% IMPORTANT: The following is UTF-8 encoded. This means that in the presence % of non-ASCII characters, it will not work with BibTeX 0.99 or older. % Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or % “biber”. @ARTICLE{Pham:304123, author = {T. T. Pham and K. Nimptsch and K. Aleksandrova and M. Jenab and V. Fedirko and A. Olsen and A. Tjønneland and C. Cadeau and G. Severi and M. B. Schulze and R. Turzanski-Fortner$^*$ and V. Katzke$^*$ and C. Agnoli and C. Sacerdote and R. Tumino and S. Signoriello and C. Trobajo-Sanmartín and J.-H. Gómez and M.-D. Chirlaque and M.-J. Sánchez and M. Crous-Bou and A. May and A. Heath and D. Aune and E. Weiderpass and T. Pischon}, title = {{C}irculating fatty acid binding protein 4 ({FABP}-4) concentrations and mortality in individuals with colorectal cancer in the {E}uropean {P}rospective {I}nvestigation into {C}ancer and {N}utrition study.}, journal = {International journal of cancer}, volume = {nn}, issn = {0020-7136}, address = {Bognor Regis}, publisher = {Wiley-Liss}, reportid = {DKFZ-2025-01786}, pages = {nn}, year = {2025}, note = {epub}, 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 (Other) / FABP‐4 (Other) / human fatty acid binding protein‐4 (Other) / incident colorectal cancer (Other) / mortality (Other)}, cin = {C180 / C020}, ddc = {610}, cid = {I:(DE-He78)C180-20160331 / 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:40857027}, doi = {10.1002/ijc.70090}, url = {https://inrepo02.dkfz.de/record/304123}, }