Trichopoulou, Antonia
Karakatsani, Anna
Martimianaki, Georgia
Palli, Domenico
Tagliabue, Giovanna
Panico, Salvatore
Tumino, Rosario
Sacerdote, Carlotta
Skeie, Guri
Merino, Susana
Bonet, Catalina
Rodriguez-Barranco, Miguel
Gil, Leire
Chirlaque, Maria-Dolores
Ardanaz, Eva
Myte, Robin
Hultdin, Johan
Perez-Cornago, Aurora
Aune, Dagfinn
Tsilidis, Konstantinos
Albanes, -
Baron, John A.
Berndt, Sonja I.
Bezieau, Stephane
Brenner, Hermann
Campbell, Peter T.
Casey, Graham
Chan, Andrew T.
Chang-Claude, Jenny
Chanock, Stephen J.
Cotterchio, Michelle
Gallinger, Steven
Gruber, Stephen B.
Haile, Robert W.
Hampe, Jochen
Hoffmeister, Michael
Hopper, John L.
Hsu, Li
Huyghe, Jeroen R.
Jenkins, Mark A.
Joshi, Amit D.
Kampman, Ellen
Larsson, Susanna C.
Le Marchand, Loic
Li, Christopher I.
Li, Li
Lindblom, Annika
Lindor, Noralane M.
Martin, Vicente
Moreno, Victor
Newcomb, Polly A.
Offit, Kenneth
Ogino, Shuji
Parfrey, Patrick S.
Pharoah, Paul D. P.
Rennert, Gad
Sakoda, Lori C.
Schafmayer, Clemens
Schmit, Stephanie L.
Schoen, Robert E.
Slattery, Martha L.
Thibodeau, Stephen N.
Ulrich, Cornelia M.
van Duijnhoven, Franzel J. B.
Weigl, Korbinian
Weinstein, Stephanie J.
White, Emily
Wolk, Alicja
Woods, Michael O.
Wu, Anna H.
Zhang, Xuehong
Ferrari, Pietro
Anton, Gabriele
Peters, Annette
Peters, Ulrike
Gunter, Marc J.
Wagner, Karl-Heinz
Freisling, Heinz
author_facet Seyed Khoei, Nazlisadat
Jenab, Mazda
Murphy, Neil
Banbury, Barbara L.
Carreras-Torres, Robert
Viallon, Vivian
Kuehn, Tilman
Bueno-de-Mesquita, Bas
Aleksandrova, Krasimira
Cross, Amanda J.
Weiderpass, Elisabete
Stepien, Magdalena
Bulmer, Andrew
Tjonneland, Anne
Boutron-Ruault, Marie-Christine
Severi, Gianluca
Carbonnel, Franck
Katzke, Verena
Boeing, Heiner
Bergmann, Manuela M.
Trichopoulou, Antonia
Karakatsani, Anna
Martimianaki, Georgia
Palli, Domenico
Tagliabue, Giovanna
Panico, Salvatore
Tumino, Rosario
Sacerdote, Carlotta
Skeie, Guri
Merino, Susana
Bonet, Catalina
Rodriguez-Barranco, Miguel
Gil, Leire
Chirlaque, Maria-Dolores
Ardanaz, Eva
Myte, Robin
Hultdin, Johan
Perez-Cornago, Aurora
Aune, Dagfinn
Tsilidis, Konstantinos
Albanes, -
Baron, John A.
Berndt, Sonja I.
Bezieau, Stephane
Brenner, Hermann
Campbell, Peter T.
Casey, Graham
Chan, Andrew T.
Chang-Claude, Jenny
Chanock, Stephen J.
Cotterchio, Michelle
Gallinger, Steven
Gruber, Stephen B.
Haile, Robert W.
Hampe, Jochen
Hoffmeister, Michael
Hopper, John L.
Hsu, Li
Huyghe, Jeroen R.
Jenkins, Mark A.
Joshi, Amit D.
Kampman, Ellen
Larsson, Susanna C.
Le Marchand, Loic
Li, Christopher I.
Li, Li
Lindblom, Annika
Lindor, Noralane M.
Martin, Vicente
Moreno, Victor
Newcomb, Polly A.
Offit, Kenneth
Ogino, Shuji
Parfrey, Patrick S.
Pharoah, Paul D. P.
Rennert, Gad
Sakoda, Lori C.
Schafmayer, Clemens
Schmit, Stephanie L.
Schoen, Robert E.
Slattery, Martha L.
Thibodeau, Stephen N.
Ulrich, Cornelia M.
van Duijnhoven, Franzel J. B.
Weigl, Korbinian
Weinstein, Stephanie J.
White, Emily
Wolk, Alicja
Woods, Michael O.
Wu, Anna H.
Zhang, Xuehong
Ferrari, Pietro
Anton, Gabriele
Peters, Annette
Peters, Ulrike
Gunter, Marc J.
Wagner, Karl-Heinz
Freisling, Heinz
author_sort Seyed Khoei, Nazlisadat
title Circulating bilirubin levels and risk of colorectal cancer: Serological and Mendelian randomization analyses
title_short Circulating bilirubin levels and risk of colorectal cancer: Serological and Mendelian randomization analyses
title_full Circulating bilirubin levels and risk of colorectal cancer: Serological and Mendelian randomization analyses
title_fullStr Circulating bilirubin levels and risk of colorectal cancer: Serological and Mendelian randomization analyses
title_full_unstemmed Circulating bilirubin levels and risk of colorectal cancer: Serological and Mendelian randomization analyses
title_sort circulating bilirubin levels and risk of colorectal cancer: serological and mendelian randomization analyses
publisher BioMed Central Ltd
publishDate 2020
url http://eprints.um.edu.my/36409/
_version_ 1814933196836438016
spelling my.um.eprints.364092024-10-28T07:19:10Z http://eprints.um.edu.my/36409/ Circulating bilirubin levels and risk of colorectal cancer: Serological and Mendelian randomization analyses Seyed Khoei, Nazlisadat Jenab, Mazda Murphy, Neil Banbury, Barbara L. Carreras-Torres, Robert Viallon, Vivian Kuehn, Tilman Bueno-de-Mesquita, Bas Aleksandrova, Krasimira Cross, Amanda J. Weiderpass, Elisabete Stepien, Magdalena Bulmer, Andrew Tjonneland, Anne Boutron-Ruault, Marie-Christine Severi, Gianluca Carbonnel, Franck Katzke, Verena Boeing, Heiner Bergmann, Manuela M. Trichopoulou, Antonia Karakatsani, Anna Martimianaki, Georgia Palli, Domenico Tagliabue, Giovanna Panico, Salvatore Tumino, Rosario Sacerdote, Carlotta Skeie, Guri Merino, Susana Bonet, Catalina Rodriguez-Barranco, Miguel Gil, Leire Chirlaque, Maria-Dolores Ardanaz, Eva Myte, Robin Hultdin, Johan Perez-Cornago, Aurora Aune, Dagfinn Tsilidis, Konstantinos Albanes, - Baron, John A. Berndt, Sonja I. Bezieau, Stephane Brenner, Hermann Campbell, Peter T. Casey, Graham Chan, Andrew T. Chang-Claude, Jenny Chanock, Stephen J. Cotterchio, Michelle Gallinger, Steven Gruber, Stephen B. Haile, Robert W. Hampe, Jochen Hoffmeister, Michael Hopper, John L. Hsu, Li Huyghe, Jeroen R. Jenkins, Mark A. Joshi, Amit D. Kampman, Ellen Larsson, Susanna C. Le Marchand, Loic Li, Christopher I. Li, Li Lindblom, Annika Lindor, Noralane M. Martin, Vicente Moreno, Victor Newcomb, Polly A. Offit, Kenneth Ogino, Shuji Parfrey, Patrick S. Pharoah, Paul D. P. Rennert, Gad Sakoda, Lori C. Schafmayer, Clemens Schmit, Stephanie L. Schoen, Robert E. Slattery, Martha L. Thibodeau, Stephen N. Ulrich, Cornelia M. van Duijnhoven, Franzel J. B. Weigl, Korbinian Weinstein, Stephanie J. White, Emily Wolk, Alicja Woods, Michael O. Wu, Anna H. Zhang, Xuehong Ferrari, Pietro Anton, Gabriele Peters, Annette Peters, Ulrike Gunter, Marc J. Wagner, Karl-Heinz Freisling, Heinz R Medicine (General) Background Bilirubin, a byproduct of hemoglobin breakdown and purported anti-oxidant, is thought to be cancer preventive. We conducted complementary serological and Mendelian randomization (MR) analyses to investigate whether alterations in circulating levels of bilirubin are associated with risk of colorectal cancer (CRC). We decided a priori to perform analyses separately in men and women based on suggestive evidence that associations may differ by sex. Methods In a case-control study nested in the European Prospective Investigation into Cancer and Nutrition (EPIC), pre-diagnostic unconjugated bilirubin (UCB, the main component of total bilirubin) concentrations were measured by high-performance liquid chromatography in plasma samples of 1386 CRC cases and their individually matched controls. Additionally, 115 single-nucleotide polymorphisms (SNPs) robustly associated (P < 5 x 10(-8)) with circulating total bilirubin were instrumented in a 2-sample MR to test for a potential causal effect of bilirubin on CRC risk in 52,775 CRC cases and 45,940 matched controls in the Genetics and Epidemiology of Colorectal Cancer Consortium (GECCO), the Colon Cancer Family Registry (CCFR), and the Colorectal Transdisciplinary (CORECT) study. Results The associations between circulating UCB levels and CRC risk differed by sex (P-heterogeneity = 0.008). Among men, higher levels of UCB were positively associated with CRC risk (odds ratio OR] = 1.19, 95% confidence interval CI] = 1.04-1.36; per 1-SD increment of log-UCB). In women, an inverse association was observed (OR = 0.86 (0.76-0.97)). In the MR analysis of the mainUGT1A1SNP (rs6431625), genetically predicted higher levels of total bilirubin were associated with a 7% increase in CRC risk in men (OR = 1.07 (1.02-1.12);P = 0.006; per 1-SD increment of total bilirubin), while there was no association in women (OR = 1.01 (0.96-1.06);P = 0.73). Raised bilirubin levels, predicted by instrumental variables excluding rs6431625, were suggestive of an inverse association with CRC in men, but not in women. These differences by sex did not reach formal statistical significance (P-heterogeneity >= 0.2). Conclusions Additional insight into the relationship between circulating bilirubin and CRC is needed in order to conclude on a potential causal role of bilirubin in CRC development. BioMed Central Ltd 2020-09 Article PeerReviewed Seyed Khoei, Nazlisadat and Jenab, Mazda and Murphy, Neil and Banbury, Barbara L. and Carreras-Torres, Robert and Viallon, Vivian and Kuehn, Tilman and Bueno-de-Mesquita, Bas and Aleksandrova, Krasimira and Cross, Amanda J. and Weiderpass, Elisabete and Stepien, Magdalena and Bulmer, Andrew and Tjonneland, Anne and Boutron-Ruault, Marie-Christine and Severi, Gianluca and Carbonnel, Franck and Katzke, Verena and Boeing, Heiner and Bergmann, Manuela M. and Trichopoulou, Antonia and Karakatsani, Anna and Martimianaki, Georgia and Palli, Domenico and Tagliabue, Giovanna and Panico, Salvatore and Tumino, Rosario and Sacerdote, Carlotta and Skeie, Guri and Merino, Susana and Bonet, Catalina and Rodriguez-Barranco, Miguel and Gil, Leire and Chirlaque, Maria-Dolores and Ardanaz, Eva and Myte, Robin and Hultdin, Johan and Perez-Cornago, Aurora and Aune, Dagfinn and Tsilidis, Konstantinos and Albanes, - and Baron, John A. and Berndt, Sonja I. and Bezieau, Stephane and Brenner, Hermann and Campbell, Peter T. and Casey, Graham and Chan, Andrew T. and Chang-Claude, Jenny and Chanock, Stephen J. and Cotterchio, Michelle and Gallinger, Steven and Gruber, Stephen B. and Haile, Robert W. and Hampe, Jochen and Hoffmeister, Michael and Hopper, John L. and Hsu, Li and Huyghe, Jeroen R. and Jenkins, Mark A. and Joshi, Amit D. and Kampman, Ellen and Larsson, Susanna C. and Le Marchand, Loic and Li, Christopher I. and Li, Li and Lindblom, Annika and Lindor, Noralane M. and Martin, Vicente and Moreno, Victor and Newcomb, Polly A. and Offit, Kenneth and Ogino, Shuji and Parfrey, Patrick S. and Pharoah, Paul D. P. and Rennert, Gad and Sakoda, Lori C. and Schafmayer, Clemens and Schmit, Stephanie L. and Schoen, Robert E. and Slattery, Martha L. and Thibodeau, Stephen N. and Ulrich, Cornelia M. and van Duijnhoven, Franzel J. B. and Weigl, Korbinian and Weinstein, Stephanie J. and White, Emily and Wolk, Alicja and Woods, Michael O. and Wu, Anna H. and Zhang, Xuehong and Ferrari, Pietro and Anton, Gabriele and Peters, Annette and Peters, Ulrike and Gunter, Marc J. and Wagner, Karl-Heinz and Freisling, Heinz (2020) Circulating bilirubin levels and risk of colorectal cancer: Serological and Mendelian randomization analyses. BMC Medicine, 18 (1). ISSN 17417015, DOI https://doi.org/10.1186/s12916-020-01703-w <https://doi.org/10.1186/s12916-020-01703-w>. 10.1186/s12916-020-01703-w
score 13.211869