Association of Sugar Intake with Inflammation- and Angiogenesis-Related Biomarkers in Newly Diagnosed Colorectal Cancer Patients

Abstract

Evidence suggests a positive association between sugar intake and colorectal cancer (CRC) outcomes. We sought to investigate inflammation and angiogenesis as underlying mechanisms behind increased sugar intake and worse CRC outcomes. Pre-surgery serum samples were obtained from 191 patients diagnosed with primary invasive stage I-IV CRC. Biomarkers of inflammation (CRP, SAA, IL-6, IL-8, MCP-1, TNFα) and angiogenesis (VEGFA, VEGFD, sICAM-1 and sVCAM-1) were analyzed (Meso-Scale-Discovery). Fructose, glucose, sucrose, and total sugar intake (calories/day, % total calories) were assessed by FFQ. Pearson’s correlation and multiple linear regression analyses were performed. Patients were on average 64 years old, 64% were male, the majority was diagnosed with stage II-III (58%) cancers, and 67% were either overweight or obese. Among normal-weight individuals (BMI <25 kg/m²), we observed a significant inverse association between VEGFD and any type of sugar intake in cal/day (sucrose: p = 0.01, glucose and fructose: p < 0.001) and MCP-1 and fructose intake (p = 0.05). The magnitude of reduction in VEGF ranged between −1.24 for sucrose to 4.49 for glucose intake, and −2.64 for fructose intake for MCP-1 levels. Sugar intake was associated with some inflammation or angiogenesis biomarkers, among CRC patients; differences were observed by adiposity that warrant further investigation.

Supplemental data for this article is available online at at 10.1080/01635581.2021.1957133.

Acknowledgments

We thank our collaborators on the ColoCare recruitment, Jenny Chang-Claude, and Michael Hoffmeister. We are grateful to all the study staff who have made this study possible, especially Torsten Kölsch, Susanne Jakob, Stefanie Skender, Werner Diehl, Rifraz Farook, Anett Brendel, Marita Wenzel and Renate Skatula. We also thank Heiner Boeing, PhD, MPH from the German Institute of Human Nutrition for his support of the nutritional analyses.

Declaration of interest statement

There are no conflicts of interests to be declared. Dr. Ulrich has as cancer center director oversight over research funded by several pharmaceutical companies, but has not received funding directly herself.

Additional information

Funding

This study was supported by National Institutes of Health (NIH) (grant no. U01 CA206110), NIH (grant nos. K07 CA222060, R01 CA207371, and R01 CA189184), the German Consortium of Translational Cancer Research (DKTK) the German Cancer Research Center (Division of Preventive Oncology, C. M. Ulrich), and the Matthias Lackas Foundation. C. Himbert is supported by NIH (grant no. R01 CA211705), the Stiftung LebensBlicke and Claussen-Simon Stiftung, Germany. C. Himbert, Lin T, Warby C.A., J. Ose, and C.M. Ulrich are funded by the Huntsman Cancer Foundation.