title: Calcium or resistant starch does not affect colonic epithelial cell proliferation throughout the colon in adenoma patients: a randomized controlled trial.
abstract: Patients with a history of sporadic adenomas have increased epithelial cell proliferative activity, an intermediate risk marker for colorectal cancer. Reduction of proliferation by dietary intervention may reflect a decreased colorectal cancer risk. To evaluate whether calcium or resistant starch could reduce proliferative activity throughout the colon, we performed a randomized controlled trial in 111 sporadic adenoma patients. Patients received two placebos, 1 g of calcium + placebo, or 30 g of amylomaize (19 g of resistant starch) + placebo. After 2 mo, biopsies were collected from the cecum, transverse and sigmoid colon, and rectum during colonoscopy. Epithelial cell proliferation was determined by dividing the number of 5-bromo-2-deoxyuridine-labeled nuclei by the total number of nuclei x 100 (labeling index, LI). LI of luminal, mid, and basal compartments was determined. Twenty-five patients dropped out. In the remaining 86 patients (28 treated with placebo, 30 with calcium + placebo, and 28 with resistant starch + placebo), no difference was observed in total LI, the LI of the three compartments, or the crypt length in the four areas of the colorectum. Colonic epithelial cell proliferative activity throughout the colon of sporadic adenoma patients is not affected by supplementation with 1 g of calcium or 19 g of resistant starch.
authors.affiliation: Department of Gastroenterology, University Hospital, Groningen, The Netherlands.
authors.forename: Britta A P
authors.initials: BA
authors.lastname: van Gorkom
authors.forename: Arend
authors.initials: A
authors.lastname: Karrenbeld
authors.forename: Tineke
authors.initials: T
authors.lastname: van der Sluis
authors.forename: Nynke
authors.initials: N
authors.lastname: Zwart
authors.forename: Roelof
authors.initials: R
authors.lastname: van der Meer
authors.forename: Elisabeth G E
authors.initials: EG
authors.lastname: de Vries
authors.forename: Jan H
authors.initials: JH
authors.lastname: Kleibeuker
mesh_terms: D000236:Adenoma / Q000178:diet therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002136:Calcium, Dietary / Q000008:administration & dosage*; D002455:Cell Division / Q000187:drug effects; D003106:Colon / Q000187:drug effects* / Q000473:pathology*; D015179:Colorectal Neoplasms / Q000178:diet therapy*; D004847:Epithelial Cells / Q000187:drug effects* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013213:Starch / Q000008:administration & dosage*
chemical_list: D002136:Calcium, Dietary; D013213:Starch