Vitamin K intake and breast cancer incidence and death: results from a prospective cohort study

Kang Wang; Qianxue Wu; Zhuyue Li; Michael K Reger; Yongfu Xiong; Guochao Zhong; Qing Li; Xiang Zhang; Hongyuan Li; Theodoros Foukakis; Tingxiu Xiang; Jianjun Zhang; Guosheng Ren

doi:10.1016/j.clnu.2020.11.009

Vitamin K intake and breast cancer incidence and death: results from a prospective cohort study

Clin Nutr. 2021 May;40(5):3370-3378. doi: 10.1016/j.clnu.2020.11.009. Epub 2020 Nov 16.

Authors

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

Affiliations

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.

PMID: 33277073
DOI: 10.1016/j.clnu.2020.11.009

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; P_trend, 0.01) and death from breast cancer (HR Q5 vs Q1, 1.71; 95% CI, 0.97 to 3.01; P_trend, 0.04). Non-linear positive dose-response associations with risks of breast cancer incidence and death were found for total MKs intake (P_{non-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.

Trial registration: ClinicalTrials.gov NCT00002540 NCT01696968 NCT01696981 NCT01696994 NCT00339495.

Keywords: Breast cancer incidence; Dietary vitamin K intake; Epidemiology; Menaquinone; Mortality; Phylloquinone.

MeSH terms

Aged
Breast Neoplasms* / epidemiology
Breast Neoplasms* / mortality
Diet / statistics & numerical data*
Female
Humans
Middle Aged
Prospective Studies
Vitamin K / analysis*

Substances

Vitamin K

Associated data

ClinicalTrials.gov/NCT00002540
ClinicalTrials.gov/NCT01696968
ClinicalTrials.gov/NCT01696981
ClinicalTrials.gov/NCT01696994
ClinicalTrials.gov/NCT00339495