Gene-diet interactions in gastric cancer risk: A systematic review

Table 2 Interactive effect between carcinogen metabolism-related genetic polymorphisms and diet on gastric cancer risk

Ref.	No. case/control	Gene	Diet/Nutrient	Outcome
	(control)	(polymorphism)		Gene	Diet/nutrient	Interaction
Nishimoto et al[58], 2000, Brazil	332/528 (Hospital)	CYP2E1 (RsaI C/A)	Meat	No assoc	The frequency of meat consumption was higher in case only among Japanese, not Brazilians	No interaction
Setiawan et al[33], 2000, China	143/433(Population)	GSTT1 (null) GSTM1 (null)	Salt, fruit, alcohol	GSTT1 null vs normal: OR = 2.5 (1.01-6.22)	Fruit (P < 0.001)Alcohol (P = 0.051)	High salt intake increased GC risk only among GSTT1 null carriers.
Gao et al[42], 2002, China	98/196 (Population)	CYP2E1 (RsaI)	Meat, soybean, vegetable (pickled or raw), tomato, garlic, tea, alcohol	No assoc	Unknown	No interaction
Gao et al[46], 2002, China	153/223(Population)	GSTM1 (null)GSTT1 (null)	Tea, alcohol	No assoc	Tea drinking was a protective effect on GC risk: OR = 0.38 (0.24-0.62)	Tea consumption decreased GC risk among those with GSTT1 null genotype; frequent alcohol intake increased GC risk in those with GSTM1 positive genotype.
Boccia et al[39], 2005, Italy	76/260 (Hospital)	SULT1A1 (His/His)	Fruit, vegetable, grilled/barbecued meat, alcohol	His/His vs Arg/Arg: OR = 3.32 (1.17-9.45)	Frequency of GC was higher among those with high fruit intake (P = 0.043)	Among individuals carrying SULT1A1 His/His genotype, high fruit or grilled/barbequed meat intake increased GC risk; alcohol intake increased GC risk among those with His/His genotype.
Nan et al[35], 2005, South Korea	421/632 (Hospital)	CYP1A1 (Ile/Val) CYP2E1 (c1/c2) GSTM1 (null) GSTT1 (null) ALDH2 (*1/*2)	Kimchi, soybean paste, vegetable, allium, seafood, soybean food	CYP1A1 Val carriers vs Ile/Ile: OR = 1.34 (1.04-1.73)	Kimchi (high vs low): OR = 1.57 (1.22-2.01);Soybean pastes (high vs low): OR = 1.62 (1.26-2.09);Non-fermented alliums (high vs low): OR = 0.70 (0.54-0.89); Non-fermented seafood (high vs low): OR = 0.66 (0.51-0.85)	High intake of kimchi or soybean pastes was associated with increased GC risk among carriers with CYP1A1 Ile/Ile, CYP2E1 c1/c1, GSTT1 positive, or ALDH2 *1/*1 genotype; non-fermented alliums were associated with a decreased GC risk among carriers of CYP1A1 Ile/Ile, CYP2E1 c1/c2 or c2/c2, GSTM1 null, GSTT1 positive, or ALDH2 *1/*2 or *2/*2 genotype; non-fermented seafood was associated with a reduced GC risk among carriers with CYP1A1 Ile/Ile, CYP2E1 c1/c1, ALDH2 *1/*1 genotype.
Boccia et al[59], 2007, Italy	107/254 (Hospital)	CYP1A1 (*2A)CYP2E1 (*5A or *6)mEH (rapid, slow, very slow)GSTM1 (null)GSTT1 (null)NAT2 (slow)SULT1A1 (Arg/His, His/His)	Alcohol, fruit/vegetable, grilled meat, meals salt addition	GSTT1 null and NAT2 slow acetylators: OR = 3.00 (1.52-5.93)	Alcohol ( < 7 g/d vs≥ 7 g/d)OR = 2.10 (1.22-3.60)	Alcohol drinkers carrying the variant allele of CYP2E1 (*5A or *6 alleles) had an increased GC risk compared to those drinking without the variant allele (P for heterogeneity = 0.001)
Kobayashi et al[40], 2009, Japan	149/296 (Hospital)	NAT2 (4 SNPs) CYP1A1 (Ile462Val) CYP1A2 (5’UTR)	Grilled/barbecued meat, HCA	No assoc	No assoc	No interaction
Malik et al[60], 2009, India	108/195 (Population)	GSTM1 (null) GSTT1 (null) GSTP1 (1313Ile/Val) GSTM3 (intron 6 3-bp del) CYP1A1 (6235T/C) CYP2E1 (Rsal-1091C/T)	High salted tea	GSTM1 null vs normal: OR = 1.98 (1.22-3.21); CYP2E1 Rsal c2 vs c1: OR = 2.18 (1.12-4.24); GSTM3 intron 6 3-bp del B vs A: OR = 0.50 (0.27-0.92)	Salted tea (high vs low): OR = 14.78 (8.22-27.23)	No interaction
Piao et al[43], 2009, South Korea	2213/1699 (Population)	GSTM1 (null) GSTT1 (null)	Alcohol	No assoc	No assoc	No interaction
Zhang et al[36], 2009, South Korea	471/471 (Hospital)	NAT2 acetylator	Meat, Vt B6, Fe, nut, stew, Kimchi, soybean paste, soybean food, allium, seaweeds, alcohol	No assoc	High intake of stews, kimchi, soybean paste, sodium, well-done meat, and alcohol increased GC risk; high intake of nuts, non-fermented soybean foods, non-fermented alliums decreased GC risk.	High intake of kimchi, stews, soybean paste, and alcohol were increased GC risk in slow/intermediate acetylators.
Shin et al[44], 2011, South Korea	445/370 (Hospital)	ALDH2 (*1/*2)	Alcohol	No assoc	Ex-drinker vs never-drinker: OR = 1.68 (1.07-2.64)	There was an interaction between drinking status and ALDH2 genotype (ALDH*1/*1 vs ALDH2 *1/*2, P interaction = 0.048).
Duell et al[41], 2012, Europe	364/1272 (EPIC study; nested case-control)	ADH1A (2 SNPs)ADH1B (5 SNPs)ADH1C (9 SNPs)ADH7 (10 SNPs)ALDH2 (2 SNPs)	Alcohol	Allelic ORADH1A rs1230025: OR = 1.30 (1.07-1.59); ADH1C rs283411: OR = 0.59 (0.38-0.91); ALDH2 rs16941667: OR = 1.34 (1.00-1.79)	Alcohol (high vs low): OR = 2.37 (1.37-4.10)	Alcohol intake modified the association between ALDH1A rs1230025 and GC risk.
Zhang et al[61], 2012, China	618/1147(Population)	GSTP1 (Ile105Val)	Alcohol	Ile/Ile vs Val/Val: OR = 3.32 (1.79-6.17)	Alcohol (drinker vs nondrinker): P < 0.002	Alcohol drinking increased GC risk among Val/Val carriers compared with Ile/Ile carriers
Matsuo et al[45], 2013, Japan	697/1372 (Hospital)	ALDH2 (Glu504Lys)	Alcohol, fruit/vegetable		Alcohol (heavy vs non-drinker): OR = 1.72 (1.17-2.52)	A significant interaction between alcohol drinking and ALDH2 Lys allele (P = 0.0054)
Eom et al[37], 2013, South Korea	477/477 (Hospital)	CYP1A2 (3 SNPs)CYP2E1 (3 SNPs)EPHX1 (3 SNPs) GSTM1 (null)GSTT1 (null)	Aflatoxin B1	CYP1A2 (CT vs CC): OR = 0.72 (0.52-0.98)	Aflatoxin B1 (low vs high): OR = 1.94 (1.43-2.63)	No interaction

CYP2E1: Cytochrome P450, family 2, subfamily E, polypeptide 1; CYP1A1: Cytochrome P450, family 1, subfamily A, polypeptide 1; EPHX1: Microsomal epoxide hydrolase 1; GSTP1: Glutathione S-transferase P1; GSTT1: Glutathione S-transferase T1; GSTM1: Glutathione S-transferase M1; SULT1A1: sulfotransferase family, cytosolic, 1A, phenol-preferring, member 1; ADH: Alcohol dehydrogenase; ALDH2: Aldehyde dehydrogenase 2 family; NAT2: N-acetyltransferase 2; Fe: Iron; Vt: Vitamin; GC: Gastric cancer; No assoc: No association; HCA: Heterocyclic amine.