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               <mods:identifier type="uri">http://hdl.handle.net/20.500.14342/5249</mods:identifier>
               <mods:identifier type="doi">https://doi.org/10.1158/1055-9965.EPI-24-1390</mods:identifier>
               <mods:abstract>Background:&#xd;
Current evidence suggests higher physical activity (PA) levels are associated with a reduced risk of colorectal cancer. However, the mediating role of the circulating metabolome in this relationship remains unclear.&#xd;
&#xd;
Methods:&#xd;
Targeted metabolomics data from 6,055 participants in the European Prospective Investigation into Cancer and Nutrition cohort were used to identify metabolites associated with PA and derive a metabolomic signature of PA levels. PA levels were estimated using the validated Cambridge PA index based on baseline questionnaires. Mediation analyses were conducted in a nested case–control study (1,585 cases, 1,585 controls) to examine whether individual metabolites and the metabolomic signature mediated the PA–colorectal cancer association.&#xd;
&#xd;
Results:&#xd;
PA was inversely associated with colorectal cancer risk (OR per category change: 0.90, 95% confidence interval, 0.83–0.97; P value = 0.009). PA levels were associated with 24 circulating metabolites after FDR correction, with the strongest associations observed for phosphatidylcholine acyl-alkyl (PC ae) C34:3 (FDR-adjusted P value = 1.18 × 10−10) and lysophosphatidylcholine acyl C18:2 (FDR-adjusted P value = 1.35 × 10−6). PC ae C34:3 partially mediated the PA–colorectal cancer association (natural indirect effect: 0.991, 95% confidence interval, 0.982–0.999; P value = 0.04), explaining 7.4% of the association. No mediation effects were observed for the remaining metabolites or the overall PA metabolite signature.&#xd;
&#xd;
Conclusions:&#xd;
PC ae C34:3 mediates part of the PA–colorectal cancer inverse association, but further studies with improved PA measures and extended metabolomic panels are needed.&#xd;
&#xd;
Impact:&#xd;
These findings provide insights into PA-related biological mechanisms influencing colorectal cancer risk and suggest potential targets for cancer prevention interventions.</mods:abstract>
               <mods:language>
                  <mods:languageTerm authority="rfc3066">eng</mods:languageTerm>
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               <mods:accessCondition type="useAndReproduction">© L'autor/a Attribution-NonCommercial-NoDerivatives 4.0 International</mods:accessCondition>
               <mods:subject>
                  <mods:topic>Metabolòmica</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>Exercici</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>Còlon -- Càncer</mods:topic>
               </mods:subject>
               <mods:titleInfo>
                  <mods:title>Identifying metabolomic mediators of the physical activity and colorectal cancer relationship</mods:title>
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               <mods:genre>info:eu-repo/semantics/article</mods:genre>
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