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Dietary intake of advanced glycation endproducts and risk of hepatobiliary cancers: A multinational cohort study
Author(s) -
Mayén AnaLucia,
Aglago Elom K.,
Knaze Viktoria,
Cordova Reynalda,
Schalkwijk Casper G.,
Wagner KarlHeinz,
Aleksandrova Krasimira,
Fedirko Veronika,
KeskiRahkonen Pekka,
Leitzmann Michael F.,
Katzke Verena,
Srour Bernard,
Schulze Matthias B.,
Masala Giovanna,
Krogh Vittorio,
Panico Salvatore,
Tumino Rosario,
BuenodeMesquita Bas,
Brustad Magritt,
Agudo Antonio,
Chirlaque López María Dolores,
Amiano Pilar,
Ohlsson Bodil,
Ramne Stina,
Aune Dagfinn,
Weiderpass Elisabete,
Jenab Mazda,
Freisling Heinz
Publication year - 2021
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.33612
Subject(s) - medicine , hazard ratio , gastroenterology , gallbladder cancer , hepatocellular carcinoma , cancer , prospective cohort study , gallbladder , cohort , proportional hazards model , liver cancer , confidence interval
Advanced glycation endproducts (AGEs) may contribute to liver carcinogenesis because of their proinflammatory and prooxidative properties. Diet is a major source of AGEs, but there is sparse human evidence on the role of AGEs intake in liver cancer etiology. We examined the association between dietary AGEs and the risk of hepatobiliary cancers in the European Prospective Investigation into Cancer and Nutrition prospective cohort (n = 450 111). Dietary intake of three AGEs, N ε ‐[carboxymethyl]lysine (CML), N ε ‐[1‐carboxyethyl]lysine (CEL) and N δ ‐[5‐hydro‐5‐methyl‐4‐imidazolon‐2‐yl]‐ornithine (MG‐H1), was estimated using country‐specific dietary questionnaires linked to an AGEs database. Cause‐specific hazard ratios (HR) and their 95% confidence intervals (CI) for associations between dietary AGEs and risk of hepatocellular carcinoma (HCC), gallbladder and biliary tract cancers were estimated using multivariable Cox proportional hazard regression. After a median follow‐up time of 14.9 years, 255 cases of HCC, 100 cases of gallbladder cancer and 173 biliary tract cancers were ascertained. Higher intakes of dietary AGEs were inversely associated with the risk of HCC (per 1 SD increment, HR‐ CML = 0.87, 95% CI: 0.76‐0.99, HR‐ CEL = 0.84, 95% CI: 0.74‐0.96 and HR‐ MH‐G1 = 0.84, 95% CI: 0.74‐0.97). In contrast, positive associations were observed with risk of gallbladder cancer (per 1 SD, HR‐ CML = 1.28, 95% CI: 1.05‐1.56, HR‐ CEL = 1.17; 95% CI: 0.96‐1.40, HR‐ MH‐G1 = 1.27, 95% CI: 1.06‐1.54). No associations were observed for cancers of the intra and extrahepatic bile ducts. Our findings suggest that higher intakes of dietary AGEs are inversely associated with the risk of HCC and positively associated with the risk of gallbladder cancer.