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Il Ju Choi 1 Article
Gastric cancer risk is reduced by a predominance of antioxidant factors in the oxidative balance: a hospital-based case-control study in Korea
Jimi Kim, Jeonghee Lee, Il Ju Choi, Young-Il Kim, Jeongseon Kim
Epidemiol Health. 2022;44:e2022089.   Published online October 17, 2022
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AbstractAbstract AbstractSummary PDFSupplementary Material
Gastric carcinogenesis is linked to oxidative stress from both exogenous and endogenous exposures. This study aimed to determine the association between the risk of gastric cancer and the oxidative balance score (OBS), which comprises antioxidant and pro-oxidant factors, including diet and lifestyle.
For this hospital-based case-control study, 808 controls and 404 patients with gastric cancer who had clinical records indicating <i>Helicobacter pylori</i> infection and the histological subtype of cancer were recruited. The OBS was determined based on diet and lifestyle factors obtained from a 106-item semiquantitative food frequency questionnaire and a constructed questionnaire. Logistic regression analysis was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).
A higher OBS was associated with a reduced gastric cancer risk (OR, 0.49; 95% CI <sub>T3 vs. T1,</sub> 0.33 to 0.71; p for trend <0.001). In a subgroup analysis, antioxidant factors showed inverse associations with gastric cancer risk (OR, 0.53; 95% CI <sub>T3 vs. T1,</sub> 0.35 to 0.79; p for trend=0.003). A stronger association with antioxidant factors was observed in patients with intestinal gastric cancer (OR, 0.34; 95% CI <sub>T3 vs. T1,</sub> 0.19 to 0.62; p for trend<0.001) and those with <i>H. pylori</i> infection (OR, 0.57; 95% CI <sub>T3 vs. T1,</sub> 0.37 to 0.88; p for trend=0.014).
A predominance of antioxidant factors compared to pro-oxidant factors from diet and lifestyle reduced the risk of gastric cancer. The combined effect of oxidative stress, which involves an altered balance between antioxidants and pro-oxidants, is important for modulating the risk of gastric cancer.
Korean summary
본 연구에서는 한국인 암 발생의 상위권을 차지하는 위암 발병률에 대해 영양소, 식품, 생활습관 등 항산화와 산화촉진 요인으로 구성된 산화 균형 점수(Oxidative Balance Score)와의 연관성을 비교 분석하였습니다. 산화촉진 요인에 비해 항산화 관련 요인에서 위암 발생의 위험이 유의하게 감소함을 나타냈습니다.
Key Message
The aim of this study was to determine the association between the risk of gastric cancer and the oxidative balance score comprising antioxidant and pro-oxidants factors, including diet and lifestyle. We found that predominantly antioxidants from diet and lifestyle, in contrast to pro-oxidants, reduce the risk of gastric cancer.


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