4.6 Article

Association between ALDH2 and ADH1B polymorphisms, alcohol drinking and gastric cancer: a replication and mediation analysis

期刊

GASTRIC CANCER
卷 21, 期 6, 页码 936-945

出版社

SPRINGER
DOI: 10.1007/s10120-018-0823-0

关键词

Alcohol drinking; ALDH2; ADH1B; Gastric cancer; Interaction; Mediation analysis

资金

  1. Japanese Ministry of Education, Culture, Sports, Science and Technology [17015018, 221S0001]
  2. JSPS KAKENHI [16H06277, 15K08792, 26860430, 17K15841, 26253041]
  3. Ministry of Health, Labour and Welfare of Japan
  4. Cancer Bio Bank Aichi

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Background Aldehyde dehydrogenase 2 (ALDH2; rs671, Glu504Lys) and alcohol dehydrogenase 1B (ADHIB; rs1229984, His47Arg) polymorphisms have a strong impact on carcinogenic acetaldehyde accumulation after alcohol drinking. To date, however, evidence for a significant ALDH2-alcohol drinking interaction and a mediation effect of ALDH2IADHIB through alcohol drinking on gastric cancer have remained unclear. We conducted two case-control studies to validate the interaction and to estimate the mediation effect on gastric cancer. Methods We calculated odds ratios (OR) and 95% confidence intervals (CI) for ALDH2IADHIB genotypes and alcohol drinking using conditional logistic regression models after adjustment for potential confounding in the HERPACC-2 (697 cases and 1372 controls) and HERPACC-3 studies (678 cases and 678 controls). We also conducted a mediation analysis of the combination of the two studies to assess whether the effects of these polymorphisms operated through alcohol drinking or through other pathways. Results ALDH2 Lys alleles had a higher risk with increased alcohol consumption compared with ALDH2 Glu/Glu (OR for heavy drinking, 3.57; 95% CI 2.04-6.27; P for trend = 0.007), indicating a significant ALDH2-alcohol drinking interaction (P-interaction = 0.024). The mediation analysis indicated a significant positive direct effect (OR 1.67; 95% CI 1.38-2.03) and a protective indirect effect (OR 0.84; 95% CI 0.76-0.92) of the ALDH2 Lys alleles with the ALDH2-alcohol drinking interaction. No significant association of ADH1B with gastric cancer was observed. Conclusion The observed ALDH2-alcohol drinking interaction and the direct effect of ALDH2 Lys alleles may suggest the involvement of acetaldehyde in the development of gastric cancer.

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