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A Nested Case–Control Study on Plasma Vitamin E and Risk of Cancer: Evidence of Effect Modification by Selenium

Published:January 31, 2019DOI:https://doi.org/10.1016/j.jand.2018.11.017

      Abstract

      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.

      Keywords

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      Biography

      J. Wang is a doctoral candidate, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China.

      Biography

      B. Wang is a professor, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China.

      Biography

      X. Qin is an associate professor, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China.

      Biography

      H. Guo is an associate professor, Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China.

      Biography

      T. Lin is a doctoral candidate, Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China.

      Biography

      Y. Song is a postdoctoral researcher, Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China.

      Biography

      H. Zhang is an associate professor, Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China.

      Biography

      X. Xu is a professor, Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China.

      Biography

      Y. Zhang is an associate professor, Department of Cardiology, Peking University First Hospital, Beijing, China.

      Biography

      J. Li is a professor, Department of Cardiology, Peking University First Hospital, Beijing, China.

      Biography

      Y. Huo is a professor, Department of Cardiology, Peking University First Hospital, Beijing, China.

      Biography

      X. Wang is a professor, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.

      Linked Article

      • Erratum
        Journal of the Academy of Nutrition and DieteticsVol. 119Issue 7
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          In “A Nested Case–Control Study on Plasma Vitamin E and Risk of Cancer: Evidence of Effect Modification by Selenium,” published in the May 2019 issue of the Journal (2019;119(5):769-781), the Methods section reads, “Controls were chosen from remaining participants who were alive and had not developed cancer during follow-up.” This should have said, “Controls were randomly chosen from the baseline CSPPT participants who did not develop cancer during the follow-up.” The authors regret this error.
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