J Acad Nutr Diet. 2019 May;119(5):769-781. doi: 10.1016/j.jand.2018.11.017. Epub 2019 Jan 31.
Evidence from epidemiologic studies has been inconsistent regarding the role of vitamin E in cancer incidence risk.
The aim of this study was to evaluate the prospective association between baseline plasma vitamin E levels and subsequent cancer risk in Chinese adults with hypertension, and to identify effect modifiers.
A nested, case-control study was conducted from 20,702 hypertensive participants in the China Stroke Primary Prevention Trial, a randomized, double-blind, controlled trial, conducted from May 2008 to August 2013.
The current study included 229 new cancer cases and 229 controls matched for age (±1 year), sex, treatment group, and study site.
Plasma vitamin E was measured by liquid chromatography with tandem quadrupole mass spectrometers and plasma selenium was measured by inductively coupled plasma mass spectrometry using Thermo Fisher iCAP Q ICP-MS.
Odds ratios (OR) of cancer in relation to plasma concentrations of vitamin E were calculated using conditional logistic regression models.
Median follow-up duration was 4.5 years. Overall, vitamin E was not associated with subsequent risk of total cancer (per 1-mg/L [2.3 μmol/L] increase: OR 1.01, 95% CI 0.93 to 1.09) and non-gastrointestinal cancer (OR 1.10, 95% CI 0.98 to 1.24). However, there was a significant, inverse association between vitamin E and gastrointestinal cancer (OR 0.86, 95% CI 0.75 to 0.99), particularly esophageal cancer (OR 0.67, 95% CI 0.48 to 0.95). Moreover, high vitamin E decreased the risk of total cancer (OR 0.91, 95% CI 0.84 to 0.99) and gastrointestinal cancer (OR 0.83, 95% CI 0.73 to 0.95) among patients with high selenium levels (median≥83.7 μg/L [1.1 μmol/L]), and increased the risk of total cancer (OR 1.13, 95% CI 1.00 to 1.26) and non-gastrointestinal cancer (OR 1.25, 95% CI 1.03 to 1.50) among those with low selenium levels (<83.7 μg/L [1.1 μmol/L]).
This study suggests that higher levels of plasma vitamin E are associated with reduced risk of gastrointestinal cancer. High vitamin E decreased the risk of total cancer among patients with high selenium levels, but increased the risk of total cancer among those with low selenium levels.
来自流行病学研究的证据表明，维生素 E 在癌症发病风险中的作用不一致。
本研究旨在评估中国高血压患者基线血浆维生素 E 水平与随后癌症风险之间的前瞻性关联，并确定其效应修饰因子。
这是一项嵌套病例对照研究，来自中国脑卒中一级预防试验（China Stroke Primary Prevention Trial）的 20702 名高血压参与者，这是一项随机、双盲、对照试验，于 2008 年 5 月至 2013 年 8 月进行。
当前研究包括 229 例新发癌症病例和 229 例年龄（±1 岁）、性别、治疗组和研究地点相匹配的对照。
采用液相色谱-串联四级杆质谱联用仪测定血浆维生素 E 水平，采用电感耦合等离子体质谱法（inductively coupled plasma mass spectrometry）测定血浆硒水平，使用 Thermo Fisher iCAP Q ICP-MS 进行分析。
采用条件逻辑回归模型计算癌症与血浆维生素 E 浓度之间的比值比（OR）。
中位随访时间为 4.5 年。总体而言，维生素 E 与总癌症（每增加 1mg/L[2.3μmol/L]：OR1.01，95%CI0.93 至 1.09）和非胃肠道癌症（OR1.10，95%CI0.98 至 1.24）的后续风险无关。然而，维生素 E 与胃肠道癌症（OR0.86，95%CI0.75 至 0.99），特别是食管癌（OR0.67，95%CI0.48 至 0.95）之间存在显著的负相关。此外，高维生素 E 降低了高硒水平（中位数≥83.7μg/L[1.1μmol/L]）患者的总癌症（OR0.91，95%CI0.84 至 0.99）和胃肠道癌症（OR0.83，95%CI0.73 至 0.95）的风险，并增加了低硒水平（<83.7μg/L[1.1μmol/L]）患者的总癌症（OR1.13，95%CI1.00 至 1.26）和非胃肠道癌症（OR1.25，95%CI1.03 至 1.50）的风险。
本研究表明，较高水平的血浆维生素 E 与降低胃肠道癌症风险有关。高维生素 E 降低了高硒水平患者的总癌症风险，但增加了低硒水平患者的总癌症风险。
