Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug 26.
doi: 10.1002/ijc.70090. Online ahead of print.

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

Thu Thi Pham  1 , Katharina Nimptsch  1 , Krasimira Aleksandrova  2   3 , Mazda Jenab  4 , Veronika Fedirko  5   6 , Anja Olsen  7   8 , Anne Tjønneland  7   9 , Claire Cadeau  10 , Gianluca Severi  10   11 , Matthias B Schulze  12   13 , Renée Turzanski Fortner  14   15 , Verena Katzke  14 , Claudia Agnoli  16 , Carlotta Sacerdote  17   18 , Rosario Tumino  19 , Simona Signoriello  20 , Camino Trobajo-Sanmartín  21   22   23 , Jesús-Humberto Gómez  22   24 , María-Dolores Chirlaque  22   25 , Maria-Jose Sánchez  22   26   27 , Marta Crous-Bou  28   29   30 , Anne May  31 , Alicia Heath  32 , Dagfinn Aune  32   33   15 , Elisabete Weiderpass  34 , Tobias Pischon  1   35   36
Affiliations

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

Thu Thi Pham et al. Int J Cancer. .

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 (HRQ4vsQ1 = 1.49; 95% CI: 1.11-2.00) and all-cause mortality (HRQ4vsQ1 = 1.49; 95% CI: 1.15-1.93), but not statistically associated with non-CRC mortality (HRQ4vsQ1 = 1.51; 95% CI: 0.82-2.76). The TE and DE per 5 kg/m2 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.

PubMed Disclaimer

References

REFERENCES

    1. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894:1‐253.
    1. Clinton SK, Giovannucci EL, Hursting SD. The World Cancer Research Fund/American Institute for Cancer Research third expert report on diet, nutrition, physical activity, and cancer: impact and future directions. J Nutr. 2020;150:663‐671.
    1. Lee J, Meyerhardt JA, Giovannucci E, Jeon JY. Association between body mass index and prognosis of colorectal cancer: a meta‐analysis of prospective cohort studies. PLoS One. 2015;10:e0120706.
    1. van Zutphen M, Kampman E, Giovannucci EL, van Duijnhoven FJB. Lifestyle after colorectal cancer diagnosis in relation to survival and recurrence: a review of the literature. Curr Colorect Cancer Rep. 2017;13:370‐401.
    1. Fedirko V, Romieu I, Aleksandrova K, et al. Pre‐diagnostic anthropometry and survival after colorectal cancer diagnosis in Western European populations. Int J Cancer. 2014;135:1949‐1960.

LinkOut - more resources