AccScience Publishing / CP / Online First / DOI: 10.36922/CP025060009
ORIGINAL RESEARCH ARTICLE

Comprehensive serum profiling in colorectal cancer: Evidence from a South Indian case–control study

Mohd Younis1,2,3* Amrit Sudershan2,4 Arizoo Hamid5 Ashma Gupta6 Parvinder Kumar2,3 Vijaya Anand1*
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1 Department of Human Genetics and Molecular Biology, Faculty of Life Sciences, Bharathiar University, Coimbatore, Tamil Nadu, India
2 Department of Human Genetics, Institute of Human Genetics, University of Jammu, Jammu and Kashmir, India
3 Department of Zoology, Faculty of Life Sciences, University of Jammu, Jammu and Kashmir, India
4 Department of Human Genetics, Faculty of Life Sciences, Sri Pratap College, Cluster University Srinagar, Jammu and Kashmir, India
5 Department of Zoology, Faculty of Life Sciences, University of Kashmir, Srinagar, Jammu and Kashmir, India
6 Department of Zoology, Faculty of Life Sciences, Government Degree College Bishnah, Jammu and Kashmir, India
Received: 8 February 2025 | Revised: 11 April 2025 | Accepted: 15 April 2025 | Published online: 2 July 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Colorectal cancer (CRC) has been associated with metabolic and inflammatory dysregulation, particularly in lipid and glucose metabolism. This study investigates the role of serum lipids and biochemical markers as potential biomarkers for CRC in the South Indian population. A case–control observational study was conducted involving 65 CRC patients and 65 age- and sex-matched healthy controls. Participants were selected based on strict inclusion and exclusion criteria, ensuring the elimination of confounding factors such as other malignancies or chronic conditions. Blood samples were analyzed for lipid profiles, high-sensitivity C-reactive protein (hs-CRP), and other biochemical parameters using enzyme immunoassay kits. Statistical analyses were performed to evaluate differences between groups, with a p<0.05 considered statistically significant. Significant elevations in total cholesterol (TC), low-density lipoprotein (LDL), and the TC/high-density lipoprotein (HDL) and LDL/HDL ratios were observed in CRC patients compared to controls. The observed high hs-CRP levels indicate the heightened inflammatory state in CRC. The levels of triglycerides, HDL, and very-LDL showed no significant differences, although trends of elevated uric acid and urea levels in CRC patients were noted. Blood glucose levels were significantly higher in CRC patients, suggesting possible disruptions in glucose metabolism. Liver and renal function markers remained within comparable ranges across both groups. The study highlights dysregulated lipid and glucose metabolism and increased inflammatory markers in CRC patients from the South Indian population. Elevated LDL, TC, and hs-CRP may serve as potential biomarkers for early detection and risk assessment in CRC. These findings highlight the importance of monitoring lipid and glucose profiles in CRC patients and pave the way for further research into their role in CRC pathogenesis and progression.

Keywords
Cholesterol biomarkers
Colorectal cancer
Inflammatory markers
Lipid profile
Metabolic dysregulation
Funding
This study was supported by the Department of Science and Technology – Promotion of University Research and Scientific Excellence program. Funding was provided through the Department of Human Genetics and Molecular Biology, Bharathiar University, Coimbatore, Tamil Nadu, India (Grant number: BU/DST PURSE-II/008/2017).
Conflict of interest
The authors declare that they have no competing interest.
References
  1. Prizment AE, Anderson KE, Visvanathan K, Folsom AR. Association of inflammatory markers with colorectal cancer incidence in the atherosclerosis risk in communities study. Cancer Epidemiol Biomarkers Prev. 2011;20(2):297-307. doi: 10.1158/1055-9965.EPI-10-1146

 

  1. Toriola AT, Cheng TY, Neuhouser ML, et al. Biomarkers of inflammation are associated with colorectal cancer risk in women but are not suitable as early detection markers. Int J Cancer. 2013;132(11):2648-2658. doi: 10.1002/ijc.27942

 

  1. Fang Z, He M, Song M. Serum lipid profiles and risk of colorectal cancer: A prospective cohort study in the UK Biobank. Br J Cancer. 2021;124(3):663-670. doi: 10.1038/s41416-020-01143-6

 

  1. Zeljkovic A, Vekic J, Mihajlovic M, et al. Revealing the role of high-density lipoprotein in colorectal cancer. Int J Mol Sci. 2021;22(7):3352. doi: 10.3390/ijms22073352

 

  1. Tao JH, Wang XT, Yuan W, et al. Reduced serum high-density lipoprotein cholesterol levels and aberrantly expressed cholesterol metabolism genes in colorectal cancer. World J Clin Cases. 2022;10(14):4446-4459. doi: 10.12998/wjcc.v10.i14.4446

 

  1. Akkus E, Öksüz NE, Utkan G. Low-density lipoprotein (LDL) is associated with earlier progression in synchronous metastatic colorectal cancer treated without curative intent. J Gastrointest Cancer. 2025;56(1):58. doi: 10.1007/s12029-025-01166-3

 

  1. Lashin AH, El-feky HM, Abd El-Fattah GA, Khoziem T. Role of serum uric acid in assessment of rectal cancer metastasis. Benha Med J. 2020;37:12-23. doi: 10.21608/bmfj.2019.14570.1014

 

  1. Vulcan A, Manjer J, Ohlsson B. High blood glucose levels are associated with higher risk of colon cancer in men: A cohort study. BMC Cancer. 2017;17:842. doi: 10.1186/s12885-017-3874-4

 

  1. Yang M, Zhang Q, Ruan GT, et al. Association between serum creatinine concentrations and overall survival inpatients with colorectal cancer: A multi-center cohort study. Front Oncol. 2021;11:710423. doi: 10.3389/fonc.2021.710423

 

  1. Scheipner L, Smolle MA, Barth D, et al. The AST/ALT ratio is an independent prognostic marker for disease-free survival in stage II and III colorectal carcinoma. Anticancer Res. 2021;41(1):429-436. doi: 10.21873/anticanres.14792

 

  1. Jalali MT, Honomaror AM, Rekabi A, Latifi M. Reference ranges for serum total cholesterol, HDL-cholesterol, LDL-cholesterol, and VLDL-cholesterol and triglycerides in healthy Iranian Ahvaz population. Indian J Clin Biochem. 2013;28:277-282. doi: 10.1007/s12291-012-0268-x

 

  1. Volanakis JE. Human C-reactive protein: Expression, structure, and function. Mol Immunol. 2001;38(2-3):189-197. doi: 10.1016/S0161-5890(01)00042-6

 

  1. Desideri G, Castaldo G, Lombardi A, et al. Is it time to revise the normal range of serum uric acid levels? Eur Rev Med Pharmacol Sci. 2014;18(9):1295-1306.

 

  1. Yang Y, Jiang H, Tang A, Xiang Z. Reference intervals for serum bilirubin, urea, and uric acid in healthy Chinese geriatric population. J Clin Lab Anal. 2018;32(3):e22318. doi: 10.1002/jcla.22318

 

  1. Ceriotti F, Boyd JC, Klein G, et al. Reference intervals for serum creatinine concentrations: Assessment of available data for global application. Clin Chem. 2008;54(3):559-566. doi: 10.1373/clinchem.2007.099648

 

  1. Zhang X, Mu Y, Yan W, Ba J, Li H. Alanine aminotransferase within reference range is associated with metabolic syndrome in middle-aged and elderly Chinese men and women. Int J Environ Res Public Health. 2014;11(12):12767-12776. doi: 10.3390/ijerph111212767

 

  1. Panteghini M, Adeli K, Ceriotti F, Sandberg S, Horvath AR. American liver guidelines and cutoffs for “normal” ALT: A potential for overdiagnosis. Clin Chem. 2017;63(7):1196-1198. doi: 10.1373/clinchem.2017.274977

 

  1. Ghasemi A, Zahediasl S, Azizi F. Reference values for fasting serum glucose levels in healthy Iranian adult subjects. Clin Lab. 2011;57(5-6):343-349.

 

  1. Younis M, Kumar P, Sudershan A, et al. Serum level of carcinoembryonic antigen and risk of colorectal cancer: A case-control study from South Indian population. Nucleus. 2025;18:1. doi: 10.1007/s13237-025-00543-4

 

  1. Younis M, Arun M, Iqbal J, et al. Analysis of genetic alterations in colorectal cancer (CRC) patients in south Indian population. Int J Hum Genet. 2018;18(3):210-218. doi: 10.31901/24566330.2018/18.3.705

 

  1. Mohd Y, Balasubramanian B, Meyyazhagan A, et al. Extricating the association between the prognostic factors of colorectal cancer. J Gastrointest Cancer. 2021;52:1022-1028. doi: 10.1007/s12029-020-00535-4

 

  1. Mohd Y, Kumar P, Kuchi Bhotla H, et al. Transmission jeopardy of adenomatosis polyposis coli and methylenetetrahydrofolate reductase in colorectal cancer. J Renin Angiotensin Aldosterone Syst. 2021;2021:7010706. doi: 10.1155/2021/7010706

 

  1. Giovannucci E. Insulin and colon cancer. Cancer Causes Control. 1995;6(2):164-179. doi: 10.1007/BF00052777

 

  1. Nago N, Ishikawa S, Goto T, Kayaba K. Low cholesterol is associated with mortality from stroke, heart disease, and cancer: The Jichi medical school cohort study. J Epidemiol. 2011;21(1):67-74. doi: 10.2188/jea.je20100065

 

  1. Tran TT, Gunathilake M, Lee J, et al. The association of low-carbohydrate diet and HECTD4 rs11066280 polymorphism with risk of colorectal cancer: A case-control study in Korea. Curr Dev Nutr. 2024;8(3):102127. doi: 10.1016/j.cdnut.2024.102127

 

  1. Li T, Qian Y, Li H, Deng J. Combination of serum lipids and cancer antigens as a novel marker for colon cancer diagnosis. Lipids Health Dis. 2018;17:261. doi: 10.1186/s12944-018-0911-5

 

  1. Sever ÖN, Başoğlu T, Yıldırım S. Relationship of tumor localization and lipid parameters with survival in patients with colorectal cancer. J Clin Med. 2025;14(4):1302. doi: 10.3390/jcm14041302

 

  1. Bayerdorffer E, Mannes GA, Richter WO, et al. Decreased high-density lipoprotein cholesterol and increased low-density cholesterol levels in patients with colorectal adenomas. Ann Intern Med. 1993;118(7):481-487. doi: 10.7326/0003-4819-118-7-199304010-00001

 

  1. Goyal A, Terry MB, Jin Z, Siegel AB. C-reactive protein and colorectal cancer mortality in U.S. adults. Cancer Epidemiol Biomarkers Prev. 2014;23(8):1609-1618. doi: 10.1158/1055-9965.EPI-13-0577

 

  1. Li S, Fang W, Zheng J, et al. Whole‐transcriptome defines novel glucose metabolic subtypes in colorectal cancer. J Cell Mol Med. 2024;28(5):e18065. doi: 10.1111/jcmm.18065

 

  1. Younis M, Sujeetha P, Sangeetha T, Kaviya M, Bharathi K. Molecular heterogeneity in colorectal cancer: Insights from genetic profiling. J Adv Res. 2021;3(5):6-15. doi: 10.46947/joaasr352021118

 

  1. Wang Z, Uchida K, Ohnaka K, et al. Sugars, sucrose and colorectal cancer risk: The Fukuoka colorectal cancer study. Scand J Gastroenterol. 2014;49(5):581-588. doi: 10.3109/00365521.2013.822091

 

  1. Liu K, Wang W, Liu Y, et al. Correlation of cumulative fasting blood glucose exposure with gastrointestinal cancers: A prospective cohort study. Medicine (Baltimore). 2025;104(7):e41529. doi: 10.1097/MD.0000000000041529

 

  1. Tanriverdi O, Cokmert S, Oktay E, et al. Prognostic significance of the baseline serum uric acid level in non-small cell lung cancer patients treated with first-line chemotherapy: A study of the Turkish descriptive oncological researches group. Med Oncol. 2014;31:217. doi: 10.1007/s12032-014-0217-z

 

  1. Cetin AO, Omar M, Calp S, et al. Hyperuricemia at the time of diagnosis is a factor for poor prognosis in patients with stage II and III colorectal cancer (uric acid and colorectal cancer). Asian Pac J Cancer Prev. 2017;18(2):485-490. doi: 10.22034/APJCP.2017.18.2.485

 

  1. Crudele L, De Matteis C, Novielli F, et al. Fasting hyperglycaemia and fatty liver drive colorectal cancer: A retrospective analysis in 1145 patients. Intern Emerg Med. 2024;19(5):1267-1277. doi: 10.1007/s11739-024-03596-6

 

  1. Casadei Gardini A, Scarpi E, Orlandi E, et al. Prognostic role of aspartate aminotransferase-lymphocyte ratio index in patients with metastatic colorectal cancer: Results from the randomized ITACa trial. Onco Targets Ther. 2018;11:5261-5268. doi: 10.2147/OTT.S166614

 

  1. Wang C, Lv T, Jin B, Li Y, Fan Z. Regulatory role of PPAR in colorectal cancer. Cell Death Discov. 2025;11(1):28. doi: 10.1038/s41420-025-02313-2

 

  1. Engstrand J, Nilsson H, Strömberg C, Jonas E, Freedman J. Colorectal cancer liver metastases-a population-based study on incidence, management and survival. BMC Cancer. 2018;18:78. doi: 10.1186/s12885-017-3925-x

 

  1. Ose J, Gigic B, Brezina S, et al. Higher plasma creatinine is associated with an increased risk of death in patients with non-metastatic rectal but not colon cancer: Results from an international cohort consortium. Cancers (Basel). 2023;15(13):3391. doi: 10.3390/cancers15133391

 

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