Peanut butter intake, GSTM1 genotype and hepatocellular carcinoma: a case–control study in Sudan
Objective: Hepatocellular carcinoma (HCC) is one of the major cancers in the world. In Sudan the incidence is thought to be high and increasing. This study aims to assess the association between peanut butter intake, as a source of aflatoxins, and the GSTM1 genotype in the etiology of HCC.
Method: A case–control study was conducted among 150 patients and 205 controls from two regions in Sudan. Food habits with special reference to peanut butter consumption, as well as peanut storage systems, have been investigated, as well as confounders such as hepatitis, drinking and smoking habits, and demographic characteristics. GSTM1 genotype was assessed in DNA extracted from blood samples (110 cases, 189 controls).
Results: A positive association was observed for highest vs. lowest quartile of peanut butter intake, humid storage system and HCC, with ORs (95% CI) being 3.0 (1.6–5.5) and 1.6 (1.1–2.5) respectively. The positive association with peanut butter intake was essentially limited to subjects with GSTM1 null genotype with OR for highest vs. lowest quartile 16.7 (2.7–105).
Conclusion: Peanut butter consumption has been identified as a strong risk factor of HCC in a region with endemic aflatoxin contamination in Sudan and was essentially limited to subjects with the GSTM1 null genotype.
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- 1.Lilly VG, Bareett HL (1969) Physiology of the Fungi. New York: McGraw Hill.Google Scholar
- 2.Goldblatt LA (1969) Aflatoxin. New York: Academic Press.Google Scholar
- 3.World Health Organization Task Group on Environmental Health Criteria for Mycotoxins (1979) Mycotoxins. Environmental Health Criteria 11. Geneva: WHO, pp. 1-127.Google Scholar
- 4.Ueno Y, Ueno I (1978) Toxicity and biochemistry of mycotoxins. In: Uraguchi K, Yamazaki M, eds. Toxicology. Biochemistry and Pathology of Mycotoxins. Tokyo: Kodansha Press, pp. 107-188.Google Scholar
- 5.IARC (1993) Monographs on the Evaluation of Carcinogenic Risks to Humans in Some Naturally Occurring Substances: Food Items and Constituents, Heterocyclic Aromatic Amines and Mycotoxins. Lyon: International Agency for Research on Cancer, pp. 245-395.Google Scholar
- 6.Peers FG, Bosch X, Kaldor J, Linsell A, Pluijmen M (1987) Aflatoxin exposure, hepatitis B virus infection and liver cancer in Swaziland. Int J Cancer 39: 545-553.Google Scholar
- 7.Yeh FS, Yu MC, Mo CC, Luo S, Tong MJ, Henderson BE (1989) Hepatitis B virus, aflatoxin and hepatocellular carcinoma in Southern Guangxi, China. Cancer Res 49: 2506-2509.Google Scholar
- 8.Lunn RM, Zhang YJ, Wang LY, et al. (1997) P53 mutations, chronic hepatitis B virus infection, and aflatoxin exposure in hepatocellular carcinoma in Taiwan. Cancer Res 57: 3471-3477.Google Scholar
- 9.Omer RE (1992) Study on the Effect of Field and Storage Environments on Aflatoxin Contamination of Rahad Agricultural Scheme-Groundnut. M.Sc. thesis submitted to the University of Khartoum.Google Scholar
- 10.Habish HA, Abdulla MA (1971) The incidence of aflatoxin in Sudanese groundnuts. Trop Sci 13: 179-287.Google Scholar
- 11.Omer RE, Bakker MI, Van't Veer P, et al. (1998) Aflatoxin and liver cancer in Sudan. Nutr Cancer 32: 174-180.Google Scholar
- 12.McGlynn KA, Rosvold EA, Lustbader ED, et al. (1995) Susceptibility to hepatocellular carcinoma is associated with genetic variation in the enzymatic detoxification of Aflatoxin B1. Proc Natl Acad Sci USA 92: 2384-2387.Google Scholar
- 13.Bell DA, Thompson CL, Miller CR, et al. (1992) Genetic monitoring of human polymorphic cancer susceptibility genes by polymerase chain reaction: application to glutathione S-transferase l. Environ Health Perspect 98: 113-117.Google Scholar
- 14.Guengerich FP, Johnson WW, Ueng Y, Yamazaki H, Shimada T (1996) Involvement of cytochrome P450, glutathione S-transferase and epoxide hydrolase in the metabolism of a¯atoxin B1 and relevance to risk of human liver cancer. Environ Health Perspect 104(Suppl. 3): 557-562.Google Scholar
- 15.Rebbeck TR (1997) Molecular epidemiology of the human glutathione S-transferase genotypes GSTM1 and GSTT1 in cancer susceptibility. Cancer Epidemiol Biomarkers Prev 6: 733-743.Google Scholar
- 16.Chen CJ, Yu MW, Liaw YF, et al. (1996) Chronic hepatitis B carriers with null genotypes of glutathione S-transferase M1 and T1 polymorphisms who are exposed to aflatoxin are at increased risk of hepatocellular carcinoma. Am J Hum Genet 59: 128-134.Google Scholar
- 17.Arand M, Muhlbauer R, Hengstler J, et al. (1996) A multiplex polymerase chain reaction protocol for the simultaneous analysis of the glutathione S-transferase GSTM1 and GSTT1 polymorphisms. Anal Biochem 236: 184-186.Google Scholar
- 18.Bell DA, Taylor JA, Paulson DF, et al. (1993) Genetic risk and carcinogen exposure: a common inherited defect of the carcinogen-metabolism gene glutathione S-transferase M1 (GSTM1) that increases susceptibiltiy to bladder cancer. J Natl Cancer Inst 85: 1159-1163.Google Scholar
- 19.Zaki M (1991) Aetiological factors in HCC. Thesis, Department of Medicine, Faculty of Medicine, University of Khartoum.Google Scholar
- 20.IARC (1987) Suppl. 7. Monograph on the Evaluation of the Carcinogenic Risk of Chemicals to Humans. Aflatoxins. Lyon: International Agency for Research on Cancer, pp. 83-87.Google Scholar
- 21.Van Rensburg SJ, Cook-Mozaffari P, Van Schalkwyk DJ, Van der Watt JJ, Vincent TJ, Purchase IF (1985) Hepatocellular carcinoma in Mozambique and Transkei. Br J Cancer 51: 713-726.Google Scholar
- 22.Campbell TC, Chen J, Liu C, Li J, Parpia B (1990) Non association of aflatoxin with primary liver cancer in a cross-sectional ecological survey in the People's Republic of China. Cancer Res 50: 6882-6893.Google Scholar
- 23.Atrup H, Seremet T, Wakhisi J, Wasunna A (1987) Aflatoxin exposure measured by urinary extraction of aflatoxin B1±guanine adduct and hepatitis B virus infection in areas with different liver cancer incidence in Kenya. Cancer Res 47: 3430-3433.Google Scholar
- 24.Hatch MC, Chen CJ, Leven B, et al. (1993) Urinary aflatoxin levels of hepatitis B virus infection and hepatocellular carcinoma in Taiwan. Int J Cancer 54: 931-934.Google Scholar
- 25.Wang LY, Hach MC, Chen CJ, et al. (1996) Aflatoxin exposure and the risk of hepatocellular carcinoma in Taiwan. Int J Cancer 67: 620-625.Google Scholar
- 26.Yu MW, Lien JP, Chiu YH, et al. (1997) Effect of aflatoxin metabolism and DNA adduct formation of hepatocellular carci-noma among chronic hepatitis B carriers in Taiwan. J Hepatol 27: 320-330.Google Scholar
- 27.Ross RK, Yuan JM, Yu MC, et al. (1992) Urinary aflatoxin biomarkers and risk of hepatocellular carcinoma. Lancet 339: 943-946.Google Scholar
- 28.Qian GS, Ross RK, Yu MC, et al. (1994) A follow-up study of urinary markers of aflatoxin exposure and liver cancer risk in Shanghai, People's Republic of China. Cancer Epidemiol Bio-markers Prev 3: 3-10.Google Scholar