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Paustenbach DJ, Brown SE, Heywood JJ, Donnell MT, Eaton DL. Risk characterization of N-nitrosodimethylamine in pharmaceuticals. Food Chem Toxicol 2024; 186:114498. [PMID: 38341171 DOI: 10.1016/j.fct.2024.114498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/23/2024] [Accepted: 01/31/2024] [Indexed: 02/12/2024]
Abstract
Since 2018, N-nitrosodimethylamine (NDMA) has been a reported contaminant in numerous pharmaceutical products. To guide the pharmaceutical industry, FDA identified an acceptable intake (AI) of 96 ng/day NDMA. The approach assumed a linear extrapolation from the Carcinogenic Potency Database (CPDB) harmonic-mean TD50 identified in chronic studies in rats. Although NDMA has been thought to act as a mutagenic carcinogen in experimental animals, it has not been classified as a known human carcinogen by any regulatory agency. Humans are exposed to high daily exogenous and endogenous doses of NDMA. Due to the likelihood of a threshold dose for NDMA-related tumors in animals, we believe that there is ample scientific basis to utilize the threshold-based benchmark dose or point-of-departure (POD) approach when estimating a Permissible Daily Exposure limit (PDE) for NDMA. We estimated that 29,000 ng/kg/day was an appropriate POD for calculating a PDE. Assuming an average bodyweight of 50 kg, we expect that human exposures to NDMA at doses below 5800 ng/day in pharmaceuticals would not result in an increased risk of liver cancer, and that there is little, if any, risk for any other type of cancer, when accounting for the mode-of-action in humans.
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Affiliation(s)
- D J Paustenbach
- Paustenbach and Associates, 970 West Broadway, Suite E, Jackson, WY, USA
| | - S E Brown
- Paustenbach and Associates, 207 Canyon Blvd, Boulder, CO, USA.
| | - J J Heywood
- Paustenbach and Associates, 207 Canyon Blvd, Boulder, CO, USA
| | - M T Donnell
- Valeo Sciences LLC, 333 Corporate Drive, Suite 130, Ladera Ranch, CA, USA
| | - D L Eaton
- Professor Emeritus, Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA, USA
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Yoshikawa MH, Rabelo NN, Telles JPM, Figueiredo EG. Modifiable risk factors for glioblastoma: a systematic review and meta-analysis. Neurosurg Rev 2023; 46:143. [PMID: 37340151 DOI: 10.1007/s10143-023-02051-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/03/2023] [Accepted: 06/10/2023] [Indexed: 06/22/2023]
Abstract
Glioblastoma (GBM) is the most common and aggressive glioma histological subtype, associated with high disability and poor survival. The etiology of this condition is still mostly unknown, and evidence about risk factors is elusive. The aim of this study is to identify modifiable risk factors for GBM. Electronic search was performed by two reviewers independently using the keywords and MeSH terms 'glioblastoma' OR 'glioma' OR 'brain tumor' AND 'risk factor'. The inclusion criteria were (1) observational studies or experimental studies on humans, (2) studies assessing the association between glioblastoma and exposure to modifiable conditions, and (3) studies published in English or Portuguese. Studies on the pediatric population or about exposure to ionizing radiation were excluded. A total of 12 studies were included. Seven were case-control studies, and five were cohort studies. The risk factors assessed included body mass index, alcohol consumption, exposure to magnetic fields, diabetes mellitus type 2 (DM2), and use of non-steroidal anti-inflammatory drugs (NSAID). No significant link was found between GBM incidence and DM2 or magnetic field exposure. On the other hand, higher BMI, alcohol consumption, and NSAID use demonstrated a protective effect on GMB risk. However, given the limited number of studies, it is not possible to obtain a behavioral recommendation; instead, these findings are relevant to guide future basic scientific studies on GBM oncogenesis.
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Sirirungreung A, Hansen J, He D, Huang X, Ritz B, Heck JE. Exposure to nitrosatable drugs during pregnancy and childhood cancer: A matched case-control study in Denmark, 1996-2016. Pharmacoepidemiol Drug Saf 2023; 32:496-505. [PMID: 36300575 PMCID: PMC10038857 DOI: 10.1002/pds.5557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 08/19/2022] [Accepted: 10/14/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Nitrosatable drugs can be synthesized to N-nitroso compounds in human stomach. In a pregnant woman, N-nitroso compounds can be translocated to the fetus through the placenta. Maternal exposure of nitrosatable compounds during pregnancy has been associated with childhood brain tumors and leukemia. However, few studies have investigated an association between nitrosatable drug exposure during pregnancy and childhood cancer. We examined if maternal prescriptions of nitrosatable drugs received during pregnancy are associated with childhood cancer. METHODS A matched case-control study was conducted using Danish nationwide registry data from 1995 to 2016. Each childhood cancer case was matched with twenty-five controls. Maternal exposure of nitrosatable drugs during pregnancy was identified from the Danish National Prescription Register. A multivariable conditional logistic regression model was used to estimate adjusted odds ratios (adj.OR) with 95% confidence intervals (CI) for each childhood cancer type. RESULTS Maternal prescriptions of nitrosatable drugs positively associate with central nervous system tumors (adj.OR = 1.25; 95% CI = 1.04-1.51) and neuroblastoma (adj.OR = 1.96; 95% CI = 1.34-2.85) in offspring. We also observed a positive association between perinatal exposure of nitrosatable drugs and acute lymphoblastic leukemia (adj.OR = 1.31; 95% CI = 1.07-1.59), however, it appeared to be due to confounding by indication, i.e., maternal infections. CONCLUSION Nitrosatable drug use during pregnancy potentially increased risk of central nervous system tumors and neuroblastoma. While a positive association between maternal prescriptions of nitrosatable drugs and acute lymphoblastic leukemia should be interpreted cautiously because of confounding by indication.
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Affiliation(s)
- Anupong Sirirungreung
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA
| | - Johnni Hansen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Di He
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA
| | - Xiwen Huang
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA
| | - Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA
- College of Health and Public Service, University of North Texas, Denton, Texas, USA
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Schrenk D, Bignami M, Bodin L, Chipman JK, del Mazo J, Hogstrand C, (Ron) Hoogenboom L, Leblanc J, Nebbia CS, Nielsen E, Ntzani E, Petersen A, Sand S, Schwerdtle T, Vleminckx C, Wallace H, Romualdo B, Cristina F, Stephen H, Marco I, Mosbach‐Schulz O, Riolo F, Christodoulidou A, Grasl‐Kraupp B. Risk assessment of N-nitrosamines in food. EFSA J 2023; 21:e07884. [PMID: 36999063 PMCID: PMC10043641 DOI: 10.2903/j.efsa.2023.7884] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
EFSA was asked for a scientific opinion on the risks to public health related to the presence of N-nitrosamines (N-NAs) in food. The risk assessment was confined to those 10 carcinogenic N-NAs occurring in food (TCNAs), i.e. NDMA, NMEA, NDEA, NDPA, NDBA, NMA, NSAR, NMOR, NPIP and NPYR. N-NAs are genotoxic and induce liver tumours in rodents. The in vivo data available to derive potency factors are limited, and therefore, equal potency of TCNAs was assumed. The lower confidence limit of the benchmark dose at 10% (BMDL10) was 10 μg/kg body weight (bw) per day, derived from the incidence of rat liver tumours (benign and malignant) induced by NDEA and used in a margin of exposure (MOE) approach. Analytical results on the occurrence of N-NAs were extracted from the EFSA occurrence database (n = 2,817) and the literature (n = 4,003). Occurrence data were available for five food categories across TCNAs. Dietary exposure was assessed for two scenarios, excluding (scenario 1) and including (scenario 2) cooked unprocessed meat and fish. TCNAs exposure ranged from 0 to 208.9 ng/kg bw per day across surveys, age groups and scenarios. 'Meat and meat products' is the main food category contributing to TCNA exposure. MOEs ranged from 3,337 to 48 at the P95 exposure excluding some infant surveys with P95 exposure equal to zero. Two major uncertainties were (i) the high number of left censored data and (ii) the lack of data on important food categories. The CONTAM Panel concluded that the MOE for TCNAs at the P95 exposure is highly likely (98-100% certain) to be less than 10,000 for all age groups, which raises a health concern.
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Shu L, Yu D, Jin F. Healthy dietary patterns, foods, and risk of glioma: A systematic review and meta-analysis of observational studies. Front Nutr 2023; 9:1077452. [PMID: 36687697 PMCID: PMC9845718 DOI: 10.3389/fnut.2022.1077452] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/13/2022] [Indexed: 01/06/2023] Open
Abstract
Background Accumulating epidemiological evidence has shown the favorable associations between healthy dietary patterns and risk of glioma, although the results remain inconclusive. Objective We therefore carried out a systematic review and meta-analysis to summarize the evidence from previous published studies, and to clarify the effects of healthy dietary patterns, typical healthy foods on glioma. Methods PubMed, Web of Science, CNKI, and Wan fang data were searched from inception up to September 2022 for eligible studies. Two authors independently performed the literature search, study selection, data extraction, and quality assessment. Heterogeneity across studies was estimated using the Cochran's Q test and I 2 statistic. According to heterogeneity, the fixed-effects model or random-effects model was selected to obtain the relative risk (RR) of the merger. Subgroup analysis, sensitivity analysis and publication bias were also used for our analysis. Results Twenty-four articles that met the selection criteria, involving 7,278 glioma cases and 2,143,528 participants, were included in our analysis. There was a reduced risk of glioma in the highest compared with the lowest categories of healthy dietary patterns (RR = 0.58; 95% CI: 0.44-0.77; P < 0.0001). Moreover, compared with the lowest intakes, the highest intakes of vegetables (RR = 0.84; 95% CI: 0.73-0.96; P = 0.012) and fruits (RR = 0.85; 95% CI: 0.72-1.00; P = 0.045) significantly reduce the risk of glioma. However, the intakes of fresh fish, nuts, whole grains, and dairy products showed no statistically significant associations with the risk of glioma (P > 0.05). Conclusion Findings from this systematic review and meta-analysis indicate that higher intakes of healthy dietary patterns, vegetables, and fruits are significantly associated with the lower risk of glioma. Further studies, particularly with prospective design, are required to confirm our findings.
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Affiliation(s)
- Long Shu
- Department of Nutrition, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Dan Yu
- Department of Endocrinology, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Fubi Jin
- Department of Endocrinology, Zhejiang Hospital, Hangzhou, Zhejiang, China,*Correspondence: Fubi Jin,
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Qi X, Jha SK, Jha NK, Dewanjee S, Dey A, Deka R, Pritam P, Ramgopal K, Liu W, Hou K. Antioxidants in brain tumors: current therapeutic significance and future prospects. Mol Cancer 2022; 21:204. [PMID: 36307808 PMCID: PMC9615186 DOI: 10.1186/s12943-022-01668-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/27/2022] [Indexed: 11/23/2022] Open
Abstract
Brain cancer is regarded among the deadliest forms of cancer worldwide. The distinct tumor microenvironment and inherent characteristics of brain tumor cells virtually render them resistant to the majority of conventional and advanced therapies. Oxidative stress (OS) is a key disruptor of normal brain homeostasis and is involved in carcinogenesis of different forms of brain cancers. Thus, antioxidants may inhibit tumorigenesis by preventing OS induced by various oncogenic factors. Antioxidants are hypothesized to inhibit cancer initiation by endorsing DNA repair and suppressing cancer progression by creating an energy crisis for preneoplastic cells, resulting in antiproliferative effects. These effects are referred to as chemopreventive effects mediated by an antioxidant mechanism. In addition, antioxidants minimize chemotherapy-induced nonspecific organ toxicity and prolong survival. Antioxidants also support the prooxidant chemistry that demonstrate chemotherapeutic potential, particularly at high or pharmacological doses and trigger OS by promoting free radical production, which is essential for activating cell death pathways. A growing body of evidence also revealed the roles of exogenous antioxidants as adjuvants and their ability to reverse chemoresistance. In this review, we explain the influences of different exogenous and endogenous antioxidants on brain cancers with reference to their chemopreventive and chemotherapeutic roles. The role of antioxidants on metabolic reprogramming and their influence on downstream signaling events induced by tumor suppressor gene mutations are critically discussed. Finally, the review hypothesized that both pro- and antioxidant roles are involved in the anticancer mechanisms of the antioxidant molecules by killing neoplastic cells and inhibiting tumor recurrence followed by conventional cancer treatments. The requirements of pro- and antioxidant effects of exogenous antioxidants in brain tumor treatment under different conditions are critically discussed along with the reasons behind the conflicting outcomes in different reports. Finally, we also mention the influencing factors that regulate the pharmacology of the exogenous antioxidants in brain cancer treatment. In conclusion, to achieve consistent clinical outcomes with antioxidant treatments in brain cancers, rigorous mechanistic studies are required with respect to the types, forms, and stages of brain tumors. The concomitant treatment regimens also need adequate consideration.
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Affiliation(s)
- Xuchen Qi
- Department of Neurosurgery, Shaoxing People's Hospital, Shaoxing, 312000, Zhejiang, China.,Department of Neurosurgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310020, Zhejiang, China
| | - Saurabh Kumar Jha
- Department of Biotechnology, School of Engineering & Technology, Sharda University, Greater Noida, Uttar Pradesh, 201310, India. .,Department of Biotechnology Engineering and Food Technology, Chandigarh University, Mohali, 140413, India. .,Department of Biotechnology, School of Applied & Life Sciences (SALS), Uttaranchal University, Dehradun, 248007, India.
| | - Niraj Kumar Jha
- Department of Biotechnology, School of Engineering & Technology, Sharda University, Greater Noida, Uttar Pradesh, 201310, India
| | - Saikat Dewanjee
- Advanced Pharmacognosy Research Laboratory, Department of Pharmaceutical Technology, Jadavpur University, Kolkata, West Bengal, 700032, India
| | - Abhijit Dey
- Department of Life Sciences, Presidency University, 86/1 College Street, Kolkata, West Bengal, 700032, India
| | - Rahul Deka
- Department of Biotechnology, School of Engineering & Technology, Sharda University, Greater Noida, Uttar Pradesh, 201310, India
| | - Pingal Pritam
- Department of Biotechnology, School of Engineering & Technology, Sharda University, Greater Noida, Uttar Pradesh, 201310, India
| | - Kritika Ramgopal
- Department of Biotechnology, School of Engineering & Technology, Sharda University, Greater Noida, Uttar Pradesh, 201310, India
| | - Weiting Liu
- School of Nursing, Anhui University of Chinese Medicine, Hefei, 230001, Anhui, China.
| | - Kaijian Hou
- School of Nursing, Anhui University of Chinese Medicine, Hefei, 230001, Anhui, China. .,School of Public Health, Shantou University, Shantou, 515000, Guangdong, China.
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Zhang W, Jiang J, He Y, Li X, Yin S, Chen F, Li W. Association between vitamins and risk of brain tumors: A systematic review and dose-response meta-analysis of observational studies. Front Nutr 2022; 9:935706. [PMID: 35967781 PMCID: PMC9372437 DOI: 10.3389/fnut.2022.935706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/11/2022] [Indexed: 11/16/2022] Open
Abstract
Background Brain tumor is one of the important causes of cancer mortality, and the prognosis is poor. Therefore, early prevention of brain tumors is the key to reducing mortality due to brain tumors. Objective This review aims to quantitatively evaluate the association between vitamins and brain tumors by meta-analysis. Methods We searched articles on PubMed, Cochrane Library, Web of Science, and Embase databases from inception to 19 December 2021. According to heterogeneity, the fixed-effects model or random-effects model was selected to obtain the relative risk of the merger. Based on the methods described by Greenland and Longnecker, we explored the dose-response relationship between vitamins and the risk of brain tumors. Subgroup analysis, sensitivity analysis, and publication bias were also used for the analysis. Results The study reviewed 23 articles, including 1,347,426 controls and 6,449 brain tumor patients. This study included vitamin intake and circulating concentration. For intake, it mainly included vitamin A, vitamin B, vitamin C, vitamin E, β-carotene, and folate. For circulating concentrations, it mainly included vitamin E and vitamin D in the serum (25-hydroxyvitamin D and α-tocopherol). For vitamin intake, compared with the lowest intakes, the highest intakes of vitamin C (RR = 0.81, 95%CI:0.66–0.99, I2 = 54.7%, Pfor heterogeneity = 0.007), β-carotene (RR = 0.78, 95%CI:0.66–0.93, I2 = 0, Pfor heterogeneity = 0.460), and folate (RR = 0.66, 95%CI:0.55–0.80, I2 = 0, Pfor heterogeneity = 0.661) significantly reduced the risk of brain tumors. For serum vitamins, compared with the lowest concentrations, the highest concentrations of serum α-tocopherol (RR = 0.61, 95%CI:0.44–0.86, I2 = 0, Pfor heterogeneity = 0.656) significantly reduced the risk of brain tumors. The results of the dose-response relationship showed that increasing the intake of 100 μg folate per day reduced the risk of brain tumors by 7% (P−nonlinearity = 0.534, RR = 0.93, 95%CI:0.90–0.96). Conclusion Our analysis suggests that the intake of vitamin C, β-carotene, and folate can reduce the risk of brain tumors, while high serum α-tocopherol concentration also has a protective effect on brain tumors. Therefore, vitamins may provide new ideas for the prevention of brain tumors. Systematic Review Registration PROSPERO, identifier CRD42022300683.
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Affiliation(s)
- Weichunbai Zhang
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jing Jiang
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yongqi He
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xinyi Li
- College of Nursing, University of South Florida, Tampa, FL, United States
| | - Shuo Yin
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Feng Chen
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wenbin Li
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Zhang W, Jiang J, He Y, Li X, Yin S, Chen F, Li W. Association Between Dietary Nitrite intake and Glioma Risk: A Systematic Review and Dose-Response Meta-Analysis of Observational Studies. Front Oncol 2022; 12:910476. [PMID: 35875114 PMCID: PMC9304866 DOI: 10.3389/fonc.2022.910476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundNitrite and nitrate intake through food and water may be an important risk factor for many cancers, including glioma. However, the association of nitrite and nitrate with glioma is unclear.ObjectiveThis review aimed to quantitatively assess the effects of nitrite and nitrate on glioma by meta-analysis.MethodsA literature search was conducted for available articles published in English using the databases of Embase, Web of Science, PubMed, Medline, and the Cochrane Library up to 24 March 2022. According to heterogeneity, the fixed-effects or random-effects model was selected to obtain the merger’s relative risk (RR). Based on the methods described by Greenland and Longnecker, we explored the dose-response relationship between nitrite/nitrate and the risk of glioma. Subgroup analysis, sensitivity analysis, and publication bias tests were also used.ResultsThis study reviewed 17 articles, including 812,107 participants and 4,574 cases. For glioma in adults, compared with the lowest intakes, the highest intakes of nitrite significantly increased the risk of glioma (RR=1.26, 95% confidence interval (95%CI):1.09-1.47). For brain tumors in children, compared with the lowest intakes, the highest intakes of nitrate significantly increased the risk of brain tumors (RR=1.27, 95%CI:1.06-1.52). The results of subgroup and sensitivity analyses remained unchanged. In the dose-response relationship, per 1 mg/day increase in nitrite intake increased the risk of glioma by 14% (RR=1.14, 95%CI:1.01-1.27).ConclusionsOur analysis suggests that nitrite increases the risk of glioma in adults, while nitrate increases the risk of brain tumors in children. Therefore, the effects of nitrite and nitrate on glioma cannot be ignored.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42022320295.
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Affiliation(s)
- Weichunbai Zhang
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jing Jiang
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yongqi He
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xinyi Li
- College of Nursing, University of South Florida, Tampa, FL, United States
| | - Shuo Yin
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Feng Chen
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wenbin Li
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- *Correspondence: Wenbin Li,
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Pellerino A, Caccese M, Padovan M, Cerretti G, Lombardi G. Epidemiology, risk factors, and prognostic factors of gliomas. Clin Transl Imaging 2022. [DOI: 10.1007/s40336-022-00489-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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10
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Zhang W, Jiang J, Li X, He Y, Chen F, Li W. Dietary Factors and Risk of Glioma in Adults: A Systematic Review and Dose-Response Meta-Analysis of Observational Studies. Front Nutr 2022; 9:834258. [PMID: 35237646 PMCID: PMC8883057 DOI: 10.3389/fnut.2022.834258] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/13/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundGliomas are the most common primary intracranial tumors in adults. Inappropriate dietary habits are thought to be a risk factor for most human cancer, and glioma is no exception. However, the effect of dietary factors on glioma is not clear.ObjectiveThis review aims to quantitatively evaluate the association between various dietary intakes and glioma using a meta-analysis.MethodsWe searched articles on PubMed, the Cochrane Library, the Web of Science, and EMBASE from their inception until October 11, 2021. According to heterogeneity, the fixed-effects or random-effects model was selected to obtain the relative risk (RR) of merger. Based on the methods described by Greenland and Longnecker, we explored the dose-response relationship between dietary intakes and the risk of glioma. Subgroup analysis, sensitivity analysis, and publication bias were also used.ResultsThis study reviewed 33 articles, including 3,606,015 controls and 8,831 patients with glioma. This study included 12 food groups. Compared with the lowest intakes, the highest intakes of tea (RR = 0.82, 95%CI:0.71–0.93), total vegetables (RR = 0.84, 95%CI: 0.70–1.00), green vegetables (RR = 0.80, 95%CI: 0.66–0.98), and orange vegetables (RR = 0.79, 95%CI: 0.66–0.96) significantly reduced the risk of glioma, while the highest intakes of grains (RR = 1.39, 95%CI: 1.16–1.66), processed meats (RR = 1.19, 95%CI: 1.00–1.42), and processed fish (RR = 1.37, 95%CI: 1.03–1.84) significantly increased the risk of glioma. The results of subgroup and sensitivity analyses remained unchanged. In the dose-response relationship, only tea was statistically significant. Taking an extra cup of tea every day reduced the risk of glioma by 4%.ConclusionsOur analysis suggests that the intakes of tea, total vegetables, green vegetables, and orange vegetables may reduce the risk of glioma, while the intakes of grains, processed meats, and processed fish may increase the risk of glioma. Therefore, the effect of dietary factors on glioma should not be ignored.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, CRD42022296658.
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Affiliation(s)
- Weichunbai Zhang
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jing Jiang
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xinyi Li
- College of Nursing, University of South Florida, Tampa, FL, United States
| | - Yongqi He
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Feng Chen
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wenbin Li
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- *Correspondence: Wenbin Li
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Francis SS, Ostrom QT, Cote DJ, Smith TR, Claus E, Barnholtz-Sloan JS. The Epidemiology of Central Nervous System Tumors. Hematol Oncol Clin North Am 2022; 36:23-42. [PMID: 34801162 DOI: 10.1016/j.hoc.2021.08.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This article reviews the current epidemiology of central nervous system tumors. Population-level basic epidemiology, nationally and internationally, and current understanding of germline genetic risk are discussed, with a focus on known and well-studied risk factors related to the etiology of central nervous system tumors.
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Affiliation(s)
- Stephen S Francis
- Department of Neurological Surgery, Division of Neuro and Molecular Epidemiology, University of California San Francisco School of Medicine, 1450 3rd Street, HD442, San Francisco, CA 94158, USA.
| | - Quinn T Ostrom
- Department of Neurosurgery, Duke University School of Medicine, 571 Research Drive, MSRB-1, Rm 442, Durham, NC 27710, USA
| | - David J Cote
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, 1200 N State Street, Suite 3300, Los Angeles, CA 90033, USA
| | - Timothy R Smith
- Department of Neurosurgery, Computational Neuroscience Outcomes Center, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Avenue, Boston, MA 02115, USA
| | - Elizabeth Claus
- Department of Neurosurgery, Yale University, Yale School of Public Health, Brigham and Women's Hospital, 60 College Street, New Haven, CT 06510, USA
| | - Jill S Barnholtz-Sloan
- Center for Biomedical Informatics and Information Technology, Trans-Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), NCI Shady Grove, 9609 Medical Center Dr, Rockville, MD 20850, USA
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12
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Exploring the Pivotal Neurophysiologic and Therapeutic Potentials of Vitamin C in Glioma. JOURNAL OF ONCOLOGY 2021. [PMID: 33598702 PMCID: PMC8691980 DOI: 10.1155/2021/6141591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Gliomas represent solely primary brain cancers of glial cell or neuroepithelial origin. Gliomas are still the most lethal human cancers despite modern innovations in both diagnostic techniques as well as therapeutic regimes. Gliomas have the lowest overall survival rate compared to other cancers 5 years after definitive diagnosis. The dietary intake of vitamin C has protective effect on glioma risk. Vitamin C is an essential compound that plays a vital role in the regulation of lysyl and prolyl hydroxylase activity. Neurons store high levels of vitamin C via sodium dependent-vitamin C transporters (SVCTs) to protect them from oxidative ischemia-reperfusion injury. Vitamin C is a water-soluble enzyme, typically seen as a powerful antioxidant in plants as well as animals. The key function of vitamin C is the inhibition of redox imbalance from reactive oxygen species produced via the stimulation of glutamate receptors. Gliomas absorb vitamin C primarily via its oxidized dehydroascorbate form by means of GLUT 1, 3, and 4 and its reduced form, ascorbate, by SVCT2. Vitamin C is able to preserve prosthetic metal ions like Fe2+ and Cu+ in their reduced forms in several enzymatic reactions as well as scavenge free radicals in order to safeguard tissues from oxidative damage. Therapeutic concentrations of vitamin C are able to trigger H2O2 generation in glioma. High-dose combination of vitamin C and radiation has a much more profound cytotoxic effect on primary glioblastoma multiforme cells compared to normal astrocytes. Control trials are needed to validate the use of vitamin C and standardization of the doses of vitamin C in the treatment of patients with glioma.
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Cote DJ, Samanic CM, Smith TR, Wang M, Smith-Warner SA, Stampfer MJ, Egan KM. Alcohol intake and risk of glioma: results from three prospective cohort studies. Eur J Epidemiol 2021; 36:965-974. [PMID: 34482513 DOI: 10.1007/s10654-021-00800-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/20/2021] [Indexed: 12/31/2022]
Abstract
PURPOSE The association between alcohol intake and glioma remains unclear. We evaluated the association between alcohol intake and incidence of glioma in three large, prospective cohort studies with repeated alcohol assessments. METHODS We harnessed data from three studies with repeat alcohol assessment to compute hazard ratios (HR) and 95% confidence intervals (CI) for glioma by overall alcohol intake and intake from specific beverages using Cox proportional hazards regression, adjusted for age, cohort, body mass index, smoking status, and caloric intake. Analyses were conducted separately for glioma overall and for glioblastoma (GBM). RESULTS We confirmed 554 incident glioma cases (362 GBM) among 237,505 participants with 6,216,378 person-years of follow up. Cumulative average alcohol intake was associated with reduced risk of glioma (HR = 0.75, 95%CI:0.56-0.99 comparing > 8-15 to ≤ 0.5 g/d; HR = 0.71, 95%CI:0.53-0.96 comparing > 15 g/d to ≤ 0.5 g/d). When stratified by sex, for the same comparisons, the HRs for men were 0.57 (95%CI:0.36-0.89) and 0.79 (0.53-1.16), and for women 0.90 (95%CI:0.62-1.30) and 0.62, 95%CI:0.39-0.97. Results were consistent when examining cumulative average, baseline, and recent intake, and with a 4 year lag. CONCLUSION These results provide evidence against a positive association between alcohol intake and glioma risk. Alcohol intake was associated with reduced risk of glioma in both men and women.
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Affiliation(s)
- David J Cote
- Channing Division of Network Medicine, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, 02115, USA. .,Department of Neurosurgery, Computational Neuroscience Outcomes Center, Brigham and Women's Hospital, Boston, MA, USA.
| | - Claudine M Samanic
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Timothy R Smith
- Department of Neurosurgery, Computational Neuroscience Outcomes Center, Brigham and Women's Hospital, Boston, MA, USA
| | - Molin Wang
- Channing Division of Network Medicine, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, 02115, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Stephanie A Smith-Warner
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Meir J Stampfer
- Channing Division of Network Medicine, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, 02115, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Kathleen M Egan
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
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Mustapha S, Jimoh T, Ndamitso M, Abdulkareem SA, Taye SD, Mohammed AK, Amigun AT. The Occurrence of N-nitrosodimethylamine (NDMA) in Swimming Pools: An Overview. ENVIRONMENTAL HEALTH INSIGHTS 2021; 15:11786302211036520. [PMID: 34376989 PMCID: PMC8335839 DOI: 10.1177/11786302211036520] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 07/12/2021] [Indexed: 05/23/2023]
Abstract
The occurrence of several disinfectant byproducts has been investigated in swimming pools. Until now, there are only a few studies on nitrosamine, particularly N-nitrosodimethylamine in swimming pool water. This could be due to the lack of a suitable method that is sensitive enough for the measurement of N-nitrosodimethylamine in pool waters. Other disinfectant byproducts formed in pool water widely documented are trihalomethanes, haloacetic acids, halonitromethanes, and chloramines but inadequate information on N-nitrosodimethylamine. This paper provides a review of the nitrogenous disinfectant byproduct in swimming pools and its health implications. Anthropogenic substances introduced by swimmers such as sweat, lotions, and urine contribute to the formation of N-nitrosodimethylamine. The reaction of secondary amines such as dimethylamine with mono/dichloroamines produced dimethyl hydrazine and further undergo oxidation to form N-nitrosodimethylamine. The reaction of chlorine and other disinfectants with these anthropogenic sources in swimming pools cause cancer and asthma in human tissues. Thus, the assessment of N-nitrosodimethylamine in the swimming pool is less well documented. Therefore, the health consequences, mutagenic, and genotoxic potentials of N-nitrosodimethylamine should be the focus of more research studies.
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Affiliation(s)
- Saheed Mustapha
- Department of Chemistry, Federal University of Technology, Minna, Nigeria
- Nanotechnology Research Group, Center for Genetic Engineering and Biotechnology, Federal University of Technology, Minna, Niger, Nigeria
| | - Tijani Jimoh
- Department of Chemistry, Federal University of Technology, Minna, Nigeria
- Nanotechnology Research Group, Center for Genetic Engineering and Biotechnology, Federal University of Technology, Minna, Niger, Nigeria
| | - Muhammed Ndamitso
- Department of Chemistry, Federal University of Technology, Minna, Nigeria
- Nanotechnology Research Group, Center for Genetic Engineering and Biotechnology, Federal University of Technology, Minna, Niger, Nigeria
| | - Saka Ambali Abdulkareem
- Nanotechnology Research Group, Center for Genetic Engineering and Biotechnology, Federal University of Technology, Minna, Niger, Nigeria
- Department of Chemical Engineering, Federal University of Technology, Minna, Niger, Nigeria
| | - Shuaib Damola Taye
- Department of Chemistry, Illinois Institute of Technology, Chicago, IL, USA
| | - Abdul Kabir Mohammed
- Department of Chemistry and Biochemistry, North Carolina Central University, Durham, NC, USA
| | - Azeezah Taiwo Amigun
- Department of Chemical and Geological Sciences, Al-Hikmah University, Ilorin, Nigeria
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Naghshi S, Sadeghian M, Nasiri M, Mobarak S, Asadi M, Sadeghi O. Association of Total Nut, Tree Nut, Peanut, and Peanut Butter Consumption with Cancer Incidence and Mortality: A Comprehensive Systematic Review and Dose-Response Meta-Analysis of Observational Studies. Adv Nutr 2020; 12:793-808. [PMID: 33307550 PMCID: PMC8166551 DOI: 10.1093/advances/nmaa152] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 08/19/2020] [Accepted: 10/27/2020] [Indexed: 12/18/2022] Open
Abstract
Data on the association of nut intake with risk of cancer and its mortality are conflicting. Although previous meta-analyses summarized available findings in this regard, some limitations may distort their findings. Moreover, none of these meta-analyses examined the dose-response associations of total nut intake with the risk of specific cancers as well as associations between specific types of nuts and cancer mortality. Therefore, this study aimed to summarize available findings on the associations of total nut (tree nuts and peanuts), tree nut (walnuts, pistachios, macadamia nuts, pecans, cashews, almonds, hazelnuts, and Brazil nuts), peanut (whole peanuts without considering peanut butter), and peanut butter consumption with risk of cancer and its mortality by considering the above-mentioned points. We searched the online databases until March 2020 to identify eligible articles. In total, 43 articles on cancer risk and 9 articles on cancer mortality were included in the current systematic review and meta-analysis. The summary effect size (ES) for risk of cancer, comparing the highest with lowest intakes of total nuts, was 0.86 (95% CI: 0.81, 0.92, P < 0.001, I2 = 58.1%; P < 0.01), indicating a significant inverse association. Such a significant inverse association was also seen for tree nut intake (pooled ES: 0.87, 95% CI: 0.78-0.96, P < 0.01, I2 = 15.8%; P = 0.28). Based on the dose-response analysis, a 5-g/d increase in total nut intake was associated with 3%, 6%, and 25% lower risks of overall, pancreatic, and colon cancers, respectively. In terms of cancer mortality, we found 13%, 18%, and 8% risk reductions with higher intakes of total nuts, tree nuts, and peanuts, respectively. In addition, a 5-g/d increase in total nut intake was associated with a 4% lower risk of cancer mortality. In conclusion, our findings support the protective association between total nut and tree nut intake and the risk of cancer and its mortality.
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Affiliation(s)
- Sina Naghshi
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran,Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Sadeghian
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Morteza Nasiri
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran,Department of Operating Room Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sara Mobarak
- Department of Infectious and Tropical Diseases, Abadan Faculty of Medical Sciences, Abadan, Iran
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Whole Grains, Refined Grains, and Cancer Risk: A Systematic Review of Meta-Analyses of Observational Studies. Nutrients 2020; 12:nu12123756. [PMID: 33297391 PMCID: PMC7762239 DOI: 10.3390/nu12123756] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 12/21/2022] Open
Abstract
PubMed, Web of Science, and the Cochrane Database of Systematic Reviews were searched for meta-analyses that provided risk estimates (±95% confidence intervals) for associations between intakes of whole and refined grains and risk of total and site-specific cancer. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed. Only meta-analyses that included whole grains and refined grains as separate food groups, and not as part of dietary patterns, were included. A total of 17 publications were identified that met inclusion criteria. Within these, results from a total of 54 distinct meta-analyses were reported for whole grains and 5 meta-analyses for refined grains. For total cancer mortality, 7 meta-analyses of cohort studies indicated that whole grain intake was associated with 6% to 12% lower risk in comparison of highest vs. lowest intake groups, and 3% to 20% lower risk for doses ranging from 15 to 90 g/day. For site-specific cancers, meta-analyses indicated that whole grain intake was consistently associated with lower risks of colorectal, colon, gastric, pancreatic, and esophageal cancers. Limited data were available for refined grains, with only 4 publications providing risk estimates, and only 1 of the meta-analyses included more than 3 studies. High intake of refined grains was associated with increased risk of colon and gastric cancer. By contrast, in the only dose-response meta-analysis, each 90 g/day consumption of refined grains was associated with a 6% lower risk of total cancer. In addition to the limited number of published meta-analyses on refined grains, results were also weakened due to the fact that refined grains were frequently defined to include both staple grain foods and indulgent grain foods, and the majority of studies included in the meta-analyses provided no specific definition of refined grains. Overall, meta-analyses of cohort and case-control studies consistently demonstrate that whole grain intake is associated with lower risk of total and site-specific cancer, and support current dietary recommendations to increase whole grain consumption. By contrast, the relationship between refined grain intake and cancer risk is inconclusive.
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Lei H, To C, Lei U. Association between fish intake and glioma risk: a systematic review and meta-analysis. J Int Med Res 2020; 48:300060520939695. [PMID: 32840400 PMCID: PMC7450294 DOI: 10.1177/0300060520939695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Objectives We investigated the association between the consumption of fresh and
processed fish and glioma risk using a meta-analysis approach. Methods We selected and analyzed observational studies that discussed the
relationships between fresh and processed fish intake on glioma risk from
PubMed, Web of Science, Embase, and the SinoMed and Wanfang databases from
inception to 31 March 2020. Studies were selected according to
pre-established eligibility criteria and data were extracted separately by
two researchers. A meta-analysis was conducted based on a random-effects
model to provide pooled odds ratios (OR) and 95% confidence intervals
(CIs). Results Eight studies considered the relationship between fish intake (seven fresh
and seven processed fish) and glioma risk and were included in this
meta-analysis. The OR effect size for fresh fish intake and glioma risk was
0.72 (95%CI 0.53–0.97) and the overall OR effect size for processed fish
intake and glioma risk was 1.88 (95%CI 1.06–3.34). Conclusion Dietary intake of fresh fish may reduce the risk of glioma, but consumption
of processed fish may increase the risk of glioma. This study had some
limitations, and further studies are therefore required to clarify the
associations between fish intake and glioma risk.
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Affiliation(s)
- Honcho Lei
- Department of Oncology, Centro Hospitalar Conde de São Januário, Macau, China
| | - Chiho To
- Department of General Practice, University Hospital, Macau, China
| | - Unpeng Lei
- Department of General Practice, Centro Hospitalar Conde de São Januário, Macau, China
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Malmir H, Shayanfar M, Mohammad-Shirazi M, Sharifi G, Esmaillzadeh A. Legume and Nuts Consumption in Relation to Glioma: A Case- Control Study. Nutr Cancer 2020; 73:760-766. [PMID: 32406278 DOI: 10.1080/01635581.2020.1766091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Data on the link between legume and nuts consumption and risk of glioma are controversial. The current study aimed to investigate the relation between legume and nuts consumption and glioma in a case-control study in Iranian adults. In this hospital-based case-control study, we enrolled 128 pathologically confirmed new cases of glioma and 256 age and sex-matched controls. Dietary intakes of study participants were assessed using the validated Block-format 123-item semi-quantitative FFQ. Data on potential confounders were also collected through the use of a pre-tested questionnaire. Mean age of cases and controls were 43.4 and 42.8 years, respectively. Individuals with the greatest legume and nuts consumption were less likely to have glioma compared with those with the lowest consumption (0.52; 95% CI: 0.30-0.88). This inverse association was not changed after controlling for age, sex and energy intake (0.46; 95% CI: 0.26-0.81). The association remained statistically significant even after taking other potential confounders, including dietary intakes into account (0.32; 95% CI: 0.14-0.72). Additional adjustments for BMI did not alter the association; such that individuals in the top category of legume and nuts consumption were 66% less likely to have glioma compared with those in the bottom category (0.34; 95% CI: 0.15-0.76). We found an inverse association between legume and nuts consumption and odds of glioma, even after controlling for a wide range of confounders.
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Affiliation(s)
- Hanieh Malmir
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Shayanfar
- Department of Clinical Nutrition and Dietetics, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Minoo Mohammad-Shirazi
- Department of Clinical Nutrition and Dietetics, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Giuve Sharifi
- Department of Neurosurgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.,Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Food Security Research Center, Department of Community Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran
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19
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Creed JH, Smith-Warner SA, Gerke TA, Egan KM. A prospective study of coffee and tea consumption and the risk of glioma in the UK Biobank. Eur J Cancer 2020; 129:123-131. [PMID: 32151942 DOI: 10.1016/j.ejca.2020.01.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/11/2019] [Accepted: 01/29/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Coffee and tea have been hypothesised to reduce the risk of some cancers; however, their impact on glioma is less well studied. METHODS We examined associations between self-reported intake of tea and coffee in relation to glioma risk in the UK Biobank. We identified 487 incident glioma cases among 379,259 participants. Hazard ratios (HR) and 95% confidence intervals (CI) for glioma according to caffeinated beverage consumption were calculated using Cox proportional hazards regression with adjustment for age, gender, race and education; daily cups of tea or coffee were included in models considering the other beverage. RESULTS Consuming 4 or more cups of tea was associated with reduced risk of glioma when compared to no tea consumption (HR = 0.69; 95% CI, 0.51-0.94). A significant inverse association was observed for glioblastoma (HR = 0.93 per 1 cup/d increment; 95% CI, 0.89-0.98) and among males for all gliomas combined (HR = 0.95 per 1 cup/d increment; 95% CI, 0.90-1.00). A suggestive inverse association was also observed with greater consumption of coffee (HR = 0.71; 95% CI, 0.49-1.05 for >4 versus 0 cups/d). Results were not materially changed with further adjustment for smoking, alcohol and body mass index. Associations were similar in 2-year and 3-year lagged analyses. CONCLUSIONS In this prospective study, we found a significant inverse association between tea consumption and the risk of developing glioma, and a suggestive inverse association for the consumption of coffee. Further investigation on the possible preventive role of caffeine in glioma is warranted.
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Affiliation(s)
- Jordan H Creed
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa FL 33612, USA
| | - Stephanie A Smith-Warner
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Travis A Gerke
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa FL 33612, USA
| | - Kathleen M Egan
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa FL 33612, USA.
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Long J, Ji Z, Yuan P, Long T, Liu K, Li J, Cheng L. Nut Consumption and Risk of Cancer: A Meta-analysis of Prospective Studies. Cancer Epidemiol Biomarkers Prev 2020; 29:565-573. [PMID: 32041895 DOI: 10.1158/1055-9965.epi-19-1167] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 11/04/2019] [Accepted: 12/09/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Epidemiologic studies have investigated the association between nut intake and risk for multiple cancers. However, current findings are inconsistent and no definite conclusion has been drawn from prospective studies. We therefore conducted this meta-analysis to evaluate the relationship between nut consumption and risk of cancer. METHODS Prospective studies reporting associations between nut intake and risk for all types of cancer were identified by searching Web of Science and PubMed databases up to June 2019. Risk ratios (RR) and 95% confidence intervals (CI) were extracted and then pooled across the studies using a random-effect model. A dose-response analysis was modeled by performing restricted cubic splines when data were available. RESULTS Thirty-three studies that included more than 50,000 cancer cases were eligible for the analysis. When comparing the highest with the lowest category of nut intake, high consumption of nuts was significantly associated with decreased risk of overall cancer (RR = 0.90; 95% CI, 0.85-0.95). The protective effect of nut consumption was especially apparent against cancers from the digestive system (RR = 0.83; 95% CI, 0.77-0.89). Among different nut classes, significant association was only obtained for intake of tree nuts. We also observed a linear dose-response relationship between nut consumption and cancer: Per 20 g/day increase in nut consumption was related to a 10% (RR = 0.90; 95% CI, 0.82-0.99) decrease in cancer risk. CONCLUSIONS Our analysis demonstrated an inverse association of dietary nut consumption with cancer risk, especially for cancers from the digestive system. IMPACT This study highlights the protective effect of nuts against cancer.
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Affiliation(s)
- Jieyi Long
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhi Ji
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Peihong Yuan
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tingting Long
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ke Liu
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiaoyuan Li
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Liming Cheng
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Kuan AS, Green J, Kitahara CM, De González AB, Key T, K. Reeves G, Floud S, Balkwill A, Bradbury K, Liao LM, Freedman ND, Beral V, Sweetland S. Diet and risk of glioma: combined analysis of 3 large prospective studies in the UK and USA. Neuro Oncol 2019; 21:944-952. [PMID: 30690490 PMCID: PMC6620629 DOI: 10.1093/neuonc/noz013] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Available evidence on diet and glioma risk comes mainly from studies with retrospective collection of dietary data. To minimize possible differential dietary recall between those with and without glioma, we present findings from 3 large prospective studies. METHODS Participants included 692 176 from the UK Million Women Study, 470 780 from the US National Institutes of Health-AARP study, and 99 148 from the US Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Cox regression yielded study-specific adjusted relative risks for glioma in relation to 15 food groups, 14 nutrients, and 3 dietary patterns, which were combined, weighted by inverse variances of the relative risks. Separate analyses by <5 and ≥5 years follow-up assessed potential biases related to changes of diet before glioma diagnosis. RESULTS The 1 262 104 participants (mean age, 60.6 y [SD 5.5] at baseline) were followed for 15.4 million person-years (mean 12.2 y/participant), during which 2313 incident gliomas occurred, at mean age 68.2 (SD 6.4). Overall, there was weak evidence for increased glioma risks associated with increasing intakes of total fruit, citrus fruit, and fiber and healthy dietary patterns, but these associations were generally null after excluding the first 5 years of follow-up. There was little evidence for heterogeneity of results by study or by sex. CONCLUSIONS The largest prospective evidence to date suggests little, if any, association between major food groups, nutrients, or common healthy dietary patterns and glioma incidence. With the statistical power of this study and the comprehensive nature of the investigation here, it seems unlikely we have overlooked major effects of diet on risk of glioma that would be of public health concern.
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Affiliation(s)
- Ai Seon Kuan
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jane Green
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Cari M Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Amy Berrington De González
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Tim Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Gillian K. Reeves
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Sarah Floud
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Angela Balkwill
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Kathryn Bradbury
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Linda M Liao
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Neal D Freedman
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Valerie Beral
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Siân Sweetland
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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23
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Howell AE, Zheng J, Haycock PC, McAleenan A, Relton C, Martin RM, Kurian KM. Use of Mendelian Randomization for Identifying Risk Factors for Brain Tumors. Front Genet 2018; 9:525. [PMID: 30483309 PMCID: PMC6240585 DOI: 10.3389/fgene.2018.00525] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 10/19/2018] [Indexed: 02/06/2023] Open
Abstract
Gliomas are a group of primary brain tumors, the most common and aggressive subtype of which is glioblastoma. Glioblastoma has a median survival of just 15 months after diagnosis. Only previous exposure to ionizing radiation and particular inherited genetic syndromes are accepted risk factors for glioma; the vast majority of cases are thought to occur spontaneously. Previous observational studies have described associations between several risk factors and glioma, but studies are often conflicting and whether these associations reflect true casual relationships is unclear because observational studies may be susceptible to confounding, measurement error and reverse causation. Mendelian randomization (MR) is a form of instrumental variable analysis that can be used to provide supporting evidence for causal relationships between exposures (e.g., risk factors) and outcomes (e.g., disease onset). MR utilizes genetic variants, such as single nucleotide polymorphisms (SNPs), that are robustly associated with an exposure to determine whether there is a causal effect of the exposure on the outcome. MR is less susceptible to confounding, reverse causation and measurement errors as it is based on the random inheritance during conception of genetic variants that can be relatively accurately measured. In previous studies, MR has implicated a genetically predicted increase in telomere length with an increased risk of glioma, and found little evidence that obesity related factors, vitamin D or atopy are causal in glioma risk. In this review, we describe MR and its potential use to discover and validate novel risk factors, mechanistic factors, and therapeutic targets in glioma.
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Affiliation(s)
- Amy Elizabeth Howell
- Brain Tumour Research Centre, Institute of Clinical Neurosciences, University of Bristol, Bristol, United Kingdom
| | - Jie Zheng
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Philip C. Haycock
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Alexandra McAleenan
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Caroline Relton
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Richard M. Martin
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Kathreena M. Kurian
- Brain Tumour Research Centre, Institute of Clinical Neurosciences, University of Bristol, Bristol, United Kingdom
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Le CT, Leenders WPJ, Molenaar RJ, van Noorden CJF. Effects of the Green Tea Polyphenol Epigallocatechin-3-Gallate on Glioma: A Critical Evaluation of the Literature. Nutr Cancer 2018; 70:317-333. [PMID: 29570984 DOI: 10.1080/01635581.2018.1446090] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The review discusses the effects of Epigallocatechin-3-gallate Gallate (EGCG) on glioma as a basis for future research on clinical application of EGCG. Epidemiological studies on the effects of green tea or EGCG on the risk of glioma is inconclusive due to the limited number of studies, the inclusion of all tea types in these studies, and the focus on caffeine rather than EGCG. In vivo experiments using EGCG monotherapy are inconclusive. Nevertheless, EGCG induces cell death, prevents cellular proliferation, and limits invasion in multiple glioma cell lines. Furthermore, EGCG enhances the efficacy of anti-glioma therapies, including irradiation, temozolomide, carmustine, cisplatin, tamoxifen, and TNF-related apoptosis-inducing ligand, but reduces the effect of bortezomib. Pro-drugs, co-treatment, and encapsulation are being investigated to enhance clinical applicability of EGCG. Mechanisms of actions of EGCG have been partly elucidated. EGCG has both anti-oxidant and oxidant properties. EGCG inhibits pro-survival proteins, such as telomerase, survivin, GRP78, PEA15, and P-gp. EGCG inhibits signaling of PDGFR, IGF-1R, and 67LR. EGCG reduces invasiveness of cancer cells by inhibiting the activities of various metalloproteinases, cytokines, and chemokines. Last, EGCG inhibits some NADPH-producing enzymes, thus disturbing redox status and metabolism of glioma cells. In conclusion, EGCG may be a suitable adjuvant to potentiate anti-glioma therapies.
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Affiliation(s)
- Chung T Le
- a Department of Medical Biology , Academic Medical Center, University of Amsterdam, Amsterdam , The Netherlands
| | | | - Remco J Molenaar
- a Department of Medical Biology , Academic Medical Center, University of Amsterdam, Amsterdam , The Netherlands
| | - Cornelis J F van Noorden
- a Department of Medical Biology , Academic Medical Center, University of Amsterdam, Amsterdam , The Netherlands
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25
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Xie L, Mo M, Jia HX, Liang F, Yuan J, Zhu J. Association between dietary nitrate and nitrite intake and sitespecific cancer risk: evidence from observational studies. Oncotarget 2018; 7:56915-56932. [PMID: 27486968 PMCID: PMC5302962 DOI: 10.18632/oncotarget.10917] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 07/18/2016] [Indexed: 01/12/2023] Open
Abstract
Epidemiological studies have reported inconsistent findings on the association between dietary nitrate and nitrite intake and cancer risk. We performed a meta-analysis of epidemiological studies to summarize available evidence on the association between dietary nitrate and nitrite intake and cancer risk from published prospective and case-control studies. PubMed database was searched to identify eligible publications through April 30th, 2016. Study-specific relative risks (RRs) with corresponding 95% confidence interval (CI) from individual studies were pooled by using random- or fixed- model, and heterogeneity and publication bias analyses were conducted. Data from 62 observational studies, 49 studies for nitrates and 51 studies for nitrites, including a total of 60,627 cancer cases were analyzed. Comparing the highest vs. lowest levels, dietary nitrate intake was inversely associated with gastric cancer risk (RR = 0.78; 95%CI = 0.67-0.91) with moderate heterogeneity (I2 = 42.3%). In contrast, dietary nitrite intake was positively associated with adult glioma and thyroid cancer risk with pooled RR of 1.21 (95%CI = 1.03-1.42) and 1.52 (95%CI = 1.12-2.05), respectively. No significant associations were found between dietary nitrate/nitrite and cancers of the breast, bladder, colorectal, esophagus, renal cell, non-Hodgkin lymphoma, ovarian, and pancreas. The present meta-analysis provided modest evidence that positive associations of dietary nitrate and negative associations of dietary nitrite with certain cancers.
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Affiliation(s)
- Li Xie
- Clinical Statistics Center, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Miao Mo
- Clinical Statistics Center, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Hui-Xun Jia
- Clinical Statistics Center, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Fei Liang
- Clinical Statistics Center, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jing Yuan
- Clinical Statistics Center, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ji Zhu
- Clinical Statistics Center, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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26
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Lian W, Wang R, Xing B, Yao Y. Fish intake and the risk of brain tumor: a meta-analysis with systematic review. Nutr J 2017; 16:1. [PMID: 28077138 PMCID: PMC5225583 DOI: 10.1186/s12937-016-0223-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 12/08/2016] [Indexed: 01/18/2023] Open
Abstract
Background Fish, rich in ω-3 polyunsaturated fatty acids, has been found to be associated with lower risk of several types of cancer risk, and beneficial for brain development. However, the association between fish intake and brain tumor risk is still inconsistent. Therefore, we conducted a meta-analysis to clarify the association. Methods Relevant studies were identified from PubMed and EMBASE databases. The pooled relative risks were obtained by the fixed-effects model when no substantial heterogeneity was observed. Otherwise, the random-effects model was employed. Subgroup and publication bias analyses were also performed. Results Nine observational studies were included in the meta-analysis. The pooled relative risk of brain cancer for the highest vs. lowest category of fish intake was 0.83 (95% confidence interval [CI]: 0.70–0.99). No significant heterogeneity was detected. Dose-response analysis showed that the RR per 100 g/day increase in fish intake was 0.95 (95% CI: 0.91–0.98). The results remained unchanged in subgroup and sensitivity analyses. Conclusions The results of our meta-analysis suggest that fish intake might be associated with lower risk of brain cancer risk. The finding should be further confirmed by future cohort studies with validated questionnaires and strict control of confounders. Electronic supplementary material The online version of this article (doi:10.1186/s12937-016-0223-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Wei Lian
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science& Peking Union Medical College, Beijing, 100730, People's Republic of China.
| | - Renzhi Wang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science& Peking Union Medical College, Beijing, 100730, People's Republic of China
| | - Bing Xing
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science& Peking Union Medical College, Beijing, 100730, People's Republic of China
| | - Yong Yao
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science& Peking Union Medical College, Beijing, 100730, People's Republic of China
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Li HX, Peng XX, Zong Q, Zhang K, Wang MX, Liu YZ, Han GL. Cigarette smoking and risk of adult glioma: a meta-analysis of 24 observational studies involving more than 2.3 million individuals. Onco Targets Ther 2016; 9:3511-23. [PMID: 27366088 PMCID: PMC4913539 DOI: 10.2147/ott.s99713] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background Cigarette smoking has been shown to be a risk factor for adult glioma by some but not all studies. We conducted a meta-analysis to systematically assess the potential association. Methods PubMed and EMBASE were searched from the date of their inception to October 1, 2015, to identify relevant articles. Reference lists from these articles were reviewed to identify additional studies. Both cohort and case–control studies were included. Fixed-effects models were used to calculate the overall relative risk (RR) with corresponding 95% confidence intervals (CIs). Results The final analysis included 24 studies (seven cohort and 17 case–control studies), involving more than 2.3 million individuals. The combined RR was 1.04 (95% CI: 1.00, 1.09; P=0.073) for ever-smokers, 0.97 (95% CI: 0.88, 1.07; P=0.574) for current-smokers, and 1.07 (95% CI: 0.98, 1.16; P=0.130) for past smokers, with little evidence of heterogeneity. Omission of any single study from the analysis had little effect on the result. No evidence of publication bias was found. A small but statistically significant increase was found in past smokers in females (RR: 1.13, 95% CI: 1.00, 1.28; P=0.046) but not in males. Conclusion In general, there was no association between cigarette smoking and adult glioma. The small but statistically significant association in females requires further investigation.
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Affiliation(s)
- Hong-Xing Li
- Department of Neurosurgery, Shengli Oilfield Central Hospital, Dongying, Shandong, People's Republic of China
| | - Xiao-Xiao Peng
- Department of Neurosurgery, Shengli Oilfield Central Hospital, Dongying, Shandong, People's Republic of China; Department of Intensive Care Unit, Dongying, Shandong, People's Republic of China
| | - Qiang Zong
- Department of Neurosurgery, Shengli Oilfield Central Hospital, Dongying, Shandong, People's Republic of China
| | - Kai Zhang
- Department of Neurosurgery, Shengli Oilfield Central Hospital, Dongying, Shandong, People's Republic of China
| | - Ming-Xin Wang
- Department of Neurosurgery, Shengli Oilfield Central Hospital, Dongying, Shandong, People's Republic of China
| | - Yi-Zhe Liu
- Department of Neurosurgery, Shengli Oilfield Central Hospital, Dongying, Shandong, People's Republic of China
| | - Guang-Liang Han
- Department of Neurosurgery, Shengli Oilfield Central Hospital, Dongying, Shandong, People's Republic of China
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Apple intake and cancer risk: a systematic review and meta-analysis of observational studies. Public Health Nutr 2016; 19:2603-17. [PMID: 27000627 DOI: 10.1017/s136898001600032x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Conflicting results on the association between fruit consumption and cancer risk have been reported. Little is known about the cancer preventive effects of different fruit types. The present meta-analysis investigates whether an association exists between apple intake and cancer risk. DESIGN Relevant observational studies were identified by literature search (PubMed, Web of Science and Embase). A random-effect model was used to estimate the cancer risk in different anatomical sites. Between-study heterogeneity and publication bias were assessed using adequate statistical tests. RESULTS Twenty case-control (three on lung, five on colorectal, five on breast, two on oesophageal, three on oral cavity, two on prostate and one each on pancreas, bladder, larynx, ovary, kidney and brain cancer) and twenty-one cohort (seven on lung, two on colorectal, three on breast and one each on oesophageal, pancreas, bladder, kidney, endometrial, head-neck, urothelial and stomach cancer) studies met the inclusion criteria. Comparing the highest v. lowest level of apple consumption, the reduction of lung cancer risk was statistically highly significant in both case-control (OR=0·75; 95% CI 0·63, 0·88; P=0·001, I 2=0 %) and cohort studies (relative risk=0·89; 95% CI 0·84, 0·94; P<0·001, I 2=53 %). Instead, in the case of colorectal (OR=0·66; 95% CI 0·54, 0·81; P<0·001, I 2=55%), breast (OR=0·79; 95% CI 0·73, 0·87; P<0·001, I 2=1 %) and overall digestive tract (OR=0·50; 95% CI 0·36, 0·69; P<0·001, I 2=90 %) cancers a significant preventive effect of apples was found only in case-control studies while prospective studies indicated no effect. No evidence of publication bias could be detected for colorectal, oral cavity, oesophageal and breast cancer. However, some confounding effects may be present and related to the consumption of other fruit which have not been considered as adjusting factors. CONCLUSIONS The present meta-analysis indicates that consumption of apples is associated with a reduced risk of cancer in different anatomical sites.
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Adherence to the Dietary Approaches to Stop Hypertension-style diet in relation to glioma: a case–control study. Br J Nutr 2016; 115:1108-16. [DOI: 10.1017/s0007114515005504] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AbstractData on the association of adherence to the Dietary Approaches to Stop Hypertension (DASH)-style and glioma are scarce. We aimed to examine the association between adherence to the DASH-style diet and glioma in Iranian adults. In this study, 128 pathologically confirmed cases of glioma were recruited from hospitals and 256 age- and sex-matched controls were enrolled from other wards of the hospital. Dietary intakes were assessed using a 126-item validated FFQ. Adherence to the DASH-style diet was followed considering the healthy and non-healthy foods emphasised in the DASH dietary pattern. After controlling for potential confounders, individuals with the greatest adherence to the DASH diet were 72 % less likely to have glioma compared with those with the lowest adherence (OR 0·28; 95 % CI 0·13, 0·57). Individuals with the highest consumption of fruits had lower odds for having glioma compared with those with the lowest intake (OR 0·31; 95 % CI 0·14, 0·68). A protective association was also observed between consumption of legumes and nuts and risk of glioma (OR 0·23; 95 % CI 0·10, 0·53). We found a significant positive association between red and processed meat (OR 2·60; 95 % CI 1·16, 5·81) and salt intakes (OR 2·87; 95 % CI 1·30, 6·34) and risk of glioma, after taking all potential confounders into account. Adherence to the DASH-style dietary pattern was inversely associated with glioma. In addition, some components of the DASH diet, including red meats and salt intakes, were positively associated with glioma. Consumption of nuts and legumes as well as fruits was inversely associated with glioma. Prospective cohort studies are required to confirm our findings.
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Wu L, Wang Z, Zhu J, Murad AL, Prokop LJ, Murad MH. Nut consumption and risk of cancer and type 2 diabetes: a systematic review and meta-analysis. Nutr Rev 2016; 73:409-25. [PMID: 26081452 DOI: 10.1093/nutrit/nuv006] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
CONTEXT The identification of foods that can decrease the risk of cancer and type 2 diabetes may be helpful in reducing the burden of these diseases. Although nut consumption has been suggested to have a disease-preventive role, current evidence remains inconsistent. OBJECTIVE The aim of this systematic review and meta-analysis was to clarify the association between nut consumption and risk of cancer or type 2 diabetes. DATA SOURCES Six databases were searched for relevant studies from the time of database inception to August 2014. Reference lists of relevant review articles were hand searched, and authors were contacted when data were insufficient. STUDY SELECTION Eligible studies included epidemiological studies (case-control and cohort) or clinical trials that reported an association between nut consumption and the outcome of type 2 diabetes or specific cancers. DATA EXTRACTION Two investigators independently extracted descriptive, quality, and risk data from included studies. DATA SYNTHESIS Random-effects meta-analysis was used to pool relative risks from the included studies. The I(2) statistic was used to assess heterogeneity. A total of 36 eligible observational studies, which included 30,708 patients, were identified. The studies had fair methodological quality, and length of follow-up ranged between 4.6 years and 30 years. Comparison of the highest category of nut consumption with the lowest category revealed significant associations between nut consumption and decreased risk of colorectal cancer (3 studies each with separate estimates for males and females, RR 0.76, 95% confidence interval [95%CI] 0.61-0.96), endometrial cancer (2 studies, RR 0.58, 95%CI 0.43-0.79), and pancreatic cancer (1 study, RR 0.68, 95%CI 0.48-0.96). No significant association was found with other cancers or type 2 diabetes. Overall, nut consumption was significantly associated with a reduced risk of cancer incidence (RR 0.85, 95%CI 0.76-0.95). CONCLUSIONS Nut consumption may play a role in reducing cancer risk. Additional studies are needed to more accurately assess the relationship between nut consumption and the prevention of individual types of cancer, given the scarcity of available data.
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Affiliation(s)
- Lang Wu
- L. Wu is with the Center for Clinical and Translational Science, Mayo Clinic, Rochester, Minnesota, USA. Z. Wang is with the Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota, USA. Z. Wang and M.H. Murad are with the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA. J. Zhu is with the Program of Quantitative Methods in Education, University of Minnesota, Minneapolis, Minnesota, USA. A.L. Murad is with the Dan Abraham Healthy Living Center, Mayo Clinic, Rochester, Minnesota, USA. L.J. Prokop is with the Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota. M.H. Murad is with the Division of Preventive Medicine, Mayo Clinic, Rochester, Minnesota, USA.
| | - Zhen Wang
- L. Wu is with the Center for Clinical and Translational Science, Mayo Clinic, Rochester, Minnesota, USA. Z. Wang is with the Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota, USA. Z. Wang and M.H. Murad are with the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA. J. Zhu is with the Program of Quantitative Methods in Education, University of Minnesota, Minneapolis, Minnesota, USA. A.L. Murad is with the Dan Abraham Healthy Living Center, Mayo Clinic, Rochester, Minnesota, USA. L.J. Prokop is with the Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota. M.H. Murad is with the Division of Preventive Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Jingjing Zhu
- L. Wu is with the Center for Clinical and Translational Science, Mayo Clinic, Rochester, Minnesota, USA. Z. Wang is with the Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota, USA. Z. Wang and M.H. Murad are with the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA. J. Zhu is with the Program of Quantitative Methods in Education, University of Minnesota, Minneapolis, Minnesota, USA. A.L. Murad is with the Dan Abraham Healthy Living Center, Mayo Clinic, Rochester, Minnesota, USA. L.J. Prokop is with the Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota. M.H. Murad is with the Division of Preventive Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Angela L Murad
- L. Wu is with the Center for Clinical and Translational Science, Mayo Clinic, Rochester, Minnesota, USA. Z. Wang is with the Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota, USA. Z. Wang and M.H. Murad are with the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA. J. Zhu is with the Program of Quantitative Methods in Education, University of Minnesota, Minneapolis, Minnesota, USA. A.L. Murad is with the Dan Abraham Healthy Living Center, Mayo Clinic, Rochester, Minnesota, USA. L.J. Prokop is with the Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota. M.H. Murad is with the Division of Preventive Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Larry J Prokop
- L. Wu is with the Center for Clinical and Translational Science, Mayo Clinic, Rochester, Minnesota, USA. Z. Wang is with the Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota, USA. Z. Wang and M.H. Murad are with the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA. J. Zhu is with the Program of Quantitative Methods in Education, University of Minnesota, Minneapolis, Minnesota, USA. A.L. Murad is with the Dan Abraham Healthy Living Center, Mayo Clinic, Rochester, Minnesota, USA. L.J. Prokop is with the Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota. M.H. Murad is with the Division of Preventive Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Mohammad H Murad
- L. Wu is with the Center for Clinical and Translational Science, Mayo Clinic, Rochester, Minnesota, USA. Z. Wang is with the Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota, USA. Z. Wang and M.H. Murad are with the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA. J. Zhu is with the Program of Quantitative Methods in Education, University of Minnesota, Minneapolis, Minnesota, USA. A.L. Murad is with the Dan Abraham Healthy Living Center, Mayo Clinic, Rochester, Minnesota, USA. L.J. Prokop is with the Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota. M.H. Murad is with the Division of Preventive Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Abstract
To systematically assess the relationship between smoking and glioma risk.A dose-response meta-analysis of case-control and cohort studies was performed. Pertinent studies were identified by searching database and reference lists. Random-effects model was employed to pool the estimates of the relative risks (RRs) with corresponding 95% confidence intervals (CIs).A total of 19 case-control and 6 cohort studies were included. Overall, compared with those who never smoked, the pooled RR and 95% CI was 0.98 (0.92-1.05) for ever smoker. The subgroups were not significantly different regarding risk of glioma except the group of age at start smoking (RR = 1.17, 95% CI: 0.93-1.48 for age < 20; RR = 1.25, 95% CI: 1.02-1.52 for age ≥ 20). Dose-response analysis also suggested no significant association between smoking and the risk of glioma, although some evidence for a linear relationship between smoking and glioma risk was observed.In conclusion, this meta-analysis provides little support for a causal relationship between smoking and risk of glioma.
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Affiliation(s)
- Chuan Shao
- From the Department of Neurosurgery, The Second Clinical Medical College of North Sichuan Medical College, Nanchong, Sichuan, China (CS, WZ, JH); and Department of Neurosurgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (ZQ)
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Saneei P, Willett W, Esmaillzadeh A. Red and processed meat consumption and risk of glioma in adults: A systematic review and meta-analysis of observational studies. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2015; 20:602-12. [PMID: 26600837 PMCID: PMC4621656 DOI: 10.4103/1735-1995.165970] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND These findings from several observational studies, investigated the association between red meat consumption and gliomas, were inconsistent. We conducted a systematic review and meta-analysis of observational studies to summarize available date on the relation between meat intake and risk of glioma. MATERIALS AND METHODS A systematic literature search of relevant reports published until May 2014 of the PubMed/Medline, ISI Web of Knowledge, Excerpta Medica database, Ovid database, Google Scholar, and Scopus databases was conducted. From 723 articles yielded in the preliminary literature search, data from eighteen publications (14 case-control, three cohort, and one nested case-control study) on unprocessed red meat, processed meat, and/or total red meat consumption in relation to glioma in adults were included in the analysis. Quality assessment of studies was performed. Random effects model was used to conduct the meta-analysis. RESULTS We found a positive significant association between unprocessed red meat intake and risk of glioma (relative risk [RR] = 1.30; 95% confidence interval [CI]: 1.08-1.58) after excluding three studies with uncertain type of brain cancer. This analysis included only one cohort study which revealed no relation between unprocessed red meat intake and glioma (RR = 1.75; 95% CI: 0.35-8.77). Consumption of processed meats was not related to increased risk of glioma in population-based case-control studies (RR = 1.26; 95% CI: 1.05-1.51) and reduced risk in hospital-based case-controls (RR = 0.79; 95% CI: 0.65-0.97). No significant association was seen between processed red meat intake and risk of glioma in cohort studies (RR: 1.08; 95% CI: 0.84-1.37). Total red meat consumption was not associated with risk of adult glioma in case-control or cohort studies. CONCLUSION In this meta-analysis of 18 observational studies, we found a modest positive association between unprocessed red meat intake and risk of gliomas based almost entirely on case-control studies. Processed red meat was overall not associated with risk of gliomas in case-control or cohort studies.
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Affiliation(s)
- Parvane Saneei
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Walter Willett
- Department of Nutrition and Epidemiology, Harvard School of Public Health, Boston, USA
| | - Ahmad Esmaillzadeh
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Lv W, Zhong X, Xu L, Han W. Association between Dietary Vitamin A Intake and the Risk of Glioma: Evidence from a Meta-analysis. Nutrients 2015; 7:8897-904. [PMID: 26516909 PMCID: PMC4663566 DOI: 10.3390/nu7115438] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 09/23/2015] [Accepted: 09/28/2015] [Indexed: 11/16/2022] Open
Abstract
The results from epidemiological studies between dietary vitamin A intake and glioma risk is not consistent. Thus, a meta-analysis was conducted to confirm the exact relationship between them. PubMed and Web of Knowledge were used to search the relevant articles up to May 2015. Pooled relative risk (RR) with 95% confidence interval (CI)was calculated using random-effect model. Egger’s test was used to assess the small-study effect. At the end, seven articles with eight case-control studies involving 1841 glioma cases and 4123 participants were included. Our study indicated that highest category of dietary vitamin A intake was significantly associated with reduced risk of glioma (RR = 0.80, 95% CI = 0.62–0.98, p = 0.014, I2 = 54.9%). Egger’s test did not find any publication bias. In conclusion, our study indicated that higher category of dietary vitamin A intake could reduce the glioma risk. However, we could not do a dose-response analysis for vitamin A intake with glioma risk due to the limited data in each reported individual article. Due to this limitation, further studies with detailed dose, cases and person-years for each category is wanted to assess this dose-response association.
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Affiliation(s)
- Wen Lv
- Department of Internal Neurology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou 310016, China.
| | - Xian Zhong
- Department of Medical Oncology, Hangzhou Binjiang Hospital, Hangzhou 310052, China.
| | - Lingmin Xu
- Department of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou 310016, China.
| | - Weidong Han
- Department of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou 310016, China.
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Mutlu H, Akca Z, Erden A, Aslan T, Ucar K, Kaplan B, Buyukcelik A. Lack of sunlight exposure influence on primary glioblastoma survival. Asian Pac J Cancer Prev 2015; 15:4165-8. [PMID: 24935364 DOI: 10.7314/apjcp.2014.15.10.4165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prognosis of primary glioblastoma (GBM) is poor. Approximately 2/3 of primary brain tumor diagnoses are GBM, of which 95% are primary lesions. In this study, we aimed to evaluate whether more sunlight exposure has an effect on survival of patients with primary GBM. MATERIALS AND METHODS A total of 111 patients with primary GBM were enrolled from Kayseri in inner Anatolia which has a cold climate (n: 40) and Mersin in Mediterranean region with a warm climate and more sunlight exposure (n: 71). The patients with primary GBM were divided into two groups as Kayseri and Mersin and compared for progression free survival (PFS) and overall survival (OS). RESULTS The PFS values were 7.0 and 4.7 months for Kayseri and Mersin groups, respectively (p=0.10) and the respective OS values were 13.3 and 9.4 months (p=0.13). We did not found any significant difference regarding age, sex, comorbidity, smoking, surgery, resurgery, adjuvant chemoradiotherapy and palliative chemotherapy between the groups. CONCLUSIONS We found that more sunlight exposure had no impact on prognosis of patients with primary GBM, adding inconsistency to the literature about the relationship between sunlight and GBM.
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Affiliation(s)
- Hasan Mutlu
- Department of Medical Oncology, Akdeniz University School of Medicine, Antalya, Turkey E-mail :
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Zhou S, Wang X, Tan Y, Qiu L, Fang H, Li W. Association between Vitamin C Intake and Glioma Risk: Evidence from a Meta-Analysis. Neuroepidemiology 2015; 44:39-44. [DOI: 10.1159/000369814] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 10/31/2014] [Indexed: 11/19/2022] Open
Abstract
Background: The field of quantifying the association between the intake of vitamin C and risk of glioma still has conflicts. Thus, we performed a comprehensive meta-analysis to test the hypothesis that a high intake of vitamin C may be a protective effect on glioma risk. Methods: Pertinent studies were identified by a search in PubMed and Web of Knowledge up to June 2014. The random-effect model was used to combine study-specific results. Publication bias was estimated using Begg' funnel plot and Egger's regression asymmetry test. Results: Thirteen articles with 15 studies (2 cohort study and 13 case-control studies) involving 3,409 glioma cases about vitamin C intake and glioma risk were used in this meta-analysis. The combined relative risks (RRs) of glioma associated with vitamin C intake was 0.86 (95% CIs = 0.75-0.99). Overall, significant protective associations were also found in the American population (RRs = 0.85, 95% CIs = 0.73-0.98) and case-control studies (RRs = 0.80, 95% CIs = 0.69-0.93). No publication bias was found. Conclusions: Our analysis indicated that vitamin C intake might decrease the risk of glioma, especially among the Americans.
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Wei Y, Zou D, Cao D, Xie P. Association between processed meat and red meat consumption and risk for glioma: A meta-analysis from 14 articles. Nutrition 2015; 31:45-50. [DOI: 10.1016/j.nut.2014.04.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 04/16/2014] [Accepted: 04/20/2014] [Indexed: 01/29/2023]
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Qin S, Wang M, Zhang T, Zhang S. Vitamin E intake is not associated with glioma risk: evidence from a meta-analysis. Neuroepidemiology 2014; 43:253-8. [PMID: 25531943 DOI: 10.1159/000369345] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 10/19/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Epidemiological studies evaluating the association between vitamin E intake and glioma risk have produced inconsistent results. Thus, we conducted a meta-analysis to summarize the evidence from epidemiological studies of vitamin E intake with the risk of glioma. METHODS Pertinent studies were identified by a search in pubmed and web of knowledge up to August 2014. The random-effect model was used to combine the results. Publication bias was estimated using the Egger's regression asymmetry test. RESULTS Twelve studies including 3180 glioma cases about vitamin E intake with the risk of glioma were included in this meta-analysis. The combined relative risk (RR) of glioma associated with vitamin E intake was 0.88 (95% CI = 0.69-1.12). The association was significant neither in the case-control studies nor in the cohort studies. No publication biases were found. CONCLUSIONS Our analysis indicated that vitamin E intake is not associated with the risk of glioma.
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Affiliation(s)
- Shiyong Qin
- Department of General Surgery, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Shandong, PR China
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Li Y. Association between fruit and vegetable intake and risk for glioma: a meta-analysis. Nutrition 2014; 30:1272-8. [PMID: 25194962 DOI: 10.1016/j.nut.2014.03.027] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Revised: 03/29/2014] [Accepted: 03/31/2014] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Epidemiologic studies evaluating the association between the intake of vegetables and fruit and the risk for glioma have produced inconsistent results. Therefore, the aim of this study was to test the hypothesis that higher vegetable and fruit intake may have a protective effect on risk for glioma. METHODS Pertinent studies were identified by a search in PubMed, Web of Knowledge, and Wan Fang Med Online up to January 2014. Random-effect model was used to combine study-specific results. Publication bias was estimated using Begg's funnel plot and Egger's regression asymmetry test. RESULTS Fifteen studies involving 5562 cases focusing on vegetable intake and 17 studies involving 3994 cases of fruit intake compared with the risk for glioma were included in this meta-analysis. The combined relative risk (RR) of glioma associated with vegetable intake was 0.775 (95% confidence interval [CI], 0.688-0.872) overall, and the association for subgroup analysis by study design, sources of control, ethnicity, and number of cases was consistent with overall data. For fruit intake and glioma risk, significant protective associations were found in an Asian population (RR, 0.573; 95% CI, 0.346-0.947), but not in a white population. No publication bias was found. CONCLUSIONS This analysis indicated that intake of vegetables might have a protective effect on glioma. The intake of fruit might have a protective effect on glioma in the Asian population; however, the results need to be confirmed.
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Affiliation(s)
- Ying Li
- Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Alcohol consumption and risk of glioma: a meta-analysis of 19 observational studies. Nutrients 2014; 6:504-16. [PMID: 24473233 PMCID: PMC3942713 DOI: 10.3390/nu6020504] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 12/24/2013] [Accepted: 01/09/2014] [Indexed: 11/26/2022] Open
Abstract
The relationship between risk of glioma and alcohol consumption has been widely studied, but results have been conflicting. We therefore conducted a meta-analysis of observational studies to systematically assess the relationship between alcohol drinking and risk of glioma. Two electronic databases (PubMed and EMBASE) were searched from inception to 8 August 2013 to identify pertinent studies that linked alcohol drinking with glioma risk. We used a random-effects model to calculate the overall relative risk (RR) with corresponding 95% confidence intervals (CIs). Fifteen case-control and four cohort studies were identified for this analysis. The combined RR for total alcohol drinkers versus non-drinkers was 0.96 (95% CI: 0.89–1.04). In the subgroup analysis by geographic area, a significant association was observed in North American studies (RR = 0.78, 95% CI: 0.65–0.93), but not in European or Asian/Australian studies. In the subgroup analysis by study design, a borderline significant association emerged in population-based case-control studies (RR = 0.82, 95% CI: 0.68–0.99), but not in hospital-based case-control studies (RR = 1.00, 95% CI: 0.99–1.01) or cohort group (RR = 1.03, 95% CI: 0.88–1.20). Our results show no material association between alcohol consumption and risk of glioma existed. Further prospective evidences are needed to confirm this association.
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Bräuner EV, Andersen ZJ, Andersen CE, Pedersen C, Gravesen P, Ulbak K, Hertel O, Loft S, Raaschou-Nielsen O. Residential radon and brain tumour incidence in a Danish cohort. PLoS One 2013; 8:e74435. [PMID: 24066143 PMCID: PMC3774631 DOI: 10.1371/journal.pone.0074435] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 07/31/2013] [Indexed: 11/29/2022] Open
Abstract
Background Increased brain tumour incidence over recent decades may reflect improved diagnostic methods and clinical practice, but remain unexplained. Although estimated doses are low a relationship between radon and brain tumours may exist. Objective To investigate the long-term effect of exposure to residential radon on the risk of primary brain tumour in a prospective Danish cohort. Methods During 1993–1997 we recruited 57,053 persons. We followed each cohort member for cancer occurrence from enrolment until 31 December 2009, identifying 121 primary brain tumour cases. We traced residential addresses from 1 January 1971 until 31 December 2009 and calculated radon concentrations at each address using information from central databases regarding geology and house construction. Cox proportional hazards models were used to estimate incidence rate-ratios (IRR) and 95% confidence intervals (CI) for the risk of primary brain tumours associated with residential radon exposure with adjustment for age, sex, occupation, fruit and vegetable consumption and traffic-related air pollution. Effect modification by air pollution was assessed. Results Median estimated radon was 40.5 Bq/m3. The adjusted IRR for primary brain tumour associated with each 100 Bq/m3 increment in average residential radon levels was 1.96 (95% CI: 1.07; 3.58) and this was exposure-dependently higher over the four radon exposure quartiles. This association was not modified by air pollution. Conclusions We found significant associations and exposure-response patterns between long-term residential radon exposure radon in a general population and risk of primary brain tumours, adding new knowledge to this field. This finding could be chance and needs to be challenged in future studies.
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Affiliation(s)
- Elvira V. Bräuner
- Diet, Genes and Environment, Danish Cancer Society Research Centre, Copenhagen, Denmark
- Construction and Health, Danish Building Research Institute, Aalborg University, Aalborg, Denmark
| | - Zorana J. Andersen
- Diet, Genes and Environment, Danish Cancer Society Research Centre, Copenhagen, Denmark
- Department of Public Health, Faculty of Health Sciences, Copenhagen University, Copenhagen, Denmark
| | - Claus E. Andersen
- Center for Nuclear Technologies, Technical University of Denmark, Roskilde, Denmark
| | - Camilla Pedersen
- Diet, Genes and Environment, Danish Cancer Society Research Centre, Copenhagen, Denmark
| | - Peter Gravesen
- Geological Survey of Denmark and Greenland, Copenhagen, Denmark
| | - Kaare Ulbak
- National Institute of Radiation Protection, Herlev, Denmark
| | - Ole Hertel
- Department of Environmental Science, Aarhus University, Aarhus, Denmark
| | - Steffen Loft
- Department of Public Health, Faculty of Health Sciences, Copenhagen University, Copenhagen, Denmark
| | - Ole Raaschou-Nielsen
- Diet, Genes and Environment, Danish Cancer Society Research Centre, Copenhagen, Denmark
- * E-mail: (ORN)
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Malerba S, Galeone C, Pelucchi C, Turati F, Hashibe M, La Vecchia C, Tavani A. A meta-analysis of coffee and tea consumption and the risk of glioma in adults. Cancer Causes Control 2012; 24:267-76. [PMID: 23247638 DOI: 10.1007/s10552-012-0126-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Accepted: 12/07/2012] [Indexed: 12/26/2022]
Abstract
BACKGROUND Coffee contains many compounds, including antioxidants, which could prevent cancerogenesis, and coffee has been related with lower incidence of cancer at several sites. Tea is also rich in antioxidants, mainly polyphenols. To provide a quantitative overall estimate on the relation between coffee and tea consumption and glioma, we combined all published data, using a meta-analytic approach. METHODS In September 2012, a bibliography search was carried out in both PubMed and Embase to identify observational studies providing quantitative estimates on the issue. Pooled estimates of the relative risks (RR) and the corresponding 95 % confidence intervals (CI) were calculated using random-effects models. RESULTS Six studies (four cohort and two case-control studies) were available for meta-analysis, for a total of about 2100 cases. The summary RRs and 95 % CIs of glioma for drinkers versus non/occasional drinkers were 0.96 (95 % CI: 0.81-1.13) for coffee and 0.86 (95 % CI: 0.78-0.94) for tea, with no heterogeneity between studies. When we compared the highest versus the lowest categories of consumption, the RRs were 1.01 (95 % CI: 0.83-1.22) for coffee, 0.88 (95 % CI: 0.69-1.12) for tea, and 0.75 (95 % CI: 0.54-1.05) for coffee plus tea. CONCLUSIONS This meta-analysis, although based on few studies, suggests a lack of association between coffee intake and glioma risk, and a tendency, if any, to a lower risk for tea and coffee plus tea drinkers.
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Affiliation(s)
- Stefano Malerba
- Department of Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri, Via Giuseppe La Masa 19, 0157, Milan, Italy
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Dubrow R, Darefsky AS, Freedman ND, Hollenbeck AR, Sinha R. Coffee, tea, soda, and caffeine intake in relation to risk of adult glioma in the NIH-AARP Diet and Health Study. Cancer Causes Control 2012; 23:757-68. [PMID: 22457000 PMCID: PMC3381735 DOI: 10.1007/s10552-012-9945-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Accepted: 03/14/2012] [Indexed: 11/28/2022]
Abstract
PURPOSE We utilized the large, prospective NIH-AARP Diet and Health Study to further explore the hypothesis, suggested by two recent prospective cohort studies, that increased intake of coffee, tea, soda, and/or caffeine is associated with reduced adult glioma risk. METHODS At baseline in 1995-1996, dietary intake, including coffee, tea, and soda, was assessed with a food frequency questionnaire. We used Cox proportional hazards models to calculate adjusted hazard ratios (HR) and 95 % confidence intervals (CI) for glioma risk in relation to beverage intake. RESULTS During follow-up of 545,771 participants through 2006, 904 participants were diagnosed with glioma. We found no trends of decreasing glioma risk with increasing intake of specific beverages or total caffeine. HR patterns for consumption of the caffeinated versus decaffeinated form of each beverage were inconsistent with a specific caffeine effect. HR patterns of reduced glioma risk for most categories of beverage intake greater than "none" prompted a post hoc analysis that revealed borderline-significant inverse associations for any versus no intake of tea (HR = 0.84; 95 % CI, 0.69-1.03), total coffee plus tea (HR = 0.70; 95 % CI, 0.48-1.03), and soda (HR = 0.82; 95 % CI, 0.67-1.01). CONCLUSIONS The borderline-significant inverse associations could be explained by a threshold effect in which any beverage intake above a low level confers a beneficial effect, most likely due to beverage constituents other than caffeine. They could also be explained by non-drinkers of these beverages sharing unknown extraneous characteristics associated with increased glioma risk, or by chance.
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Affiliation(s)
- Robert Dubrow
- Yale School of Public Health, Yale School of Medicine, New Haven, CT, USA.
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Kyritsis AP, Bondy ML, Levin VA. Modulation of glioma risk and progression by dietary nutrients and antiinflammatory agents. Nutr Cancer 2011; 63:174-84. [PMID: 21302177 PMCID: PMC3047463 DOI: 10.1080/01635581.2011.523807] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Gliomas are tumors of glial origin formed in the central nervous system and exhibit profound morphological and genetic heterogeneity. The etiology of this heterogeneity involves an interaction between genetic alterations and environmental risk factors. Scientific evidence suggests that certain natural dietary components, such as phytoestrogens, flavonoids, polyunsaturated fatty acids, and vitamins, may exert a protective effect against gliomas by changing the nature of the interaction between genetics and environment. Similarly, certain antiinflammatory drugs and dietary modifications, such as methionine restriction and the adoption of low-calorie or ketogenic diets, may take advantage of glioma and normal glial cells' differential requirements for glucose, methionine, and ketone bodies and may, therefore, be effective as part of preventive or treatment strategies for gliomas. Treatment trials of glioma patients and chemoprevention trials of individuals with a known genetic predisposition to glioma using the most promising of these agents, such as the antiinflammatory drugs curcumin and gamma-linolenic acid, are needed to validate or refute these agents' putative role in gliomas.
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Michaud DS, Gallo V, Schlehofer B, Tjønneland A, Olsen A, Overvad K, Dahm CC, Teucher B, Lukanova A, Boeing H, Schütze M, Trichopoulou A, Lagiou P, Kyrozis A, Sacerdote C, Krogh V, Masala G, Tumino R, Mattiello A, Bueno-de-Mesquita HB, Ros MM, Peeters PHM, van Gils CH, Skeie G, Engeset D, Parr CL, Ardanaz E, Chirlaque MD, Dorronsoro M, Sánchez MJ, Argüelles M, Jakszyn P, Nilsson LM, Melin BS, Manjer J, Wirfält E, Khaw KT, Wareham N, Allen NE, Key TJ, Romieu I, Vineis P, Riboli E. Coffee and tea intake and risk of brain tumors in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort study. Am J Clin Nutr 2010; 92:1145-50. [PMID: 20844074 DOI: 10.3945/ajcn.2010.29876] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In a recent US cohort study, total coffee and tea consumption was inversely associated with risk of glioma, and experimental studies showed that caffeine can slow the invasive growth of glioblastoma. OBJECTIVE The objective was to examine the relation between coffee and tea intake and the risk of glioma and meningioma in a large European cohort study, the European Prospective Investigation into Cancer and Nutrition (EPIC). DESIGN Data on coffee and tea intake were collected from men and women recruited into the EPIC cohort study. Over an average of 8.5 y of follow-up, 343 cases of glioma and 245 cases of meningioma were newly diagnosed in 9 countries. We used Cox proportional hazards models to examine the relation between coffee and tea and brain tumors. RESULTS We observed no associations between coffee, tea, or combined coffee and tea consumption and risk of either type of brain tumor when using quantiles based on country-specific distributions of intake. However, a significant inverse association was observed for glioma risk among those consuming ≥100 mL coffee and tea per day compared with those consuming <100 mL/d (hazard ratio: 0.66; 95% CI: 0.44, 0.97; P = 0.03). The association was slightly stronger in men (hazard ratio: 0.59; 95% CI: 0.34, 1.01) than in women (hazard ratio: 0.74; 95% CI: 0.42, 1.31), although neither was statistically significant. CONCLUSIONS In this large cohort study, we observed an inverse association between total coffee and tea consumption and risk of glioma that was consistent with the findings of a recent study. These findings, if further replicated in other studies, may provide new avenues of research on gliomas.
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Affiliation(s)
- Dominique S Michaud
- Department of Epidemiology and Public Health, Imperial College, London, United Kingdom.
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Holick CN, Smith SG, Giovannucci E, Michaud DS. Coffee, tea, caffeine intake, and risk of adult glioma in three prospective cohort studies. Cancer Epidemiol Biomarkers Prev 2010; 19:39-47. [PMID: 20056621 DOI: 10.1158/1055-9965.epi-09-0732] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Current data suggest that caffeinated beverages may be associated with lower risk of glioma. Caffeine has different effects on the brain, some of which could play a role in brain carcinogenesis, and coffee has been consistently associated with reduced risk of liver cancer, thus suggesting a potential anticarcinogenic effect. A total of 335 incident cases of gliomas (men, 133; women, 202) were available from three independent cohort studies. Dietary intake was assessed by food frequency questionnaires obtained at baseline and during follow-up. Cox proportional hazard models were used to estimate incidence rate ratios (RR) and 95% confidence intervals (CI) between consumption of coffee, tea, carbonated beverages, caffeine, and glioma risk adjusting for age and total caloric intake. Estimates from each cohort were pooled using a random-effects model. Consumption of five or more cups of coffee and tea daily compared with no consumption was associated with a decrease risk of glioma (RR, 0.60; 95% CI, 0.41-0.87; P(trend) = 0.04). Inverse, although weaker, associations were also observed between coffee, caffeinated coffee, tea, and carbonated beverages and glioma risk. No association was observed between decaffeinated coffee and glioma risk. Among men, a statistically significant inverse association was observed between caffeine consumption and risk of glioma (RR, 0.46; 95% CI, 0.26-0.81; P(trend) = 0.03); the association was weaker among women. Our findings suggest that consumption of caffeinated beverages, including coffee and tea, may reduce the risk of adult glioma, but further research is warranted to confirm these findings in other populations.
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Affiliation(s)
- Crystal N Holick
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
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Michaud DS, Holick CN, Batchelor TT, Giovannucci E, Hunter DJ. Prospective study of meat intake and dietary nitrates, nitrites, and nitrosamines and risk of adult glioma. Am J Clin Nutr 2009; 90:570-7. [PMID: 19587083 PMCID: PMC2728643 DOI: 10.3945/ajcn.2008.27199] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The hypothesis that nitrosamine exposure may increase the risk of glioma has been circulating for several decades, but testing it has been difficult because of the ubiquitous nature of nitrosamine exposure. Diet has been the focus of many studies because it can substantially influence nitrosamine exposure, mostly from the endogenous formation of nitrosamines based on intake of nitrite and nitrate. OBJECTIVE The objective was to examine the relation between intakes of meats, nitrate, nitrite, and 2 nitrosamines [nitrosodimethylamine (NDMA) and nitrosopyrolidine (NPYR)] and glioma risk in a prospective analysis. METHODS Data from 3 US prospective cohort studies were combined for this analysis; 335 glioma cases were diagnosed during < or =24 y of follow-up. Dietary intake was assessed with food-frequency questionnaires. Nitrate, nitrite, and nitrosamine values were calculated based on published values of these nutrients in various foods over different periods in time. Cox proportional hazards models were used to estimate incidence rate ratios (RRs) and 95% CIs. Estimates from each cohort were pooled by using a random-effects model. RESULTS Risk of glioma was not elevated among individuals in the highest intake category of total processed meats (RR: 0.92; 95% CI: 0.48, 1.77), nitrate (RR: 1.02; 95% CI: 0.66, 1.58), nitrites (RR: 1.26; 95% CI: 0.89, 1.79), or NDMA (RR: 0.88; 95% CI: 0.57, 1.36) compared with the lowest category. No effect modification was observed by intake of vitamins C or E or other antioxidant measures. CONCLUSION We found no suggestion that intake of meat, nitrate, nitrite, or nitrosamines is related to the risk of glioma.
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Affiliation(s)
- Dominique S Michaud
- Department of Epidemiology and Public Health, Imperial College London, United Kingdom.
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Mandelzweig L, Novikov I, Sadetzki S. Smoking and risk of glioma: a meta-analysis. Cancer Causes Control 2009; 20:1927-38. [DOI: 10.1007/s10552-009-9386-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2009] [Accepted: 06/10/2009] [Indexed: 11/29/2022]
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Terry MB, Howe G, Pogoda JM, Zhang FF, Ahlbom A, Choi W, Giles GG, Little J, Lubin F, Menegoz F, Ryan P, Schlehofer B, Preston-Martin S. An international case-control study of adult diet and brain tumor risk: a histology-specific analysis by food group. Ann Epidemiol 2009; 19:161-71. [PMID: 19216998 PMCID: PMC3832293 DOI: 10.1016/j.annepidem.2008.12.010] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2008] [Revised: 12/07/2008] [Accepted: 12/11/2008] [Indexed: 11/23/2022]
Abstract
PURPOSE Existing studies of diet and adult brain tumors have been limited by small numbers in histology-specific subgroups. Dietary data from an international collaborative case-control study on adult brain tumors were used to evaluate associations between histology-specific risk and consumption of specific food groups. METHODS The study included 1548 cases diagnosed between 1984 and 1991 and 2486 control subjects from 8 study centers in 6 countries. Of the 1548 cases, 1185 were gliomas, 332 were meningiomas, and 31 were other tumor types. Dietary consumption was measured as average grams per day. RESULTS We found inverse associations between some vegetable groups and glioma risk, the strongest for yellow-orange vegetables (odds ratio [OR], 0.7, 95% confidence interval [CI], 0.5-0.9 for the 4th vs. 1st quartile of consumption, p for trend<0.001), and the association was limited to specific glioma subtypes. There was no association with cured meat. Non-cured meat was associated with a modest increase in glioma risk (OR, 1.3; 95% CI, 1.0-1.7 for 4th quartile vs. 1st quartile, p for trend=0.01). We also found positive associations between egg, grain, and citrus fruit consumption and glioma but not meningioma risk. CONCLUSIONS Our study suggests that selected dietary food groups may be associated with adult gliomas and its subtypes but not meningiomas.
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Abstract
Gliomas account for more than 70% of all brain tumors, and of these, glioblastoma is the most frequent and malignant histologic type (World Health Organization [WHO] grade IV). There is a tendency toward a higher incidence of gliomas in highly developed, industrialized countries. Some reports indicate that Caucasians have a higher incidence than African or Asian populations. With the exception of pilocytic astrocytomas (WHO grade I), the prognosis of glioma patients is still poor. Fewer than 3% of glioblastoma patients are still alive at 5 years after diagnosis, older age being the most significant and consistent prognostic factor of poorer outcome. Gliomas are components of several inherited tumor syndromes, but the prevalence of these syndromes is very low. Many environmental and lifestyle factors including several occupations, environmental carcinogens, and diet have been reported to be associated with an elevated glioma risk, but the only factor unequivocally associated with an increased risk is therapeutic X-irradiation. In particular, children treated with X-irradiation for acute lymphoblastic leukemia show a significantly elevated risk of developing gliomas and primitive neuroectodermal tumors, often within 10 years after therapy. Significant correlation between G:C --> A:T transitions in the TP53 gene and promoter methylation of the O6 -methylguanine-DNA methyltransferase (MGMT) gene in glio-mas have been reported in several studies, suggesting the possible involvement of O6-methylguanine DNA adducts, which may be produced by exogenous or endogenous alkylating agents in the development of gliomas.
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Affiliation(s)
- Hiroko Ohgaki
- Pathology Group, International Agency for Research on Cancer, Lyon, France
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Holick CN, Giovannucci EL, Rosner B, Stampfer MJ, Michaud DS. Prospective study of cigarette smoking and adult glioma: dosage, duration, and latency. Neuro Oncol 2007; 9:326-34. [PMID: 17504930 PMCID: PMC1907415 DOI: 10.1215/15228517-2007-005] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Tobacco products are major contributors of exogenous N-nitroso compounds, a group of potent neurocarcinogens. Overall results from studies of smoking and brain tumors have been null, but have provided little information on duration, age at smoking initiation, and latency. We prospectively examined the relation between cigarette smoking and glioma risk among men and women in three large U.S. cohort studies: the Health Professionals Follow-up Study (HPFS), the Nurses' Health Study I (NHS), and NHS II. Information on smoking history was obtained at baseline (1986 for HPFS, 1976 for NHS, and 1989 for NHS II) and updated biennially through 2002 in the HPFS and the NHS and 2003 in the NHS II. We confirmed 110 incident gliomas among men and 255 gliomas among women during 667,673 and 4,388,515 person-years of follow-up, respectively. Cox proportional hazard models were used to estimate incidence rate ratios and 95% confidence intervals between smoking and glioma risk adjusting for age, total meat intake, and alcohol and coffee consumption. Estimates from each cohort were pooled using a random-effects model after determining that there was no heterogeneity by sex. No association with glioma risk was observed between baseline or updated smoking status, intensity, duration, or age at smoking initiation among men and women. Furthermore, no association with glioma risk was observed after allowing for an induction period between smoking and glioma diagnosis. These findings provide strong evidence that cigarette smoking is not associated with an appreciably elevated risk of adult glioma.
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Affiliation(s)
- Crystal N Holick
- Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.
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