Kang Wang1, Qianxue Wu2, Zhuyue Li3, Michael K Reger4, Yongfu Xiong5, Guochao Zhong6, Qing Li2, Xiang Zhang2, Hongyuan Li2, Theodoros Foukakis7, Tingxiu Xiang8, Jianjun Zhang9, Guosheng Ren10. 1. Department of Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016, China; Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Department of Oncology-Pathology, Karolinska Institutet, 17164, Stockholm, Sweden. 2. Department of Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016, China. 3. West China Hospital / West China School of Nursing, Sichuan University, Chengdu, China. 4. College of Health Professions Ferris State University, 200 Ferris Drive, VFS 300B, Big Rapids, MI, 49307, USA. 5. The First Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637007, China. 6. Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China. 7. Department of Oncology-Pathology, Karolinska Institutet, 17164, Stockholm, Sweden; Breast Center, Theme Cancer, Karolinska University Hospital, 17176, Stockholm, Sweden. 8. Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. Electronic address: xiangtx@cqmu.edu.cn. 9. Department of Epidemiology, Fairbanks School of Public Health Melvin and Bren Simon Comprehensive Cancer Center Indiana University, 1050 Wishard Boulevard, RG5118, Indianapolis, IN, 46202, USA. Electronic address: JZ21@iu.edu. 10. Department of Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016, China; Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. Electronic address: rengs726@126.com.
Abstract
BACKGROUND & AIMS: Vitamin K prevents growth and metastasis of certain cancers, but there is little evidence regarding the association between dietary vitamin K and breast cancer incidence and death. We sought to examine whether intakes of total vitamin K, phylloquinone (vitamin K1) and menaquinones (MKs) (vitamin K2) may influence risks of breast cancer incidence and death in the US population. METHODS: Herein, 2286 breast cancer cases and 207 breast cancer deaths were identified during 702,748 person-years of follow-up. Cox regression and competing risk regression were used to estimate multivariable-adjusted hazards ratios (HRs) and 95% confidence intervals (95% CIs) by dietary vitamin K intake quintile (Q) for risk of breast cancer incidence and mortality. RESULTS: After adjustment for confounders, the total MK intake was associated with an increased risk of breast cancer (HR Q5 vs Q1, 1.26; 95% CI, 1.05 to 1.52; Ptrend, 0.01) and death from breast cancer (HR Q5 vs Q1, 1.71; 95% CI, 0.97 to 3.01; Ptrend, 0.04). Non-linear positive dose-response associations with risks of breast cancer incidence and death were found for total MKs intake (Pnon-linearity<0.05). No statistically significant associations were observed between the intake of total vitamin K and phylloquinone and breast cancer. CONCLUSIONS: The present study suggests that total MK intake was associated with an altered risk of the occurrence and death of breast cancer in the general US population. If our findings are replicated in other epidemiological studies, reducing dietary intake of menaquinones may offer a novel strategy for breast cancer prevention.
BACKGROUND & AIMS:Vitamin K prevents growth and metastasis of certain cancers, but there is little evidence regarding the association between dietary vitamin K and breast cancer incidence and death. We sought to examine whether intakes of total vitamin K, phylloquinone (vitamin K1) and menaquinones (MKs) (vitamin K2) may influence risks of breast cancer incidence and death in the US population. METHODS: Herein, 2286 breast cancer cases and 207 breast cancer deaths were identified during 702,748 person-years of follow-up. Cox regression and competing risk regression were used to estimate multivariable-adjusted hazards ratios (HRs) and 95% confidence intervals (95% CIs) by dietary vitamin K intake quintile (Q) for risk of breast cancer incidence and mortality. RESULTS: After adjustment for confounders, the total MK intake was associated with an increased risk of breast cancer (HR Q5 vs Q1, 1.26; 95% CI, 1.05 to 1.52; Ptrend, 0.01) and death from breast cancer (HR Q5 vs Q1, 1.71; 95% CI, 0.97 to 3.01; Ptrend, 0.04). Non-linear positive dose-response associations with risks of breast cancer incidence and death were found for total MKs intake (Pnon-linearity<0.05). No statistically significant associations were observed between the intake of total vitamin K and phylloquinone and breast cancer. CONCLUSIONS: The present study suggests that total MK intake was associated with an altered risk of the occurrence and death of breast cancer in the general US population. If our findings are replicated in other epidemiological studies, reducing dietary intake of menaquinones may offer a novel strategy for breast cancer prevention.
Authors: Claire R Palmer; Jamie W Bellinge; Frederik Dalgaard; Marc Sim; Kevin Murray; Emma Connolly; Lauren C Blekkenhorst; Catherine P Bondonno; Kevin D Croft; Gunnar Gislason; Anne Tjønneland; Kim Overvad; Carl Schultz; Joshua R Lewis; Jonathan M Hodgson; Nicola P Bondonno Journal: Eur J Epidemiol Date: 2021-09-30 Impact factor: 8.082