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Gastric cancer risk is reduced by a predominance of antioxidant factors in the oxidative balance: a hospital-based case-control study in Korea
Jimi Kim, Jeonghee Lee, Il Ju Choi, Young-Il Kim, Jeongseon Kim
Epidemiol Health. 2022;44:e2022089.   Published online October 17, 2022
DOI: https://doi.org/10.4178/epih.e2022089
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AbstractAbstract PDF
Abstract
OBJECTIVES
Gastric carcinogenesis is linked to oxidative stress from both exogenous and endogenous exposures. This study aimed to determine the association between the risk of gastric cancer and the oxidative balance score (OBS), which comprises antioxidant and pro-oxidant factors, including diet and lifestyle.
METHODS
For this hospital-based case-control study, 808 controls and 404 patients with gastric cancer who had clinical records indicating Helicobacter pylori infection and the histological subtype of cancer were recruited. The OBS was determined based on diet and lifestyle factors obtained from a 106-item semiquantitative food frequency questionnaire and a constructed questionnaire. Logistic regression analysis was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).
RESULTS
A higher OBS was associated with a reduced gastric cancer risk (OR, 0.49; 95% CI 0.33 to 0.71; p for trend <0.001). In a subgroup analysis, antioxidant factors showed inverse associations with gastric cancer risk (OR, 0.53; 95% CI T3 vs. T1, 0.35 to 0.79; p for trend=0.003). A stronger association with antioxidant factors was observed in patients with intestinal gastric cancer (OR, 0.34; 95% CI T3 vs. T1, 0.19 to 0.62; p for trend<0.001) and those with H. pylori infection (OR, 0.57; 95% CI T3 vs. T1, 0.37 to 0.88; p for trend=0.014).
CONCLUSIONS
A predominance of antioxidant factors compared to pro-oxidant factors from diet and lifestyle reduced the risk of gastric cancer. The combined effect of oxidative stress, which involves an altered balance between antioxidants and pro-oxidants, is important for modulating the risk of gastric cancer.
Summary
Korean summary
Key Message
The influence of the dietary intake of vitamin C and vitamin E on the risk of gastric intestinal metaplasia in a cohort of Koreans
Sung Keun Park, Yeongu Chung, Chang-Mo Oh, Jae-Hong Ryoo, Ju Young Jung
Epidemiol Health. 2022;44:e2022062.   Published online July 29, 2022
DOI: https://doi.org/10.4178/epih.e2022062
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  • 153 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Studies have suggested that the dietary intake of antioxidant vitamins, such as vitamin C and vitamin E, has a potential role in inhibiting gastric carcinogenesis. The present study investigated the effect of antioxidant vitamins on the incidence of gastric intestinal metaplasia (GIM).
METHODS
This study included 67,657 Koreans free of GIM who periodically underwent health check-ups. Dietary intake was assessed by a semiquantitative food frequency questionnaire based on the Korean National Health and Nutrition Examination Survey. Participants were categorized into 4 groups by quartiles of dietary vitamin C and vitamin E intake. The Cox proportional hazard assumption was used to determine the multivariable hazard ratio (HR) and 95% confidence interval (95% CI) for GIM.
RESULTS
The third and fourth quartiles of vitamin C intake had a lower risk of GIM than the first quartile (multivariable-adjusted HR, 0.95; 95% CI, 0.88 to 1.03 in the second quartile, HR, 0.88; 95% CI, 0.81 to 0.97 in the third quartile, and HR, 0.85; 95% CI, 0.76 to 0.95 in the fourth quartile). Vitamin E intake greater than the second quartile level was significantly associated with a lower risk of GIM than the first quartile (multivariable-adjusted HR, 0.90; 95% CI, 0.82 to 0.97 in the second quartile, HR, 0.90; 95% CI, 0.82 to 0.99 in the third quartile, and HR, 0.83; 95% CI, 0.74 to 0.94 in the fourth quartile). This association was observed only in the subgroup analysis for men.
CONCLUSIONS
Higher dietary intake of vitamin C and vitamin E was associated with a lower risk of GIM.
Summary
Korean summary
본 연구에서는 6만명 이상의 한국인을 대상으로 비타민 C와 비타민 E의 섭취량과 장기적인 위 장상피화생 (GIM) 발생 위험도의 상관 관계를 연구했다. 우리는 비타민 C와 E 섭취량이 많은 근로 연령대의 한국인에서 낮은 위 장상피화생 발생 위험을 확인했다. 이 연관성은 여성보다 남성에서 더 분명하게 나타났다.
Key Message
1. This study investigated the long-term effect of vitamin C and vitamin E intake on the longitudinal risk of GIM in more than 60,000 Koreans 2. We found increased intake of Vitamin C/E is associated with lower incidental risk of GIM in working aged Korean. 3. This association was more prominent in men than women.
A Case-Control Study on dietary Factors of Colorectal Adenomatous Polyps by Sites.
Mi Kyung Kim, Won Chul Lee, Kyu Yong Choi, Su Kil Kim, Se Young Lee, Yang Cha Lee-Kim, Kwang Ho Meng
Korean J Epidemiol. 1998;20(1):154-166.
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  • 14 Download
AbstractAbstract PDF
Abstract
Colorectal adenomas are benign neoplasm in the large bowel that are thought to be precursors lesion to colorectal cancer. So, studying adenomatous polyps instead of cancer might allow one to measure the diet of relatively asymptomatic subjects closer to the time of the initial neoplastic process. Some dietary factor, or set of factors, apparently plays an impotant role in the etiology of colorectal adenomatous polyps. The difference of the possible association of colorectal adenomatous polyps with dietary risk factors by anatomic subsite and gender was investigated in this case-control study. Between July 1994 and April 1998, 314 cases of patients with pathologically confirmed incident colorectal adenomatous polyps and 88 control subjects were collected from Our Lady of Mercy Hospital, The Catholic University. After colonoscopy, infor-mation on exposure was obtained by the interviewers. Also, subjects were interviewed using the semiquantitative food frequency questionnaire, and average daily nutrient intakes were calculated. Site- and gender-specific odds ratio relative to the lowest tertile of intake for each nutrient were determined using unconditional logistic regression after adjusting for a number of potential confounders. In females, significant odds ratio were found for b-carotene(0.31, 95% CI, 0.10~0.95), vitamin C(0.11, 95% CI, 0.02~0.61), vitamin-E(0.11, 95% CI, 0.02~0.78) in right colon but only the odds ratio of vitamin E(0.17, 95% CI, 0.03~0.90) was statistically significant in left colon. Among food groups, the odds ratio of green yellow vegetables was significant(OR=0.21, 95% CI, 0.05~0.96) in right colon. In males, almost all the above dietary factors were statistically not significant. In males, cigarette smoking appears to be a signigicant risk factor(OR=8.86, 95% CI, 1.10~71.5) in left colon, it was statistically not signigicant(OR=1.63, 95% CI, 0.42~4.76) in the right colon. Findings fron this study show that many associations of the nutrients with colorectal adenomatous polyps risk are different by anatomic subsite and gender and support the hypothesis that high intake of antioxidant vitamins and green yellow vagetables decreases the risk of polyps.
Summary
Korean summary
Key Message
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