TY - JOUR
T1 - A Nested Case–Control Study on Plasma Vitamin E and Risk of Cancer
T2 - Evidence of Effect Modification by Selenium
AU - Wang, Jiancheng
AU - Guo, Huiyuan
AU - Lin, Tengfei
AU - Song, Yun
AU - Zhang, Hao
AU - Wang, Binyan
AU - Zhang, Yan
AU - Li, Jianping
AU - Huo, Yong
AU - Wang, Xiaobin
AU - Qin, Xianhui
AU - Xu, Xiping
PY - 2019/5
Y1 - 2019/5
N2 - 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.
AB - 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.
KW - Antioxidant
KW - Cancer incidence
KW - Hypertension
KW - Selenium
KW - Vitamin E
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UR - http://www.scopus.com/inward/citedby.url?scp=85060756203&partnerID=8YFLogxK
U2 - 10.1016/j.jand.2018.11.017
DO - 10.1016/j.jand.2018.11.017
M3 - Article
C2 - 30713028
AN - SCOPUS:85060756203
VL - 119
SP - 769
EP - 781
JO - Journal of the Academy of Nutrition and Dietetics
JF - Journal of the Academy of Nutrition and Dietetics
SN - 2212-2672
IS - 5
ER -