Association between dietary 3-monochloropropane-1,2-diol esters (3-MCPDE) and renal cancer in Peninsular Malaysia: exposure assessment and matched case-control study

Abstract

3-Monochloropropane-1,2-diol esters (3-MCPDE) are food contaminants commonly found in refined vegetable oils and fats, which have possible carcinogenic implications in humans. To investigate this clinically, we conducted an occurrence level analysis on eight categories of retail and cooked food commonly consumed in Malaysia. This was used to estimate the daily exposure level, through a questionnaire-based case-control study involving 77 subjects with renal cancer, with 80 matching controls. Adjusted Odds Ratio (AOR) was calculated using the multiple logistic regression model adjusted for confounding factors. A pooled estimate of total 3-MCPDE intake per day was compared between both groups, to assess exposure and disease outcome. Among the food categories analysed, vegetable fats and oils recorded the highest occurrence levels (mean: 1.91 ± 1.90 mg/kg), significantly more than all other food categories (p < .05). Risk estimation found the Chinese ethnic group to be five times more likely to develop renal cancer compared to Malays (AOR = 5.15, p = .001). However, an inverse association was observed as the 3-MCPDE exposure among the Malays (median: 0.162 ± 0.229 mg/day/person) were found to be significantly higher than the Chinese (p = .001). There was no significant difference (p = .405) in 3-MCPDE intake between the cases (median: 0.115 ± 0.137 mg/day/person) and controls (median: 0.105 ± 0.151 mg/day/person), with no association between high intake of 3-MCPDE and the development of renal cancer (OR = 1.41, 95% CI: 0.5091–2.5553). Thus, there was insufficient clinical evidence to suggest that this contaminant contributes to the development of renal malignancies in humans through dietary consumption. Further research is necessary to support these findings, which could have significant public health ramifications for the improvement of dietary practices and food safety measures.

Keywords:

• 3-MCPD
• renal cancer
• case control
• food safety
• food contaminant

Acknowledgement

The authors would like to thank the Director General of Health Malaysia for his permission to publish this article. We would like to acknowledge all the officers and staff involved from Herbal Medicine Research Centre, Nutrition, Metabolic & Cardiovascular Research Centre, Institute for Medical Research, Food Safety and Quality Division, Ministry of Health, and Department of Chemistry, Malaysia who have contributed directly or indirectly towards the successful conduct of this study. We also extend our warm gratitude and appreciation to the Director of Institute for Medical Research, Institute for Public Health, Senior Director of Food Safety and Quality Division, Ministry of Health, Director General of Department of Chemistry, Malaysia, and all the directors of the government hospitals and clinics involved in our survey (Hospital Kuala Lumpur, Hospital Pulau Pinang, Hospital Johor Bahru, Hospital Selayang and Klinik Kesihatan Kuala Lumpur).

Author contribution

Conceptualisation: Tasnim K. Ami Fazlin SM., Fairulnizal MN. Methodology: Tasnim K., Ami Fazlin SM., Ruhaya S., Lalitha P., Mohamad Hasnan A. Formal analysis: Siti Hajar MR., Lau MS., Norhayati MK., Nurul Izzah A., Lalitha P., Laila Rabaah AS., Zawiyah S., Nurhazwani AR., Investigation: Siti Hajar MR., Lau MS., Tasnim K, Siti Khuzaimah M, Sughanti J, Syazwani SA, Norhayati MK, Nurul Huda R. Resources: Tasnim K, Siti Hajar MR., Lau MS., Ami Fazlin SM., Norhayati MK., Fairulnizal MN, Ruhaya S., Lalitha P., Laila Rabaah AS., Zawiyah S., Nurhazwani AR., Ros Suzanna AB., Rohan M., Teoh BW., Khoo SC., Lim CS. Data Curation: Siti Hajar MR., Lau MS. Writing – Original Draft: Siti Hajar MR. Writing – Review & Editing: Siti Hajar MR., Nurul Izzah A., Ami Fazlin SM., Lau MS. Visualization: Siti Hajar MR., Nurul Izzah A., Ami Fazlin SM. Supervision: Ami Fazlin SM., Ros Suzanna AB., Rohan M., Teoh BW, Khoo SC., Lim CS. Project administration: Ami Fazlin SM. Funding acquisition: Tasnim K, Ami Fazlin SM.

Disclosure statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Additional information

Funding

The research and publication of this study was funded by National Institutes of Health (NIH), Ministry of Health Malaysia (Kementerian Kesihatan Malaysia) [JPP-NIH-17-020 registered with NMRR-17-904-35863].