title: Association of serum α-tocopherol, β-carotene, and retinol with liver cancer incidence and chronic liver disease mortality.
abstract: BACKGROUND
  Micronutrients may influence the development or progression of liver cancer and liver disease. We evaluated the association of serum α-tocopherol, β-carotene, and retinol with incident liver cancer and chronic liver disease (CLD) mortality in a prospective cohort of middle-aged Finnish male smokers.
  
  
  METHODS
  Baseline and 3-year follow-up serum were available from 29,046 and 22,805 men, respectively. After 24 years of follow-up, 208 men were diagnosed with liver cancer and 237 died from CLD. Hazards ratios and 95% confidence intervals were calculated for highest vs lowest quartiles from multivariate proportional hazards models.
  
  
  RESULTS
  Higher β-carotene and retinol levels were associated with less liver cancer (β-carotene: 0.35, 0.22-0.55, P-trend <0.0001; retinol: 0.58, 0.39-0.85, P-trend=0.0009) and CLD mortality (β-carotene: 0.47, 0.30-0.75, P-trend=0.001; retinol: 0.55, 0.38-0.78, P-trend=0.0007). α-Tocopherol was associated with CLD mortality (0.63, 0.40-0.99, P-trend=0.06), but not with liver cancer (1.06, 0.64-1.74, P-trend=0.77). Participants with higher levels of β-carotene and retinol, but not α-tocopherol, at both baseline and year 3 had lower risk of each outcome than those with lower levels.
  
  
  CONCLUSIONS
  Our findings suggest that higher concentrations of β-carotene and retinol are associated with incident liver cancer and CLD. However, such data do not indicate that supplementation should be considered for these diseases.
authors.affiliation: 1] Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA [2] Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Room 6E316, Bethesda, MD 20892, USA.
authors.forename: G Y
authors.initials: GY
authors.lastname: Lai
authors.affiliation: Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Room 6E316, Bethesda, MD 20892, USA.
authors.forename: S J
authors.initials: SJ
authors.lastname: Weinstein
authors.affiliation: Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Room 6E316, Bethesda, MD 20892, USA.
authors.forename: D
authors.initials: D
authors.lastname: Albanes
authors.affiliation: Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA.
authors.forename: P R
authors.initials: PR
authors.lastname: Taylor
authors.affiliation: Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Virtamo
authors.affiliation: Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: McGlynn
authors.affiliation: Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Room 6E316, Bethesda, MD 20892, USA.
authors.forename: N D
authors.initials: ND
authors.lastname: Freedman
mesh_terms: D000368:Aged; D002908:Chronic Disease; D006801:Humans; D015994:Incidence; D008107:Liver Diseases / Q000097:blood / Q000401:mortality*; D008113:Liver Neoplasms / Q000097:blood / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D014801:Vitamin A / Q000097:blood*; D024502:alpha-Tocopherol / Q000097:blood*; D019207:beta Carotene / Q000097:blood*
chemical_list: D019207:beta Carotene; D014801:Vitamin A; D024502:alpha-Tocopherol