title: Prediagnostic serum tocopherol levels and the risk of non-hodgkin lymphoma: the multiethnic cohort.
abstract: BACKGROUND
  Compromised immunity and chronic inflammation are thought to contribute to the development of non-Hodgkin lymphoma (NHL). Because tocopherols protect cells through antioxidant mechanisms, they may play a role in NHL etiology.
  
  
  METHODS
  This nested case-control study within the Multiethnic Cohort examined the association of prediagnostic serum tocopherols levels measured in 271 NHL cases and 538 matched controls by high-pressure liquid chromatography/photodiode array detection with NHL risk. Conditional logistic regression was used to calculate ORs and 95% confidence intervals (CI).
  
  
  RESULTS
  We observed U-shaped associations with NHL for total and α-tocopherols [Ptrend < 0.01 for polynomial terms (3 df)]. The ORs (95% CI) for total tocopherols, which consisted primarily of α-tocopherol, were 0.41 (0.25-0.68), 0.52 (0.32-0.85), 0.39 (0.23-0.65), and 0.78 (0.47-1.29) for the second to fifth quintiles as compared with the first. The risk estimates were similar for α-tocopherol but nonsignificant for β- and γ-tocopherol combined and for γ-tocopherol. Adjustment for serum lipids strengthened the nonlinear associations for total and α-tocopherols. Serum total tocopherol levels were higher for vitamin E supplement users at cohort entry than nonusers (21.32 ± 9.04 vs. 17.72 ± 7.43 μg/mL; P < 0.0001), but supplement use was not associated with NHL risk. No heterogeneity in risk estimates was detected by sex, ethnicity, vitamin E supplement use, or NHL subtype.
  
  
  CONCLUSIONS
  Circulating tocopherols, at levels likely reflecting adequate dietary intakes, may be protective against NHL, whereas higher intakes from supplementation may not be beneficial.
  
  
  CONCLUSIONS
  The association between serum tocopherol levels and NHL risk provides possible new insights into the etiology of NHL.
authors.affiliation: Authors' Affiliations: University of Hawaii Cancer Center; Department of Public Health Sciences, University of Hawaii, Honolulu, Hawaii; Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; and Community and Population Health Research Institute, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Morimoto
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Ollberding
authors.forename: Robert V
authors.initials: RV
authors.lastname: Cooney
authors.forename: Lynne R
authors.initials: LR
authors.lastname: Wilkens
authors.forename: Adrian A
authors.initials: AA
authors.lastname: Franke
authors.forename: Loïc
authors.initials: L
authors.lastname: Le Marchand
authors.forename: Marc T
authors.initials: MT
authors.lastname: Goodman
authors.forename: Brenda Y
authors.initials: BY
authors.lastname: Hernandez
authors.forename: Laurence N
authors.initials: LN
authors.lastname: Kolonel
authors.forename: Gertraud
authors.initials: G
authors.lastname: Maskarinec
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D002851:Chromatography, High Pressure Liquid; D015331:Cohort Studies; D004032:Diet; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D007249:Inflammation / Q000097:blood; D016015:Logistic Models; D008137:Longitudinal Studies; D015141:Los Angeles / Q000453:epidemiology; D008228:Lymphoma, Non-Hodgkin / Q000097:blood* / Q000453:epidemiology / Q000208:ethnology; D008297:Male; D024505:Tocopherols / Q000008:administration & dosage / Q000097:blood*
chemical_list: D024505:Tocopherols
references.citation: Oncogene. 2004 Aug 23;23(38):6524-34
references.pmid: 15322522
references.citation: PLoS One. 2012;7(7):e40204
references.pmid: 22792240
references.citation: Cancer Epidemiol Biomarkers Prev. 2013 Mar;22(3):337-47
references.pmid: 23300021
references.citation: Carcinogenesis. 2010 Apr;31(4):533-42
references.pmid: 19748925
references.citation: Epidemiology. 2006 Jul;17(4):404-12
references.pmid: 16755268
references.citation: Br J Nutr. 2011 Dec;106 Suppl 3:S5-78
references.pmid: 22133051
references.citation: Int J Cancer. 2010 Feb 15;126(4):992-1003
references.pmid: 19685491
references.citation: Br J Nutr. 2001 Sep;86(3):405-14
references.pmid: 11570993
references.citation: Cancer Causes Control. 2009 Mar;20(2):211-23
references.pmid: 18821021
references.citation: Leuk Lymphoma. 2006 Dec;47(12):2477-87
references.pmid: 17169793
references.citation: J Am Coll Nutr. 2006 Aug;25(4):292-9
references.pmid: 16943450
references.citation: J Natl Cancer Inst. 1998 Mar 18;90(6):440-6
references.pmid: 9521168
references.citation: Int J Cancer. 2008 Aug 15;123(4):739-52
references.pmid: 18512238
references.citation: FASEB J. 1999 Jul;13(10):1145-55
references.pmid: 10385606
references.citation: Am J Epidemiol. 2006 Dec 15;164(12):1222-32
references.pmid: 17005624
references.citation: Am J Clin Nutr. 2001 Apr;73(4):777-85
references.pmid: 11273853
references.citation: Cancer Epidemiol Biomarkers Prev. 2009 Jul;18(7):1962-70
references.pmid: 19531680
references.citation: Cancer Epidemiol Biomarkers Prev. 1995 Apr-May;4(3):207-15
references.pmid: 7606195
references.citation: Cancer Prev Res (Phila). 2012 May;5(5):701-5
references.pmid: 22490437
references.citation: Cochrane Database Syst Rev. 2012 Mar 14;(3):CD007176
references.pmid: 22419320
references.citation: Cancer Epidemiol Biomarkers Prev. 2000 May;9(5):477-85
references.pmid: 10815692
references.citation: Am J Clin Nutr. 2006 Jun;83(6):1401-10
references.pmid: 16762953
references.citation: JAMA. 2009 Jan 7;301(1):39-51
references.pmid: 19066370
references.citation: Cancer Causes Control. 2008 Jun;19(5):491-503
references.pmid: 18204928
references.citation: Int J Cancer. 2013 Jul;133(1):190-200
references.pmid: 23238796
references.citation: Pathophysiology. 2006 Aug;13(3):143-9
references.pmid: 16814530
references.citation: Am J Clin Nutr. 1991 Mar;53(3):723-9
references.pmid: 2000827
references.citation: Am J Epidemiol. 2000 Feb 15;151(4):346-57
references.pmid: 10695593
references.citation: Public Health Nutr. 2002 Dec;5(6A):865-71
references.pmid: 12638594
references.citation: Ann Intern Med. 2005 Jan 4;142(1):37-46
references.pmid: 15537682
references.citation: Am J Epidemiol. 1989 Jan;129(1):125-37
references.pmid: 2910056
references.citation: Ann Oncol. 2006 Apr;17(4):713-8
references.pmid: 16556850
references.citation: Cancer Epidemiol Biomarkers Prev. 2007 Mar;16(3):392-5
references.pmid: 17337642
references.citation: Am J Epidemiol. 1988 Feb;127(2):283-96
references.pmid: 3257350
references.citation: JAMA. 2011 Oct 12;306(14):1549-56
references.pmid: 21990298
references.citation: Int J Cancer. 2012 Sep 1;131(5):1158-68
references.pmid: 22038870
references.citation: Cancer Epidemiol Biomarkers Prev. 2008 Jan;17(1):196-203
references.pmid: 18187389
references.citation: Cancer Causes Control. 2012 Oct;23(10):1693-703
references.pmid: 22907421
references.citation: J Chromatogr. 1993 Apr 21;614(1):43-57
references.pmid: 8496285
references.citation: Blood. 2010 Nov 18;116(20):e90-8
references.pmid: 20699439
references.citation: J Physiol Biochem. 2001 Mar;57(2):43-56
references.pmid: 11579997