A Nested Case–Control Study on Plasma Vitamin E and Risk of Cancer: Evidence of Effect Modification by Selenium - 25/04/19
, Xiping Xu, MD, PhDAbstract |
Background |
Evidence from epidemiologic studies has been inconsistent regarding the role of vitamin E in cancer incidence risk.
Objective |
The aim of this study was to evaluate the prospective association between baseline plasma vitamin E levels and subsequent cancer risk in Chinese adults with hypertension, and to identify effect modifiers.
Design |
A nested, case–control study was conducted from 20,702 hypertensive participants in the China Stroke Primary Prevention Trial, a randomized, double-blind, controlled trial, conducted from May 2008 to August 2013.
Participants |
The current study included 229 new cancer cases and 229 controls matched for age (±1 year), sex, treatment group, and study site.
Main outcome measures |
Plasma vitamin E was measured by liquid chromatography with tandem quadrupole mass spectrometers and plasma selenium was measured by inductively coupled plasma mass spectrometry using Thermo Fisher iCAP Q ICP-MS.
Statistical analyses |
Odds ratios (OR) of cancer in relation to plasma concentrations of vitamin E were calculated using conditional logistic regression models.
Results |
Median follow-up duration was 4.5 years. Overall, vitamin E was not associated with subsequent risk of total cancer (per 1-mg/L [2.3 μmol/L] increase: OR 1.01, 95% CI 0.93 to 1.09) and non-gastrointestinal cancer (OR 1.10, 95% CI 0.98 to 1.24). However, there was a significant, inverse association between vitamin E and gastrointestinal cancer (OR 0.86, 95% CI 0.75 to 0.99), particularly esophageal cancer (OR 0.67, 95% CI 0.48 to 0.95). Moreover, high vitamin E decreased the risk of total cancer (OR 0.91, 95% CI 0.84 to 0.99) and gastrointestinal cancer (OR 0.83, 95% CI 0.73 to 0.95) among patients with high selenium levels (median≥83.7 μg/L [1.1 μmol/L]), and increased the risk of total cancer (OR 1.13, 95% CI 1.00 to 1.26) and non-gastrointestinal cancer (OR 1.25, 95% CI 1.03 to 1.50) among those with low selenium levels (<83.7 μg/L [1.1 μmol/L]).
Conclusions |
This study suggests that higher levels of plasma vitamin E are associated with reduced risk of gastrointestinal cancer. High vitamin E decreased the risk of total cancer among patients with high selenium levels, but increased the risk of total cancer among those with low selenium levels.
Le texte complet de cet article est disponible en PDF.Keywords : Vitamin E, Selenium, Cancer incidence, Antioxidant, Hypertension
Plan
| STATEMENT OF POTENTIAL CONFLICT OF INTEREST X. Xu reports grants from the Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing; the Science and Technology Planning Project of Guangzhou, China; the Science, Technology and Innovation Committee of Shenzhen. X. Qin reports grants from the Projects of the National Natural Science Foundation; the President Foundation of Nanfang Hospital, Southern Medical University; and the Outstanding Youths Development Scheme of Nanfang Hospital, Southern Medical University. Y. Huo reports grants from National Key Research and Development Program. No potential conflict of interest was reported by the remaining authors. |
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| FUNDING/SUPPORT This work was supported by the National Key Research and Development Program (2016YFC0903101, 2016YFC0904900, 2016YFE0205400), the Projects of the National Natural Science Foundation of China (81473052 and 81402735); the Science and Technology Planning Project of Guangzhou, China (201707020010); the Science, Technology and Innovation Committee of Shenzhen (KQCX20120816105958775, JSGG20160229173428526, JSGG20170412155639040, GJHS20170314114526143, KC2014JSCX0071A); the President Foundation of Nanfang Hospital, Southern Medical University (2017C007), the Outstanding Youths Development Scheme of Nanfang Hospital, Southern Medical University (2017J009). |
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| The CSPPT was registered with ClinicalTrials.gov (ID NCT00794885). |
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| AUTHOR CONTRIBUTIONS X. Xu and X. Qin contributed to conceived the study and funding acquisition. J. Wang and H. Guo contributed to the data collection, statistical analyses, and original drafting of the manuscript. All authors reviewed and commented on subsequent drafts of the manuscript. |
Vol 119 - N° 5
P. 769-781 - mai 2019 Retour au numéro
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