Dietary intake of vitamin C and gastric cancer: a pooled analysis within the Stomach cancer Pooling (StoP) Project

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2024年3月4日

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Michele Sassano,
Monireh Sadat Seyyedsalehi,
Giulia Collatuzzo,
Claudio Pelucchi,
Rossella Bonzi,
Monica Ferraroni,
Domenico Palli,
Guo-Pei Yu,
Zuo-Feng Zhang,
Lizbeth López-Carrillo,
Nuno Lunet,
Samantha Morais,
David Zaridze,
Dmitry Maximovich,
Vicente Martín,
Gemma Castano-Vinyals,
Jesús Vioque,
Sandra González-Palacios,
Mary H. Ward,
Reza Malekzadeh,
Mohammadreza Pakseresht,
Raul Ulises Hernández-Ramirez,
Malaquias López-Cervantes,
Eva Negri,
Federica Turati,
Charles S. Rabkin,
Shoichiro Tsugane,
Akihisa Hidaka,
Areti Lagiou,
Pagona Lagiou,
M. Constanza Camargo,
Maria Paula Curado,
Stefania Boccia,
Carlo La Vecchia,
Paolo Boffetta

摘要

Background

Previous studies suggest that dietary vitamin C is inversely associated with gastric cancer (GC), but most of them did not consider intake of fruit and vegetables. Thus, we aimed to evaluate this association within the Stomach cancer Pooling (StoP) Project, a consortium of epidemiological studies on GC.

Methods

Fourteen case–control studies were included in the analysis (5362 cases, 11,497 controls). We estimated odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for the association between dietary intake of vitamin C and GC, adjusted for relevant confounders and for intake of fruit and vegetables. The dose–response relationship was evaluated using mixed-effects logistic models with second-order fractional polynomials.

Results

Individuals in the highest quartile of dietary vitamin C intake had reduced odds of GC compared with those in the lowest quartile (OR: 0.64; 95% CI: 0.58, 0.72). Additional adjustment for fruit and vegetables intake led to an OR of 0.85 (95% CI: 0.73, 0.98). A significant inverse association was observed for noncardia GC, as well as for both intestinal and diffuse types of the disease. The results of the dose–response analysis showed decreasing ORs of GC up to 150–200 mg/day of vitamin C (OR: 0.54; 95% CI: 0.41, 0.71), whereas ORs for higher intakes were close to 1.0.

Conclusions

The findings of our pooled study suggest that vitamin C is inversely associated with GC, with a potentially beneficial effect also for intakes above the currently recommended daily intake (90 mg for men and 75 mg for women).