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Dietary Nitrates, Nitrites, and Nitrosamines Intake and the Risk of Gastric Cancer: A Meta-Analysis.

Abstract

The potential associations between dietary consumption of nitrates, nitrites, and nitrosamines and gastric cancer risk have been investigated by several studies, but yielded inconclusive results. We conducted a meta-analysis to provide a quantitative assessment of their relationships. Relevant articles were identified by a systematic literature searching of PubMed and Embase databases prior to August 2015. Random-effects models were employed to pool the relative risks. A total of 22 articles consisting of 49 studies-19 studies for nitrates, 19 studies for nitrites, and 11 studies for N-nitrosodimethylamine (NDMA)-were included. The summary relative risk of stomach cancer for the highest categories, compared with the lowest, was 0.80 (95% confidence interval (CI), 0.69-0.93) for dietary nitrates intake, 1.31 (95% CI, 1.13-1.52) for nitrites, and 1.34 (95% CI, 1.02-1.76) for NDMA (p for heterogeneity was 0.015, 0.013 and <0.001, respectively). The study type was found as the main source of heterogeneity for nitrates and nitrites. The heterogeneity for NDMA could not be eliminated completely through stratified analysis. Although significant associations were all observed in case-control studies, the cohort studies still showed a slight trend. The dose-response analysis indicated similar results as well. High nitrates intake was associated with a weak but statistically significant reduced risk of gastric cancer. Whereas increased consumption of nitrites and NDMA seemed to be risk factors for cancer. Due to the lack of uniformity for exposure assessment across studies, further prospective researches are warranted to verify these findings.

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  • Authors+Show Affiliations

    ,

    Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China. pengsong90@126.com.

    ,

    Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China. leiwu90@gmail.com.

    Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China. wenxian_guan@126.com.

    Source

    Nutrients 7:12 2015 Dec 01 pg 9872-95

    MeSH

    Diet
    Humans
    Meat
    Nitrates
    Nitrites
    Nitrosamines
    Stomach Neoplasms

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't
    Review

    Language

    eng

    PubMed ID

    26633477

    Citation

    Song, Peng, et al. "Dietary Nitrates, Nitrites, and Nitrosamines Intake and the Risk of Gastric Cancer: a Meta-Analysis." Nutrients, vol. 7, no. 12, 2015, pp. 9872-95.
    Song P, Wu L, Guan W. Dietary Nitrates, Nitrites, and Nitrosamines Intake and the Risk of Gastric Cancer: A Meta-Analysis. Nutrients. 2015;7(12):9872-95.
    Song, P., Wu, L., & Guan, W. (2015). Dietary Nitrates, Nitrites, and Nitrosamines Intake and the Risk of Gastric Cancer: A Meta-Analysis. Nutrients, 7(12), pp. 9872-95. doi:10.3390/nu7125505.
    Song P, Wu L, Guan W. Dietary Nitrates, Nitrites, and Nitrosamines Intake and the Risk of Gastric Cancer: a Meta-Analysis. Nutrients. 2015 Dec 1;7(12):9872-95. PubMed PMID: 26633477.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Dietary Nitrates, Nitrites, and Nitrosamines Intake and the Risk of Gastric Cancer: A Meta-Analysis. AU - Song,Peng, AU - Wu,Lei, AU - Guan,Wenxian, Y1 - 2015/12/01/ PY - 2015/09/22/received PY - 2015/11/11/revised PY - 2015/11/16/accepted PY - 2015/12/4/entrez PY - 2015/12/4/pubmed PY - 2016/9/16/medline KW - diet KW - gastric cancer KW - nitrates KW - nitrites KW - nitrosamines SP - 9872 EP - 95 JF - Nutrients JO - Nutrients VL - 7 IS - 12 N2 - The potential associations between dietary consumption of nitrates, nitrites, and nitrosamines and gastric cancer risk have been investigated by several studies, but yielded inconclusive results. We conducted a meta-analysis to provide a quantitative assessment of their relationships. Relevant articles were identified by a systematic literature searching of PubMed and Embase databases prior to August 2015. Random-effects models were employed to pool the relative risks. A total of 22 articles consisting of 49 studies-19 studies for nitrates, 19 studies for nitrites, and 11 studies for N-nitrosodimethylamine (NDMA)-were included. The summary relative risk of stomach cancer for the highest categories, compared with the lowest, was 0.80 (95% confidence interval (CI), 0.69-0.93) for dietary nitrates intake, 1.31 (95% CI, 1.13-1.52) for nitrites, and 1.34 (95% CI, 1.02-1.76) for NDMA (p for heterogeneity was 0.015, 0.013 and <0.001, respectively). The study type was found as the main source of heterogeneity for nitrates and nitrites. The heterogeneity for NDMA could not be eliminated completely through stratified analysis. Although significant associations were all observed in case-control studies, the cohort studies still showed a slight trend. The dose-response analysis indicated similar results as well. High nitrates intake was associated with a weak but statistically significant reduced risk of gastric cancer. Whereas increased consumption of nitrites and NDMA seemed to be risk factors for cancer. Due to the lack of uniformity for exposure assessment across studies, further prospective researches are warranted to verify these findings. SN - 2072-6643 UR - https://www.unboundmedicine.com/medline/citation/26633477/full_citation L2 - http://www.mdpi.com/resolver?pii=nu7125505 DB - PRIME DP - Unbound Medicine ER -