Association between dietary vitamin C and risk of cutaneous melanoma in a population of Northern Italy

Malavolti M, Malagoli C, Fiorentini C, Longo C, Farnetani F, Ricci C, Albertini G, Lanzoni A, Reggiani C, Virgili A, Pagliarello C, Santini M, Fanti PA, Dika E, Sieri S, Krogh V, Pellacani G, Vinceti M.

Int J Vitam Nutr Res. 2013;83(5):291-8. PMID:25305224

Abstract

Cutaneous melanoma incidence has been increasing during the last few years, and diet has been suggested as one of the lifestyle factors responsible for this increase. Since antioxidant nutrients such as ascorbic acid might prevent skin carcinogenesis, we investigated the risk of cutaneous melanoma related to vitamin C intake in a population-based case-control study in Northern Italy based on 380 melanoma patients and 719 matched controls, to whom we administered a semiquantitative food-frequency questionnaire. After adjusting for potential confounders, odds ratio of melanoma were 0.86 (95 % confidence interval 0.65 - 1.15) and 0.59 (95 % confidence interval 0.37 - 0.94) in the intermediate and highest categories of vitamin C dietary intake respectively, compared with the bottom one. The association between vitamin C and decreased risk persisted after adjustment for some potential confounders. In age- and gender-stratified analyses, this association was seen in young females (< 60 years old), and was found to be enhanced in subjects with phototypes II and III. These results suggest a possible protective activity of vitamin C intake against cutaneous melanoma in specific subgroups of this population of Northern Italy.

 

Toenail selenium and risk of type 2 diabetes: the ORDET cohort study

Vinceti M, Grioni S, Alber D, Consonni D, Malagoli C, Agnoli C, Malavolti M, Pala V, Krogh V, Sieri S.

J Trace Elem Med Biol. 2014 Aug 4. pii: S0946-672X(14)00148-5. PMID: 25169979

Abstract

Epidemiologic studies, particularly randomized controlled trials, have shown a direct relation between dietary and environmental exposure to the metalloid selenium and risk of type 2 diabetes. We investigated the association between baseline toenail selenium levels and diabetes occurrence in a case-control study nested in ORDET, a population-based female cohort in Northern Italy. After a median follow-up of 16 years, we identified 226 cases of type 2 diabetes cases and 395 age-matched control women with available toenail samples at baseline. The multivariate odds ratios of diabetes in increasing a priori defined categories of toenail selenium exposure were 1.09 (95% confidence interval 0.61, 1.96), 0.71 (0.38, 1.34) and 1.14 (0.46, 2.80) compared with the lowest category. The results were not substantially altered when quartile distribution of toenail selenium in controls was used to define exposure categories. Spline regression analysis did not show homogeneous risk trends. Overall, we did not find an association between toenail selenium and subsequent development of diabetes. Since the diabetogenic activity of selenium is strongly supported by experimental studies and some observational investigations, our null results might be explained by the limitations of overall selenium toenail content to assess environmental exposure to selenium species of etiologic relevance in the study population.

Risk of birth defects associated with maternal pregestational diabetes

Vinceti M, Malagoli C, Rothman KJ, Rodolfi R, Astolfi G, Calzolari E, Puccini A, Bertolotti M, Lunt M, Paterlini L, Martini M, Nicolini F.

Eur J Epidemiol. 2014 Jun;29(6):411-8. PMID: 24861339

Abstract

Maternal diabetes preceding pregnancy may increase the risk of birth defects in the offspring, but not all studies confirm this association, which has shown considerable variation over time, and the effect of having type 1 versus type 2 diabetes is unclear. We conducted a population-based cohort study in the Northern Italy Emilia-Romagna region linking administrative databases with a Birth Defects Registry. From hospital discharge records we identified all diabetic pregnancies during 1997-2010, and a population of non-diabetic parturients matched for age, residence, year and delivery hospital. We collected available information on education, smoking and drug prescriptions, from which we inferred the type of diabetes. We found 62 malformed infants out of 2,269 births among diabetic women, and 162 out of 10,648 births among non-diabetic women. The age-standardized prevalence ratio (PR) of malformation associated with maternal pregestational diabetes was 1.79 (95 % confidence interval 1.34-2.39), a value that varied little by age. Type of diabetes strongly influenced the PR, with higher values related to type 2 diabetic women. Most major subgroups of anomalies had PRs above 1, including cardiovascular, genitourinary, musculoskeletal, and chromosomal abnormalities. There was an unusually high PR for the rare defect 'extra-ribs', but it was based on only two cases. This study indicates that maternal pregestational type 2 diabetes is associated with a higher prevalence of specific birth defects in offspring, whereas for type 1 diabetic mothers, particularly in recent years, the association was unremarkable.

Selenium for preventing cancer

Vinceti M, Dennert G, Crespi CM, Zwahlen M, Brinkman M, Zeegers MP, Horneber M, D'Amico R, Del Giovane C.

Cochrane Database Syst Rev. 2014 Mar 30;3:CD005195. PMID: 24683040

Abstract

BACKGROUND:This review is an update of the first Cochrane publication on selenium for preventing cancer (Dennert 2011).Selenium is a metalloid with both nutritional and toxicological properties. Higher selenium exposure and selenium supplements have been suggested to protect against several types of cancers.

OBJECTIVES: Two research questions were addressed in this review: What is the evidence for:1. an aetiological relation between selenium exposure and cancer risk in humans? and2. the efficacy of selenium supplementation for cancer prevention in humans?

SEARCH METHODS: We conducted electronic searches of the Cochrane Central Register of Controlled Trials (CENTRAL, 2013, Issue 1), MEDLINE (Ovid, 1966 to February 2013 week 1), EMBASE (1980 to 2013 week 6), CancerLit (February 2004) and CCMed (February 2011). As MEDLINE now includes the journals indexed in CancerLit, no further searches were conducted in this database after 2004.

SELECTION CRITERIA: We included prospective observational studies (cohort studies including sub-cohort controlled studies and nested case-control studies) and randomised controlled trials (RCTs) with healthy adult participants (18 years of age and older).

DATA COLLECTION AND ANALYSIS: For observational studies, we conducted random effects meta-analyses when five or more studies were retrieved for a specific outcome. For RCTs, we performed random effects meta-analyses when two or more studies were available. The risk of bias in observational studies was assessed using forms adapted from the Newcastle-Ottawa Quality Assessment Scale for cohort and case-control studies; the criteria specified in the Cochrane Handbook for Systematic Reviews of Interventions were used to evaluate the risk of bias in RCTs.

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Mercury and selenium intake by seafood from the Ionian Sea: A risk evaluation

Copat C, Vinceti M, D'Agati MG, Arena G, Mauceri V, Grasso A, Fallico R, Sciacca S, Ferrante M.

Ecotoxicol Environ Saf. 2014 Feb;100:87-92. PMID: 24433795

Abstract

The subject of the present study is the evaluation of the concentrations of mercury (Hg) and selenium (Se) in fish and shellfish from the Gulf of Catania (Ionian Sea) and the assessment of related risk-based consumption limits per single contaminant in adults and children. In contrast to the potential harm from Hg, Se is an essential element that is normally found in high levels in seafood. If the amount of Hg is high enough, it could bind Se and irreversibly inhibit selenium-dependent enzymes. Thus, adequate levels of Se need to be available to replace the amount of Se lost to Hg sequestration, thereby maintaining normal selenoprotein synthesis. Hg analysis was conducted using a flow injection analysis system coupled with an atomic adsorption spectrometer, and Se analysis was conducted using an inductively coupled plasma mass spectrometry (ICP-MS). Of the trace elements investigated, only Hg has a limit set by the European Community for human consumption, and this was never exceeded. Nevertheless, based on Target Hazard Quotient (THQ) over 1, and on the Estimated Daily Intake per meal (EDIm) higher than the Provisional Tolerable Intake (PTI) suggested by the Joint FAO/WHO Expert Committee on Food Additive (JECFA), Hg oral exposure derived from consumption of the benthonic fish and of the bigger pelagic fish species analyzed, could follow the occurrence of systemic effects. Se was found always in molar excess respect to Hg in all pelagic fish and in the shellfish, nearly equimolar in the benthonic fish. Determining the evidence that foods, such as pelagic fish, with high molar excess of Se, could contribute to replace the amount of Se bound to Hg and thereby maintaining normal selenoprotein synthesis, is useful for a better understanding of the seafood safety. 

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