Plasma and dietary carotenoid, retinol and tocopherol levels and the risk of gastric adenocarcinomas in the European prospective investigation into cancer and nutrition

Abstract

Despite declining incidence rates, gastric cancer (GC) is a major cause of death worldwide. Its aetiology may involve dietary antioxidant micronutrients such as carotenoids and tocopherols. The objective of this study was to determine the association of plasma levels of seven common carotenoids, their total plasma concentration, retinol and a-and g-tocopherol, with the risk of gastric adenocarcinoma in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), a large cohort involving 10 countries. A secondary objective was to determine the association of total sum of carotenoids, retinol and a-tocopherol on GCs by anatomical subsite (cardia/noncardia) and histological subtype (diffuse/intestinal). Analytes were measured by high-performance liquid chromatography in prediagnostic plasma from 244 GC cases and 645 controls matched by age, gender, study centre and date of blood donation. Conditional logistic regression models adjusted by body mass index, total energy intake, smoking and Helicobacter pylori infection status were used to estimate relative cancer risks. After an average 3.2 years of follow-up, a negative association with GC risk was observed in the highest vs the lowest quartiles of plasma b-cryptoxanthin (odds ratio (OR) ¼ 0.53, 95% confidence intervals (CI) ¼ 0.30-0.94, P trend ¼ 0.006), zeaxanthin (OR ¼ 0.39, 95% CI ¼ 0.22-0.69, P trend ¼ 0.005), retinol (OR ¼ 0.55, 95% CI ¼ 0.33-0.93, P trend ¼ 0.005) and lipid-unadjusted a-tocopherol (OR ¼ 0.59, 95% CI ¼ 0.37-0.94, P trend ¼ 0.022). For all analytes, no heterogeneity of risk estimates or significant associations were observed by anatomical subsite. In the diffuse histological subtype, an inverse association was observed with the highest vs lowest quartile of lipid-unadjusted a-tocopherol (OR ¼ 0.26, 95% CI ¼ 0.11-0.65, P trend ¼ 0.003). These results show that higher plasma concentrations of some carotenoids, retinol and a-tocopherol are associated with reduced risk of GC.

High Serum Level of Retinol and α-Tocopherol Affords Protection Against Oral Cancer in a Multiethnic Population

“…This finding is further corroborated by an earlier study where serum level of vitamin A (a group of organic compound including retinol) and E (a group of organic compound including tocopherol) was also found to be lower in cases as compared to controls where low serum level of these vitamins was associated with 10.9 times and 5.6 times increased risk for oral cancer (Lawal et al, 2012). Inverse association of retinol and α-tocopherol have also been reported in other cancers such as lung (Klarod et al, 2011), breast (Shim et al, 2012) and gastric cancer (Jenab et al, 2006). The protective effect exerted by retinol and α-tocopherol could be explained by their role as potent regulators of cellular activities, thus having significant impact on oral carcinogenesis (Mukherjee et al, 2011).…”

Body Mass and Physical Activity and Risk of Gastric Cancer in a Population-Based Cohort Study in Norway

“…Moreover, no detailed information on nutritional factors was available (e.g., intake of antioxidative vitamins, which may have a protective effect against gastric cancer; refs. [24][25][26]. It is plausible that such dietary factors could be associated with weight and level of physical activity, and obese persons tend to have lower blood levels of antioxidants (27,28).…”

The Association of Gastric Cancer Risk with Plasma Folate, Cobalamin, and Methylenetetrahydrofolate Reductase Polymorphisms in the European Prospective Investigation into Cancer and Nutrition

“…Within the EurGast collaboration (35)(36)(37)(38)(39) of the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort (40,41), we had the opportunity to conduct the first prospective study on gastric cancer risk and folate levels measured in blood. Additionally, we included measurements of plasma cobalamin, total homocysteine (tHcy), methylmalonic acid (MMA), and the two common MTHFR single nucleotide polymorphisms (SNP; 677 C!T and 1298 A!C) to provide a more comprehensive assessment of the role of B vitamins in gastric cancer.…”