Separating the effects of early and later life adiposity on colorectal cancer risk: a Mendelian randomization study

Author:

Papadimitriou NikosORCID,Bull Caroline J.,Jenab Mazda,Hughes David J.,Bell Joshua A.,Sanderson Eleanor,Timpson Nicholas J.,Smith George Davey,Albanes Demetrius,Campbell Peter T.,Küry Sébastien,Le Marchand Loic,Ulrich Cornelia M.,Visvanathan Kala,Figueiredo Jane C.,Newcomb Polly A.,Pai Rish K.,Peters Ulrike,Tsilidis Kostas K.,Boer Jolanda M. A.,Vincent Emma E.,Mariosa Daniela,Gunter Marc J.,Richardson Tom G.,Murphy Neil

Abstract

Abstract Background Observational studies have linked childhood obesity with elevated risk of colorectal cancer; however, it is unclear if this association is causal or independent from the effects of obesity in adulthood on colorectal cancer risk. Methods We conducted Mendelian randomization (MR) analyses to investigate potential causal relationships between self-perceived body size (thinner, plumper, or about average) in early life (age 10) and measured body mass index in adulthood (mean age 56.5) with risk of colorectal cancer. The total and independent effects of body size exposures were estimated using univariable and multivariable MR, respectively. Summary data were obtained from a genome-wide association study of 453,169 participants in UK Biobank for body size and from a genome-wide association study meta-analysis of three colorectal cancer consortia of 125,478 participants. Results Genetically predicted early life body size was estimated to increase odds of colorectal cancer (odds ratio [OR] per category change: 1.12, 95% confidence interval [CI]: 0.98–1.27), with stronger results for colon cancer (OR: 1.16, 95% CI: 1.00–1.35), and distal colon cancer (OR: 1.25, 95% CI: 1.04–1.51). After accounting for adult body size using multivariable MR, effect estimates for early life body size were attenuated towards the null for colorectal cancer (OR: 0.97, 95% CI: 0.77–1.22) and colon cancer (OR: 0.97, 95% CI: 0.76–1.25), while the estimate for distal colon cancer was of similar magnitude but more imprecise (OR: 1.27, 95% CI: 0.90–1.77). Genetically predicted adult life body size was estimated to increase odds of colorectal (OR: 1.27, 95% CI: 1.03, 1.57), colon (OR: 1.32, 95% CI: 1.05, 1.67), and proximal colon (OR: 1.57, 95% CI: 1.21, 2.05). Conclusions Our findings suggest that the positive association between early life body size and colorectal cancer risk is likely due to large body size retainment into adulthood.

Funder

Cancer Research UK

International Hundred K+ Cohorts Consortium / Global Genomic Medicine Collaborative

World Cancer Research Fund

UK MRC

Diabetes UK

CRUK Integrative Cancer Epidemiology Programme

Wellcome Trust

MRC & WT

University of Bristol NIHR Biomedical Research Centre

MRC Integrative Epidemiology Unit

UK Medical Research Council

University of Bristol

Medical Research Council Integrative Epidemiology Unit

UKRI Innovation Research

Publisher

Springer Science and Business Media LLC

Subject

General Medicine

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