Diet and lifestyle in relation to small intestinal cancer risk: findings from the European Prospective Investigation into Cancer and Nutrition (EPIC)
Metadatos
Mostrar el registro completo del ítemEditorial
Springer Nature
Materia
Cáncer Small intestine Adenocarcinoma Carcinoid Diet Lifestyle Alcohol Smoking
Fecha
2023-06-18Referencia bibliográfica
Ersoy Guller, Z., Harewood, R.N., Weiderpass, E. et al. Diet and lifestyle in relation to small intestinal cancer risk: findings from the European Prospective Investigation into Cancer and Nutrition (EPIC). Cancer Causes Control 34, 927–937 (2023). [https://doi.org/10.1007/s10552-023-01731-w]
Patrocinador
United States National Institute of Environmental Health Sciences.Resumen
Background Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are a family of highly fluorinated aliphatic
compounds, which are widely used in commercial applications, including food packaging, textiles, and non-stick
cookware. Folate might counteract the effects of environmental chemical exposures. We aimed to explore the
relationship between blood folate biomarker concentrations and PFAS concentrations.
Methods This observational study pooled cross-sectional data from the National Health and Nutrition Examination
Survey (NHANES) 2003 to 2016 cycles. NHANES is a population-based national survey that measures the health and
nutritional status of the US general population every 2 years by means of questionnaires, physical examination, and
biospecimen collection. Folate concentrations in red blood cells and in serum, and perfluorooctanoic acid (PFOA),
perfluorooctanesulfonic acid (PFOS), perfluorononanoic acid (PFNA), and perfluorohexane sulfonic acid (PFHxS)
concentrations in serum were examined. We used multivariable regression models to assess the percentage change
in serum PFAS concentrations in relation to changes in folate biomarker concentrations. We additionally used
models with restricted cubic splines to investigate the shape of these associations.
Findings This study included 2802 adolescents and 9159 adults who had complete data on PFAS concentrations, folate
biomarkers, and covariates, were not pregnant, and had never had a cancer diagnosis at the time of the survey. The
mean age was 15·4 years (SD 2·3) for adolescents and 45·5 years (17·5) for adults. The proportion of male participants
was slightly higher in adolescents (1508 [54%] of 2802 participants) than in adults (3940 [49%] of 9159 participants). We
found negative associations between red blood cell folate concentrations and serum concentrations of PFOS (percentage
change for a 2·7 fold-increase in folate level –24·36%, 95% CI –33·21 to –14·34) and PFNA (–13·00%, –21·87 to –3·12)
in adolescents, and PFOA (–12·45%, –17·28 to –7·35), PFOS (–25·30%, –29·67 to –20·65), PFNA (–21·65%,
–26·19 to –16·82), and PFHxS (–11·70%, –17·32 to 5·70) in adults. Associations for serum folate concentrations and
PFAS were in line with those found for red blood cell folate levels, although the magnitude of the effects was lower.
Restricted cubic spline models suggested linearity of the observed associations, particularly for associations in adults.
Interpretation In this large-scale, nationally representative study, we found consistent inverse associations for most
examined serum PFAS compounds in relation to folate concentrations measured in either red blood cells or serum
among both adolescents and adults. These findings are supported by mechanistic in-vitro studies that show the
potential of PFAS to compete with folate for several transporters implicated in PFAS toxicokinetics. If confirmed in
experimental settings, these findings could have important implications for interventions to reduce the accumulated
PFAS body burden and mitigate the related adverse health effects.