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| Item Type: | Article |
|---|---|
| Title: | Circulating fatty acid binding protein 4 (FABP‐4) concentrations and mortality in individuals with colorectal cancer in the European Prospective Investigation into Cancer and Nutrition study |
| Creators: |
Pham, Thu Thi  ORCID: https://orcid.org/0000-0002-2129-0911, Nimptsch, Katharina ORCID: https://orcid.org/0000-0001-7877-205X, Aleksandrova, Krasimira ORCID: https://orcid.org/0000-0002-1275-1827, Jenab, Mazda ORCID: https://orcid.org/0000-0002-0573-1852, Fedirko, Veronika ORCID: https://orcid.org/0000-0002-7805-9913, Olsen, Anja, Tjønneland, Anne, Cadeau, Claire, Severi, Gianluca ORCID: https://orcid.org/0000-0001-7157-419X, Schulze, Matthias B. ORCID: https://orcid.org/0000-0002-0830-5277, Fortner, Renée Turzanski ORCID: https://orcid.org/0000-0002-1426-8505, Katzke, Verena ORCID: https://orcid.org/0000-0002-6509-6555, Agnoli, Claudia, Sacerdote, Carlotta ORCID: https://orcid.org/0000-0002-8008-5096, Tumino, Rosario, Signoriello, Simona, Trobajo-Sanmartín, Camino ORCID: https://orcid.org/0000-0001-5105-252X, Gómez, Jesús-Humberto, Chirlaque, Maria-Dolores, Sánchez, Maria Jose ORCID: https://orcid.org/0000-0003-4817-0757, Crous-Bou, Marta ORCID: https://orcid.org/0000-0003-1493-4288, May, Anne ORCID: https://orcid.org/0000-0003-0643-3790, Heath, Alicia K. ORCID: https://orcid.org/0000-0001-6517-1300, Aune, Dagfinn, Weiderpass, Elisabete and Pischon, Tobias ORCID: https://orcid.org/0000-0003-1568-767X
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| Abstract: | Human fatty acid binding protein-4 (FABP-4), a protein elevated in obesity that promotes colon cancer cell invasiveness and metastasis, may be associated with higher mortality in individuals with colorectal cancer (CRC) and may serve as a mediator of the obesity–mortality association in these individuals. We used a causal diagram to inform covariate selection and applied Cox proportional hazards models to estimate hazard ratios (HRs) for CRC-specific, non-CRC-specific, and all-cause mortality by FABP-4 levels measured in baseline blood samples from 1371 incident CRC cases from the European Prospective Investigation into Cancer and Nutrition cohort. Competing risk analyses were adapted for CRC and non-CRC deaths. Mediation analyses were conducted to estimate total effects (TEs), direct effects (DEs), and mediation proportions (MPs) by FABP-4 of pre-diagnostic body mass index (BMI) on mortality. In the fully adjusted model including BMI, higher circulating FABP-4 concentrations were associated with higher CRC mortality (HR(Q4vsQ1) = 1.49; 95% CI: 1.11–2.00) and all-cause mortality (HR(Q4vsQ1) = 1.49; 95% CI: 1.15–1.93), but not statistically associated with non-CRC mortality (HR(Q4vsQ1) = 1.51; 95% CI: 0.82–2.76). The TE and DE per 5 kg/m(2) of BMI on all-cause mortality were 1.21; 95% CI: 1.10–1.34, and 1.13; 95% CI: 1.02–1.26, respectively, with a MP of 34.5% (p = .002) by FABP-4. For CRC-specific and non-CRC-specific mortality, MPs by FABP-4 were 33.7% (p = .03) and 36.1% (p = .02), respectively. In conclusion, higher concentrations of FABP-4 were associated with higher CRC-specific and all-cause mortality in individuals with CRC. FABP-4 was a significant partial mediator of the adiposity-mortality relationship in individuals with CRC. |
| Keywords: | EPIC, FABP-4, Human Fatty Acid Binding Protein-4, Incident Colorectal Cancer, Mortality |
| Source: | International Journal of Cancer |
| ISSN: | 0020-7136 |
| Publisher: | Wiley |
| Volume: | 158 |
| Number: | 3 |
| Page Range: | 546-559 |
| Date: | 1 February 2026 |
| Official Publication: | https://doi.org/10.1002/ijc.70090 |
| PubMed: | View item in PubMed |
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