Patients with colorectal cancer (CRC) are at high risk of frailty, leading to reduced quality of life and survival. Diet is associated with frailty in the elderly through regulating inflammation. Thus, we hypothesized that dietary inflammatory potential (as assessed by dietary inflammatory index [DII]) might be associated with frailty in patients with CRC through regulating inflammatory biomarkers. A total of 231 patients with CRC were included in this cross-sectional study. Dietary intake was evaluated by 3-day, 24-hour dietary recalls, and frailty status was assessed in accordance with the Fried frailty criteria. Plasma inflammatory cytokines were determined in 126 blood samples. A total of 67 patients (29.0%) were frail, with significantly higher DII scores than nonfrail patients, accompanied with significantly increased interleukin-6 (IL-6) and decreased interleukin-10 (IL-10) concentrations. Each 1-point increase of DII was related to a 25.0% increased risk of frailty. IL-6 was positively correlated with frailty and DII, whereas IL-10 was negatively correlated. After adjusting for age, sex, body mass index, education level, smoking status, and energy, mediation analysis revealed that the association between DII and frailty was significantly mediated by IL-6 (average causal mediation effect [ACME], 0.052; 95% confidence interval, 0.020–0.087; = .002) and IL-10 (ACME, 0.025; 95% confidence interval, 0.004–0.063; = .016). The ρ values for the sensitivity measure at which estimated ACMEs were zero were 0.3 and –0.2 for IL-6 and IL-10, respectively. Therefore, a pro-inflammatory diet was associated with frailty in patients with CRC possibly in part by affecting circulating IL-6 and IL-10 concentrations.

中文翻译：

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结肠直肠癌患者的饮食炎症潜力与虚弱之间的关联是由炎症介导的：一项横断面研究

结直肠癌 (CRC) 患者虚弱的风险很高，导致生活质量和生存率下降。饮食通过调节炎症与老年人的虚弱有关。因此，我们假设膳食炎症潜力（通过膳食炎症指数 [DII] 评估）可能通过调节炎症生物标志物与 CRC 患者的虚弱相关。这项横断面研究总共纳入了 231 名 CRC 患者。通过 3 天、24 小时饮食回忆评估膳食摄入量，并根据 Fried 衰弱标准评估衰弱状态。在 126 个血液样本中测定了血浆炎症细胞因子。共有67名患者（29.0%）体质虚弱，其DII评分显着高于非虚弱患者，并伴有白细胞介素6（IL-6）浓度显着升高和白细胞介素10（IL-10）浓度显着降低。 DII 每增加 1 分，虚弱风险就会增加 25.0%。 IL-6 与虚弱和 DII 呈正相关，而 IL-10 呈负相关。调整年龄、性别、体重指数、教育水平、吸烟状况和精力后，中介分析显示 DII 与虚弱之间的关联显着由 IL-6 介导（平均因果中介效应 [ACME]，0.052；95%）置信区间，0.020–0.087；= .002）和 IL-10（ACME，0.025；95% 置信区间，0.004–0.063；= .016）。 IL-6 和 IL-10 的估计 ACME 为零时的灵敏度测量的 ρ 值分别为 0.3 和 –0.2。因此，促炎饮食与 CRC 患者的虚弱有关，可能部分是通过影响循环 IL-6 和 IL-10 浓度来实现的。