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@ARTICLE{Rothwell:166199,
      author       = {J. A. Rothwell and N. Murphy and J. Bešević and N.
                      Kliemann and M. Jenab and P. Ferrari and D. Achaintre and A.
                      Gicquiau and B. Vozar and A. Scalbert and I. Huybrechts and
                      H. Freisling and C. Prehn and J. Adamski and A. J. Cross and
                      V. M. Pala and M.-C. Boutron-Ruault and C. C. Dahm and K.
                      Overvad and I. T. Gram and T. M. Sandanger and G. Skeie and
                      P. Jakszyn and K. K. Tsilidis and K. Aleksandrova and M. B.
                      Schulze and D. J. Hughes and B. van Guelpen and S. Bodén
                      and M.-J. Sánchez and J. A. Schmidt and V. Katzke$^*$ and
                      T. Kühn$^*$ and S. Colorado-Yohar and R. Tumino and B.
                      Bueno-de-Mesquita and P. Vineis and G. Masala and S. Panico
                      and A. K. Eriksen and A. Tjønneland and D. Aune and E.
                      Weiderpass and G. Severi and V. Chajès and M. J. Gunter},
      title        = {{M}etabolic {S}ignatures of {H}ealthy {L}ifestyle
                      {P}atterns and {C}olorectal {C}ancer {R}isk in a {E}uropean
                      {C}ohort.},
      journal      = {Clinical gastroenterology and hepatology},
      volume       = {20},
      number       = {5},
      issn         = {1542-3565},
      address      = {New York, NY},
      publisher    = {Elsevier Science},
      reportid     = {DKFZ-2020-02701},
      pages        = {e1061-e1082},
      year         = {2022},
      note         = {2022 May;20(5):e1061-e1082},
      abstract     = {Colorectal cancer risk can be lowered by adherence to the
                      World Cancer Research Fund/American Institute for Cancer
                      Research (WCRF/AICR) guidelines. We derived metabolic
                      signatures of adherence to these guidelines and tested their
                      associations with colorectal cancer risk in the European
                      Prospective Investigation into Cancer (EPIC) cohort.Scores
                      reflecting adherence to the WCRF/AICR recommendations (scale
                      1-5) were calculated from participant data on weight
                      maintenance, physical activity, diet, and alcohol among a
                      discovery set of 5,738 cancer-free EPIC participants with
                      metabolomics data. Partial least squares regression was used
                      to derive fatty acid and endogenous metabolite signatures of
                      WCRF/AICR score in this group. In an independent set of
                      1,608 colorectal cancer cases and matched controls, odds
                      ratios (OR) and $95\%$ confidence intervals (CI) were
                      calculated for colorectal cancer risk per unit increase in
                      WCRF/AICR score and per the corresponding change in
                      metabolic signatures using multivariable conditional
                      logistic regression.Higher WCRF/AICR scores were
                      characterized by metabolic signatures of elevated odd-chain
                      fatty acids, serine, glycine and specific
                      phosphatidylcholines. Signatures were more strongly
                      inversely associated with colorectal cancer risk (fatty
                      acids: OR 0.51 per unit increase, $95\%$ CI 0.29-0.90;
                      endogenous metabolites: OR 0.62 per unit change, $95\%$ CI
                      0.50-0.78) than the WCRF/AICR score (OR 0.93 per unit
                      change, $95\%$ CI 0.86-1.00) overall. Signature associations
                      were stronger in male compared to female
                      participants.Metabolite profiles reflecting adherence to
                      WCRF/AICR guidelines and additional lifestyle or biological
                      risk factors were associated with colorectal cancer.
                      Measuring a specific panel of metabolites representative of
                      healthy or unhealthy lifestyle may identify strata of the
                      population at higher risk of colorectal cancer.},
      cin          = {C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:33279777},
      doi          = {10.1016/j.cgh.2020.11.045},
      url          = {https://inrepo02.dkfz.de/record/166199},
}