title: Carotenoid intake and risk of non-Hodgkin lymphoma: a systematic review and dose-response meta-analysis of observational studies.
abstract: Carotenoids may play a protective role in the development of non-Hodgkin lymphoma (NHL), but findings from epidemiological studies on the associations between carotenoid intake and NHL risk are inconsistent. We therefore performed a meta-analysis to systemically evaluate the associations. Eligible studies were identified by a search of PubMed, Web of Science, Embase, and article reference lists. We pooled risk estimates from individual studies using a random-effect model to quantify the associations between intakes of specific carotenoids and NHL risk. A total of 10 (7 case-control and 3 cohort) studies met our inclusion criteria. In the highest versus lowest analyses, intakes of alpha-carotene, beta-carotene, and lutein/zeaxanthin, but not lycopene or beta-cryptoxanthin, were associated with a significant reduced risk of NHL. The estimated summary relative risks (95% confidence intervals) for alpha-carotene, beta-carotene, and lutein/zeaxanthin were 0.87 (0.78-0.97), 0.80 (0.68-0.94), and 0.82 (0.69-0.97), respectively. Subgroup analyses showed that evidence supporting these protective associations was mostly based on studies with a case-control design. In addition, intakes of alpha-carotene and beta-carotene were associated with a significant decreased risk of diffuse large B-cell lymphoma, but not follicular lymphoma or small lymphocytic lymphoma/chronic lymphocytic leukemia. There was a significant inverse dose-response relationship between alpha-carotene intake and NHL risk (13% lower risk per 1000 μg/day increment of intake). In conclusion, our findings suggest that higher intakes of alpha-carotene, beta-carotene, and lutein/zeaxanthin might protect against NHL development. Further cohort studies with a control of plausible confounding are needed to confirm these associations.
authors.affiliation: Department of Hematology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, People's Republic of China.
authors.forename: Feifei
authors.initials: F
authors.lastname: Chen
authors.affiliation: Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China.
authors.forename: Jiyi
authors.initials: J
authors.lastname: Hu
authors.affiliation: Department of Medicine, Division of Nephrology, University of Calgary, Calgary, AB, Canada.|School of Nursing, Southwest Medical University, Luzhou, Sichuan, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Liu
authors.affiliation: Department of Hematology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, People's Republic of China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Hematology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, People's Republic of China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Wei
authors.affiliation: Department of Hematology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, People's Republic of China. liu.peng@zs-hospital.sh.cn.
authors.forename: Peng
authors.initials: P
authors.lastname: Liu
mesh_terms: D002338:Carotenoids / Q000008:administration & dosage*; D016022:Case-Control Studies; D015331:Cohort Studies; D006801:Humans; D014975:Lutein / Q000008:administration & dosage*; D008228:Lymphoma, Non-Hodgkin / Q000517:prevention & control*; D064887:Observational Studies as Topic; D011379:Prognosis; D012307:Risk Factors; D065146:Zeaxanthins / Q000008:administration & dosage*; D019207:beta Carotene / Q000008:administration & dosage*
chemical_list: D065146:Zeaxanthins; D019207:beta Carotene; D002338:Carotenoids; C041635:alpha-carotene; D014975:Lutein
keywords: Carotenoids; Dose-response; Meta-analysis; Non-Hodgkin lymphoma; Risk