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Dietary mercury intake, the IL23R rs10889677 polymorphism, and the risk of gastric cancer in a Korean population: a hospital-based case-control study
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Ji Hyun Kim, Madhawa Gunathilake, Jeonghee Lee, Il Ju Choi, Young-Il Kim, Jeongseon Kim
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Epidemiol Health. 2024;46:e2024051. Published online May 21, 2024
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DOI: https://doi.org/10.4178/epih.e2024051
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Abstract
OBJECTIVES
Mercury can stimulate immune responses through T helper 17 (Th17). The gene <i>IL23R</i> is a key factor in Th17 function, which may also contribute to digestive tract diseases. The aim of this study was to identify the associations between dietary mercury and gastric cancer (GC) and to investigate whether the <i>IL23R</i> rs10889677 polymorphism modifies those associations.
METHODS This case-control study included 377 patients with GC and 756 healthy controls. Dietary mercury intake (total mercury and methylmercury) was assessed using a dietary heavy metal database incorporated into the food frequency questionnaire. <i>IL23R</i> genetic polymorphism rs10889677 (A>C) was genotyped. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using unconditional logistic regression models with adjustments for potential confounders.
RESULTS A higher dietary methylmercury intake was associated with an elevated risk of GC (OR for the highest vs. lowest tertile [T<sub>3</sub> vs. T<sub>1</sub>], 2.02; 95% CI, 1.41 to 2.91; p for trend <0.001). The <i>IL23R</i> rs10889677 reduced the risk of GC in individuals who carried at least 1 minor allele (OR, 0.62; 95% CI, 0.46 to 0.83; p=0.001; AC/CC vs. AA). Individuals with a C allele exhibited a lower susceptibility to GC through methylmercury intake than those with the AA genotype (OR for the T<sub>3</sub> of methylmercury and AA carriers, 2.93; 95% CI, 1.77 to 4.87; and OR for the T<sub>3</sub> of methylmercury and AC/CC genotype, 1.30; 95% CI, 0.76 to 2.21; p-interaction=0.013).
CONCLUSIONS Our findings suggest that a genetic polymorphism, rs10889677 in <i>IL23R</i>, plays a role in modifying the association between dietary methylmercury intake and the risk of GC.
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Summary
Korean summary
본 연구는 식이 수은과 위암 간의 연관성을 탐색하고, microRNA-lethal-7의 예측된 결합 부위 내에 위치한 IL23R rs10889677 다형성이 이러한 연관성에 영향을 미칠 수 있는지 규명하고자 합니다. 식이 메틸수은 섭취량에 비례하여 위암 발생 위험이 증가하는 경향이 확인되었고, IL23R rs10889677 다형성은 식이 메틸수은으로 의한 위암 발생 위험을 조절하는 인자로 작용할 수 있음을 시사합니다.
Key Message
This study aimed to investigate the associations between dietary mercury and gastric cancer (GC) and to determine whether the IL23R rs10889677 polymorphism, located within a predicted binding site for microRNA-lethal-7, may modify these associations. A higher dietary methylmercury intake was associated with an increased risk of GC, while the IL23R rs10889677 polymorphism may modify the detrimental effect of dietary methylmercury on gastric carcinogenesis.
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Dietary intake and cancer incidence in Korean adults: a systematic review and meta-analysis of observational studies
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Ji Hyun Kim, Shinyoung Jun, Jeongseon Kim
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Epidemiol Health. 2023;45:e2023102. Published online November 30, 2023
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DOI: https://doi.org/10.4178/epih.e2023102
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Abstract
Cancer is a major health burden in Korea, and dietary factors have been suggested as putative risk factors for cancer development at various sites. This study systematically reviewed the published literature investigating the associations between dietary factors and cancer incidence among Korean adults, following the Preferred Reporting Items for Systematic Reviews and Meta- Analyses guidelines. We focused on the 5 most studied cancer sites (stomach, colorectum, breast, thyroid, and cervix) as outcomes and dietary exposures with evidence levels greater than limited-suggestive according to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) panel’s judgment for any of the cancer sites. This resulted in the inclusion of 72 studies. Pooled estimates of the impact of dietary factors on cancer risk suggested protective associations of fruits and vegetables with risks for gastric cancer (GC), colorectal cancer (CRC), and breast cancer (BC) and dietary vitamin C with the risk of GC, as well as a harmful association between fermented soy products and the risk of GC. Despite the limited number of studies, we observed consistent protective associations of dietary fiber with GC and dietary fiber, coffee, and calcium with CRC. These findings are largely consistent with the WCRF/AICR expert report. However, pooled estimates for the associations of other salt-preserved foods with GC, meat with CRC, and dietary carotenoids and dairy products with BC did not reach statistical significance. Further studies with prospective designs, larger sample sizes, and diverse types of dietary factors and cancer sites are necessary.
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Summary
Korean summary
한국 성인을 대상으로 주요 암종 발생과 관련된 식이 요인을 탐색한 72개 역학연구들을 체계적으로 리뷰하고 메타 분석한 결과, 과일 및 채소는 위암, 대장암, 유방암에 대한 보호 효과가 있으며, 식이 비타민 C는 위암 예방에 도움이 된다는 결과가 확인되었다. 반면, 염장 식품 중 발효 대두 제품은 위암 발생 위험을 증가시킬 수 있다. 향후 식이 섭취와 밀접하게 관련되었으나 기존 국내 연구가 부족한 암종과 다양한 식이 요인의 영향을 탐색하는 대규모 전향적 코호트 연구가 요구된다.
Key Message
We conducted a systematic review and meta-analysis on the associations between dietary factors and cancer incidence among Korean adults. Pooled estimates suggested protective associations of fruits and vegetables with risks for gastric cancer (GC), colorectal cancer (CRC), and breast cancer (BC) and dietary vitamin C with the risk of GC, as well as a harmful association between fermented soy products and GC risk. Further research is warranted, emphasizing longitudinal designs, larger sample sizes, and a comprehensive exploration of dietary factors, with a specific focus on anatomical sites with a substantial burden of disease but understudied in the context of diet.
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