The Association between Dietary Vitamin A and Carotenes and the Risk of Primary Liver Cancer: A Case–Control Study

Abstract

Dietary intake of vitamin A (VA) and carotenes has shown beneficial effects for decreasing the risk of some types of cancer, but findings on the risk of primary liver cancer (PLC) are inconsistent. This case–control study explored the associations between the dietary intake of VA and carotenes and the risk of PLC. We recruited 644 incident PLC patients (diagnosed within one month of each other) and 644 age- and gender-matched controls in Guangzhou, China. A food frequency questionnaire was used to assess habitual dietary intake. Logistic regression analyses found that higher intakes of VA and carotenes were independently associated with decreased PLC risk (all P-trend < 0.001). The multivariable-adjusted ORs (95% CI) of PLC for the highest (vs. lowest) quartile were 0.34 (0.24–0.48) for vitamin A and 0.35 (0.25–0.49) for carotenes. The associations were not significantly modified by smoking, alcohol, or tea drinking (P-interactions: 0.062–0.912). Dose–response analysis showed a U-shaped VA–PLC relationship, with sharply decreased risks at the intakes of about 1000 μg retinol equivalent (RE)/day, and then slowly went down toward the flat-bottomed risks with the lowest risk at 2300 μg RE/day. Our findings suggest that greater intake of retinol, carotenes, and total VA may decrease PLC risk among the Chinese population at an intake of 1000 μg RE/day or greater from food sources.

Dietary patterns and primary liver cancer in Chinese adults: a case-control study

“…Inverse association between the consumption of fruit and/or vegetables and hepatocellular carcinoma (HCC) was also observed in many studies, such as the European Prospective Investigation into Cancer and nutrition (EPIC) study [ 14 ], the Japan Public Health Center-based Prospective Study (JPHC study) Cohort II [ 36 ], the Shanghai Women’s and Men’s Health Studies [ 37 ] and the Hiroshima/Nagasaki Life Span Study [ 38 ]. Our previous study also showed a favorable association of dietary sources of antioxidants with PLC [ 13 ]. Moreover, there is also substantial evidence that foods rich in PUFAs, such as fish, play a role in reducing HCC risk through the anti-inflammatory effect of n-3 PUFAs on chronic hepatitis [ 17 , 18 ].…”

“…Dietary consumption was evaluated by an interviewer-administered 79-item food frequency questionnaire (FFQ) that has been validated in previous studies [ 13 ]. All participants were required to report their intake frequency (never, per year, per month, per week, or per day) and the average amount of each food item.…”

“…Previous studies have showed that many foods and nutrients are associated with the risk of PLC. For example, carbohydrates [ 7 ], foods from animal sources with rich saturated fat (e.g., meat [ 8 , 9 ], and dairy products [ 10 ]), alcohol [ 11 ] and soft drinks [ 12 ] tend to increase the PLC risk, while vitamins [ 13 ], dietary fiber [ 7 ], a great deal of foods from plant sources [ 14 ], coffee [ 15 , 16 ] and fish [ 17 , 18 ] tend to decrease the risk. They provide comprehensive knowledge of the effect of a single/type food or nutrient on the diseases.…”

Adherence to the Chinese or American Dietary Guidelines is Associated with a Lower Risk of Primary Liver Cancer in China: A Case-Control Study

“…In addition, the results from the available data indicate that a higher consumption of fish, white meat, and grains and a lower intake of red meat and dietary sugar were associated with the reduced risk of HCC [ 4 , 7 , 35 ]. Furthermore, healthy diets are often rich in antioxidants (e.g., flavonoids, beta-carotene, vitamin C, vitamin D, and selenium), fiber, and unsaturated fatty acids, which have been observed to protect against HCC [ 4 , 36 , 37 , 38 ]. Additionally, the ratio of monounsaturated to saturated fat in the aMED and the ratio of total poly- and monounsaturated to saturated fatty acids in the HEI-2010 also showed inverse associations with HCC incidence [ 18 ].…”

Role of Dietary Carotenoids in Different Etiologies of Chronic Liver Diseases

“…In another study involving cell lines, it was found that acyclic retinoid (synthetic analog of retinoids) retards overexpression of Ras/Erk signaling system, thereby declining the progression of HCC [48]. In a human study, it was found that greater intake of retinol, total vitamin A, and carotenes decreases the risk of primary liver cancer at an intake of 1000 μg retinol equivalent (RE)/day or greater from food sources [49]. In another human study in the presence of hepatitis B virus, levels of dietary and serum vitamin A and β-carotene were significantly lower in HCC patients than in the control subjects [32].…”