Dietary Zinc and Risk of Prostate Cancer in Spain: MCC-Spain Study

Abstract

Zinc is a key trace element in normal prostate cell metabolism, and is decreased in neoplastic cells. However, the association between dietary zinc and prostate cancer (PC) in epidemiologic studies is a conflicting one. Our aim was to explore this association in an MCC-Spain case-control study, considering tumor aggressiveness and extension, as well as genetic susceptibility to PC. 733 incident cases and 1228 population-based controls were included for this study. Dietary zinc was assessed using a food frequency questionnaire, and genetic susceptibility was assessed with a single nucleotide polymorphisms (SNP)-based polygenic risk score (PRS). The association between zinc intake and PC was evaluated with mixed logistic and multinomial regression models. They showed an increased risk of PC in those with higher intake of zinc (Odds Ratio (OR) tertile 3vs1: 1.39; 95% Confidence interval (CI):1.00–1.95). This association was mainly observed in low grade PC (Gleason = 6 RRR tertile 3vs1: 1.76; 95% CI:1.18–2.63) as well as in localized tumors (cT1-cT2a RRR tertile 3vs1: 1.40; 95% CI:1.00–1.95) and among those with higher PRS (OR tertile 3vs1: 1.50; 95% CI:0.89–2.53). In conclusion, a higher dietary zinc intake could increase the risk of low grade and localized tumors. Men with higher genetic susceptibility might also have a higher risk of PC associated with this nutrient intake.

The impact of plasma zinc status on the severity of prostate cancer disease

“…However, a recent evaluation of the relationship between dietary zinc intake and the disease grade and stage by Gutiérrez-González et al [27] did not support this association. Additionally, Park et al [28] found no association between serum zinc status and PCa grade and stage.…”

The Effect of Zinc, Selenium, and Their Combined Supplementation on Androgen Receptor Protein Expression in the Prostate Lobes and Serum Steroid Hormone Concentrations of Wistar Rats

“…Also, epidemiologic studies on Zn actions and risk of PCa are ambiguous and provide conflicting results. Recently, Gutierrez-Gonzalez et al (2019) [15] proved that high dietary zinc intake could be associated with a higher PCa risk (especially for low-grade and localized tumors) [15].…”

“…Normal cells of peripheral zone accumulate high contents of Zn, in contrast to neoplastic, in which Zn concentration is remarkably lower, what results in reduced pro-apoptotic effects of this element. Therefore, it is hypothesized that increasing Zn concentrations can promote the apoptosis of malignant cells and inhibit neoplastic cell proliferation, migration, and invasion [15,16]. Similarly to Zn, Se is also used in anticancer supplementation, as it offers protection against free radicals, modifies immunity, DNA repair, apoptosis, and angiogenesis [17,18].…”

Dietary Factors and Prostate Cancer Development, Progression, and Reduction

“…However, when prostate cancer was diagnosed at the advanced stage, any significant effect of higher zinc intake was not observed. In turn, the results from the MCC-Spain case–control study [ 150 ] covering 733 men with prostate cancer and 1228 population-based control individuals revealed that the dietary zinc intake at the level of at least 10.53 mg/day vs. 8.34 mg/day or less was associated with a 39% higher risk of prostate cancer (OR = 1.39, 95% CI = 1.00–1.95). When zinc intake was compared with prostate cancer aggressiveness, it turned out that patients with a low-grade tumor (Gleason score = 6) more frequently consumed zinc at a higher level (relative risk ratio = 1.66, 95% CI = 1.07–2.57) than patients who consumed less than 8.34 mg/day.…”