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Alegria-Lertxundi I, Aguirre C, Bujanda L, Fernández FJ, Polo F, Ordovás JM, Etxezarraga MC, Zabalza I, Larzabal M, Portillo I, M. de Pancorbo M, Palencia-Madrid L, Garcia-Etxebarria K, Rocandio AM, Arroyo-Izaga M. Gene-Diet Interactions in Colorectal Cancer: Survey Design, Instruments, Participants and Descriptive Data of a Case-Control Study in the Basque Country. Nutrients 2020; 12:E2362. [PMID: 32784647 PMCID: PMC7468855 DOI: 10.3390/nu12082362] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 07/31/2020] [Accepted: 07/31/2020] [Indexed: 02/07/2023] Open
Abstract
Epidemiologic studies have revealed inconsistent evidence of gene-diet interaction in relation to colorectal cancer (CRC). The aim of this study was to analyze them in a sample of cases and controls from the population-based bowel cancer screening program of the Osakidetza/Basque Health Service. This study analyzed dietetic, genetic, demographic, socioeconomic factors and lifestyles. In the present manuscript, the survey design, sampling, instruments, measurements and related quality management were presented. Moreover, we analyze differences between cases and controls in some data, especially those related to diet. The participants were 308 cases and 308 age- and sex-matched subjects as controls. Cases were more likely than controls to have overweight/obesity (67.5% vs. 58.1%, p < 0.05), a lower intake of vitamin B2 (0.86 ± 0.23 vs. 0.92 ± 0.23 mg/1000 kcal, p < 0.01) and calcium:phosphorus ratio (0.62 ± 0.12 vs. 0.65 ± 0.13, p < 0.01). A higher proportion of cases than controls did not meet the Nutritional Objectives for saturated fatty acids (85.7% vs. 67.5%, p < 0.001) or cholesterol (35.4% vs. 25.0%, p < 0.01). In conclusion, the present study provides valuable data for analyzing the complexity of gene-diet interaction in relation to CRC. The results presented here suggest that overweight/obesity and a high intake of certain dietary components, especially saturated fatty acids and cholesterol, are more frequent in cases than in controls.
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Affiliation(s)
- Iker Alegria-Lertxundi
- Department of Pharmacy and Food Sciences. Faculty of Pharmacy, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain; (I.A.-L.); (A.M.R.)
| | - Carmelo Aguirre
- Pharmacovigilance Unit, Galdakao-Usansolo University Hospital, Osakidetza, 48960 Galdakao, Spain;
| | - Luis Bujanda
- Department of Gastroenterology, Donostia University Hospital/Biodonostia Health Research Institute, University of the Basque Country UPV/EHU, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 20014 San Sebastian, Spain;
| | - Francisco J. Fernández
- Department of Gastroenterology, Galdakao-Usansolo University Hospital, Osakidetza, 48960 Galdakao, Spain;
| | - Francisco Polo
- Department of Gastroenterology, Basurto University Hospital, Osakidetza, 48013 Bilbao, Spain;
| | - José M. Ordovás
- Nutrition and Genomics Laboratory, Jean Mayer Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02111, USA;
- Institute IMDEA Food, Institutos Madrileños de Estudios Avanzados (IMDEA), 28049 Madrid, Spain
| | - M. Carmen Etxezarraga
- Department of Pathology, Basurto University Hospital, Osakidetza, 48013 Bilbao, Spain;
- Department of Physician and Surgeon Specialities, University of the Basque Country UPV/EHU, 48940 Leioa, Spain
| | - Iñaki Zabalza
- Department of Pathology, Galdakao-Usansolo University Hospital, Osakidetza, 48960 Galdakao, Spain;
| | - Mikel Larzabal
- Department of Pathology, Donostia Hospital/Biodonostia Health Research Institute, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 20014 San Sebastian, Spain;
| | - Isabel Portillo
- Central Coordinating Center of the Bowel Cancer Screening Program, Healthcare subdirectorate, Osakidetza, 48011 Bilbao, Spain;
| | - Marian M. de Pancorbo
- BIOMICs Research Group, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain; (M.M.d.P.); (L.P.-M.)
| | - Leire Palencia-Madrid
- BIOMICs Research Group, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain; (M.M.d.P.); (L.P.-M.)
| | - Koldo Garcia-Etxebarria
- Biodonostia Health Research Institute, Gastrointestional genetics group, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 20014 San Sebastian, Spain;
| | - Ana M. Rocandio
- Department of Pharmacy and Food Sciences. Faculty of Pharmacy, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain; (I.A.-L.); (A.M.R.)
- BIOMICs Research Group, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain; (M.M.d.P.); (L.P.-M.)
| | - Marta Arroyo-Izaga
- Department of Pharmacy and Food Sciences. Faculty of Pharmacy, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain; (I.A.-L.); (A.M.R.)
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Elmariah S, Doros G, Benavente OR, Bhatt DL, Connolly SJ, Yusuf S, Steinhubl SR, Liu Y, Hsieh WH, Yeh RW, Mauri L. Impact of Clopidogrel Therapy on Mortality and Cancer in Patients With Cardiovascular and Cerebrovascular Disease: A Patient-Level Meta-Analysis. Circ Cardiovasc Interv 2019; 11:e005795. [PMID: 29311290 DOI: 10.1161/circinterventions.117.005795] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 11/27/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Clinical trial data associate extended clopidogrel therapy with increased mortality and cancer. We sought to determine the impact of continued clopidogrel use on mortality and cancer within a patient-level meta-analysis of randomized clinical trials. METHODS AND RESULTS Meta-analytic clinical event rates for all-cause, cardiovascular, noncardiovascular, and cancer-related mortality; cancer; myocardial infarction; stroke; and fatal and major nonfatal bleeding were generated using patient-level data from 6 randomized trials comparing prolonged versus no or short-duration clopidogrel on a background of aspirin in patients with cardiovascular and cerebrovascular disease. Among 48 817 randomized patients (median follow-up 546 days), there was no difference in all-cause (7.23% versus 7.26%; P=0.97), cardiovascular (5.25% versus 5.22%; P=0.86), noncardiovascular (1.98% versus 2.03%; P=0.73), and cancer-related (0.93% versus 0.99%; P=0.59) mortality or in new cancer diagnoses (2.97% versus 2.96%; P>0.99). Rates of myocardial infarction (3.21% versus 4.05%; P<0.0001) and stroke (3.04% versus 3.75%; P<0.0001) were significantly lower in patients receiving continued clopidogrel. Fatal bleeding was more common with continued clopidogrel use (0.39% versus 0.27%; P=0.03), as were major nonfatal bleeding (4.06% versus 2.68%; P<0.0001) and intracranial hemorrhage (0.43% versus 0.30%; P=0.02). CONCLUSIONS Across trials of cardiovascular and cerebrovascular disease, extended-duration clopidogrel on a background of aspirin has no overall effect on mortality or cancer but does reduce rates of myocardial infarction and stroke and increase rates of bleeding. These findings emphasize the need for selective use of extended clopidogrel therapy in patients in whom the risks of ischemia are not fully counterbalanced by the risks of bleeding.
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Affiliation(s)
- Sammy Elmariah
- From the Cardiology Division, Department of Medicine, Massachusetts General Hospital (S.E.), Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital (D.L.B., L.M.), Smith Center for Outcomes Research in Cardiology, Department of Medicine, Beth-Israel Deaconess Medical Center (R.W.Y.), Harvard Medical School, Boston, MA (S.E., D.L.B., R.W.Y., L.M.); Baim Institute for Clinical Research, Boston, MA (S.E., G.D., Y.L., W.-H.H., R.W.Y., L.M.); Department of Biostatistics, Boston University School of Public Health, MA (G.D.); University of British Columbia, Vancouver, Canada (O.R.B.); Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada (S.J.C., S.Y.); and Scripps Translational Science Institute, La Jolla, CA (S.R.S.)
| | - Gheorghe Doros
- From the Cardiology Division, Department of Medicine, Massachusetts General Hospital (S.E.), Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital (D.L.B., L.M.), Smith Center for Outcomes Research in Cardiology, Department of Medicine, Beth-Israel Deaconess Medical Center (R.W.Y.), Harvard Medical School, Boston, MA (S.E., D.L.B., R.W.Y., L.M.); Baim Institute for Clinical Research, Boston, MA (S.E., G.D., Y.L., W.-H.H., R.W.Y., L.M.); Department of Biostatistics, Boston University School of Public Health, MA (G.D.); University of British Columbia, Vancouver, Canada (O.R.B.); Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada (S.J.C., S.Y.); and Scripps Translational Science Institute, La Jolla, CA (S.R.S.)
| | - Oscar R Benavente
- From the Cardiology Division, Department of Medicine, Massachusetts General Hospital (S.E.), Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital (D.L.B., L.M.), Smith Center for Outcomes Research in Cardiology, Department of Medicine, Beth-Israel Deaconess Medical Center (R.W.Y.), Harvard Medical School, Boston, MA (S.E., D.L.B., R.W.Y., L.M.); Baim Institute for Clinical Research, Boston, MA (S.E., G.D., Y.L., W.-H.H., R.W.Y., L.M.); Department of Biostatistics, Boston University School of Public Health, MA (G.D.); University of British Columbia, Vancouver, Canada (O.R.B.); Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada (S.J.C., S.Y.); and Scripps Translational Science Institute, La Jolla, CA (S.R.S.)
| | - Deepak L Bhatt
- From the Cardiology Division, Department of Medicine, Massachusetts General Hospital (S.E.), Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital (D.L.B., L.M.), Smith Center for Outcomes Research in Cardiology, Department of Medicine, Beth-Israel Deaconess Medical Center (R.W.Y.), Harvard Medical School, Boston, MA (S.E., D.L.B., R.W.Y., L.M.); Baim Institute for Clinical Research, Boston, MA (S.E., G.D., Y.L., W.-H.H., R.W.Y., L.M.); Department of Biostatistics, Boston University School of Public Health, MA (G.D.); University of British Columbia, Vancouver, Canada (O.R.B.); Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada (S.J.C., S.Y.); and Scripps Translational Science Institute, La Jolla, CA (S.R.S.)
| | - Stuart J Connolly
- From the Cardiology Division, Department of Medicine, Massachusetts General Hospital (S.E.), Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital (D.L.B., L.M.), Smith Center for Outcomes Research in Cardiology, Department of Medicine, Beth-Israel Deaconess Medical Center (R.W.Y.), Harvard Medical School, Boston, MA (S.E., D.L.B., R.W.Y., L.M.); Baim Institute for Clinical Research, Boston, MA (S.E., G.D., Y.L., W.-H.H., R.W.Y., L.M.); Department of Biostatistics, Boston University School of Public Health, MA (G.D.); University of British Columbia, Vancouver, Canada (O.R.B.); Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada (S.J.C., S.Y.); and Scripps Translational Science Institute, La Jolla, CA (S.R.S.)
| | - Salim Yusuf
- From the Cardiology Division, Department of Medicine, Massachusetts General Hospital (S.E.), Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital (D.L.B., L.M.), Smith Center for Outcomes Research in Cardiology, Department of Medicine, Beth-Israel Deaconess Medical Center (R.W.Y.), Harvard Medical School, Boston, MA (S.E., D.L.B., R.W.Y., L.M.); Baim Institute for Clinical Research, Boston, MA (S.E., G.D., Y.L., W.-H.H., R.W.Y., L.M.); Department of Biostatistics, Boston University School of Public Health, MA (G.D.); University of British Columbia, Vancouver, Canada (O.R.B.); Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada (S.J.C., S.Y.); and Scripps Translational Science Institute, La Jolla, CA (S.R.S.)
| | - Steven R Steinhubl
- From the Cardiology Division, Department of Medicine, Massachusetts General Hospital (S.E.), Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital (D.L.B., L.M.), Smith Center for Outcomes Research in Cardiology, Department of Medicine, Beth-Israel Deaconess Medical Center (R.W.Y.), Harvard Medical School, Boston, MA (S.E., D.L.B., R.W.Y., L.M.); Baim Institute for Clinical Research, Boston, MA (S.E., G.D., Y.L., W.-H.H., R.W.Y., L.M.); Department of Biostatistics, Boston University School of Public Health, MA (G.D.); University of British Columbia, Vancouver, Canada (O.R.B.); Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada (S.J.C., S.Y.); and Scripps Translational Science Institute, La Jolla, CA (S.R.S.)
| | - Yuyin Liu
- From the Cardiology Division, Department of Medicine, Massachusetts General Hospital (S.E.), Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital (D.L.B., L.M.), Smith Center for Outcomes Research in Cardiology, Department of Medicine, Beth-Israel Deaconess Medical Center (R.W.Y.), Harvard Medical School, Boston, MA (S.E., D.L.B., R.W.Y., L.M.); Baim Institute for Clinical Research, Boston, MA (S.E., G.D., Y.L., W.-H.H., R.W.Y., L.M.); Department of Biostatistics, Boston University School of Public Health, MA (G.D.); University of British Columbia, Vancouver, Canada (O.R.B.); Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada (S.J.C., S.Y.); and Scripps Translational Science Institute, La Jolla, CA (S.R.S.)
| | - Wen-Hua Hsieh
- From the Cardiology Division, Department of Medicine, Massachusetts General Hospital (S.E.), Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital (D.L.B., L.M.), Smith Center for Outcomes Research in Cardiology, Department of Medicine, Beth-Israel Deaconess Medical Center (R.W.Y.), Harvard Medical School, Boston, MA (S.E., D.L.B., R.W.Y., L.M.); Baim Institute for Clinical Research, Boston, MA (S.E., G.D., Y.L., W.-H.H., R.W.Y., L.M.); Department of Biostatistics, Boston University School of Public Health, MA (G.D.); University of British Columbia, Vancouver, Canada (O.R.B.); Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada (S.J.C., S.Y.); and Scripps Translational Science Institute, La Jolla, CA (S.R.S.)
| | - Robert W Yeh
- From the Cardiology Division, Department of Medicine, Massachusetts General Hospital (S.E.), Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital (D.L.B., L.M.), Smith Center for Outcomes Research in Cardiology, Department of Medicine, Beth-Israel Deaconess Medical Center (R.W.Y.), Harvard Medical School, Boston, MA (S.E., D.L.B., R.W.Y., L.M.); Baim Institute for Clinical Research, Boston, MA (S.E., G.D., Y.L., W.-H.H., R.W.Y., L.M.); Department of Biostatistics, Boston University School of Public Health, MA (G.D.); University of British Columbia, Vancouver, Canada (O.R.B.); Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada (S.J.C., S.Y.); and Scripps Translational Science Institute, La Jolla, CA (S.R.S.)
| | - Laura Mauri
- From the Cardiology Division, Department of Medicine, Massachusetts General Hospital (S.E.), Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital (D.L.B., L.M.), Smith Center for Outcomes Research in Cardiology, Department of Medicine, Beth-Israel Deaconess Medical Center (R.W.Y.), Harvard Medical School, Boston, MA (S.E., D.L.B., R.W.Y., L.M.); Baim Institute for Clinical Research, Boston, MA (S.E., G.D., Y.L., W.-H.H., R.W.Y., L.M.); Department of Biostatistics, Boston University School of Public Health, MA (G.D.); University of British Columbia, Vancouver, Canada (O.R.B.); Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada (S.J.C., S.Y.); and Scripps Translational Science Institute, La Jolla, CA (S.R.S.).
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