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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Gastric cancer in Zambian adults: A prospective case-control study that assessed dietary intake and antioxidant status by using urinary isoprostane excretion
American Journal of Clinical Nutrition, Volume 97, No. 5, Year 2013
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Description
Background: Gastric cancer is increasingly recognized in Zambia. Although nutritional factors contribute to gastric cancer risk, their effect in Zambia is unknown. Objective: The objective was to investigate the association between intake of dietary antioxidants, urinary 8-iso prostaglandin F2a (8-iso PGF2a) as a marker of oxidative stress, and gastric cancer. Design: This was a case-control study at the University Teaching Hospital in Zambia. Gastric cancer cases were compared with ageand sex-matched controls. Urine 8-iso PGF2a was measured primarily by ELISA, and by gas chromatography-mass spectrometry in a subset, expressed as a ratio to creatinine. Blood was collected for Helicobacter pylori, HIV serology, gastrin-17, and pepsinogen 1 and 2 concentrations. Clinical and dietary data were collected by using questionnaires. Food items were broadly classified into 7 major categories (fruit, vegetables, fish, meat, insects, cereals, and starches). Results: Fifty cases with gastric cancer (mean age: 61 y; n = 31 males) and 90 controls (mean age: 54 y; n = 41 males) were enrolled. Median urinary 8-iso PGF2a excretion was higher in cases (0.014; IQR: 0.008-0.021) than in controls (0.011; IQR: 0.006-0.018; P = 0.039). On univariate analysis, habitual fruit intake was lower in cases than in controls during the dry season (P = 0.02). On multivariate analysis, smoking (OR: 7.22; IQR: 1.38-37.9) and gastric atrophy (OR: 2.43; IQR: 1.12-5.13) were independently associated with cancer, and higher fruit intake was protective (OR: 0.44; IQR: 0.20-0.95). Isoprostane excretion was inversely correlated with total fruit intake (r = 20.23; n = 140; P = 0.006). Conclusion: Urinary 8-iso PGF2a excretion was associated with the risk of gastric cancer, as were smoking and gastric atrophy, but increased fruit intake conferred protection. This trial was registered at www. pactr.org as ISRCTN52971746. © 2013 American Society for Nutrition.
Authors & Co-Authors
Asombang, Akwi Wasi
United States, Hershey
Division of Gastroenterology
United States
Tropical Gastroenterology and Nutrition Group
Kayamba, Violet
Unknown Affiliation
Mwanza-Lisulo, Mpala
United States
Tropical Gastroenterology and Nutrition Group
Colditz, Graham A.
United States, Winston Salem
Division of Public Health Sciences
Mudenda, Victor C.
Zambia, Lusaka
University of Zambia School of Medicine
Yarasheski, Kevin E.
United States, Rochester
Metabolism
Chott, Robert
United States, Rochester
Metabolism
Rubin, Deborah C.
United States, Hershey
Division of Gastroenterology
United States, St. Louis
Washington University School of Medicine in St. Louis
Gyawali, C. Prakash
United States, Hershey
Division of Gastroenterology
Sinkala, Edford
United States
Tropical Gastroenterology and Nutrition Group
Mwanamakondo, Stayner
United States
Tropical Gastroenterology and Nutrition Group
Anderson-Spearie, Catherine
United States, Winston Salem
Division of Public Health Sciences
Kelly, Paul M.
Zambia, Lusaka
University of Zambia School of Medicine
United Kingdom, London
Barts and the London School of Medicine and Dentistry
Statistics
Citations: 24
Authors: 13
Affiliations: 7
Identifiers
Doi:
10.3945/ajcn.112.051284
ISSN:
00029165
e-ISSN:
19383207
Research Areas
Cancer
Food Security
Health System And Policy
Infectious Diseases
Study Design
Cohort Study
Case-Control Study
Study Locations
Zambia