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.
Article info
Publication history
Published online: January 31, 2019
Accepted:
November 26,
2018
Received:
June 21,
2018
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST X. Xu reports grants from the Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing; the Science and Technology Planning Project of Guangzhou, China; the Science, Technology and Innovation Committee of Shenzhen. X. Qin reports grants from the Projects of the National Natural Science Foundation; the President Foundation of Nanfang Hospital, Southern Medical University; and the Outstanding Youths Development Scheme of Nanfang Hospital, Southern Medical University. Y. Huo reports grants from National Key Research and Development Program. No potential conflict of interest was reported by the remaining authors.
FUNDING/SUPPORT This work was supported by the National Key Research and Development Program (2016YFC0903101, 2016YFC0904900, 2016YFE0205400), the Projects of the National Natural Science Foundation of China (81473052 and 81402735); the Science and Technology Planning Project of Guangzhou, China (201707020010); the Science, Technology and Innovation Committee of Shenzhen (KQCX20120816105958775, JSGG20160229173428526, JSGG20170412155639040, GJHS20170314114526143, KC2014JSCX0071A); the President Foundation of Nanfang Hospital, Southern Medical University (2017C007), the Outstanding Youths Development Scheme of Nanfang Hospital, Southern Medical University (2017J009).
The CSPPT was registered with ClinicalTrials.gov (ID NCT00794885).
AUTHOR CONTRIBUTIONS X. Xu and X. Qin contributed to conceived the study and funding acquisition. J. Wang and H. Guo contributed to the data collection, statistical analyses, and original drafting of the manuscript. All authors reviewed and commented on subsequent drafts of the manuscript.
Identification
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© 2019 by the Academy of Nutrition and Dietetics.
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- ErratumJournal of the Academy of Nutrition and DieteticsVol. 119Issue 7
- PreviewIn “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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