Blood Iron, Glutathione, and Micronutrient Levels and the Risk of Oral Cancer

Abstract

The risk of oral cavity cancer was determined in relation to serological levels of iron; vitamins A, B2, C, E; zinc; thiamin; and glutathione (GSH). The study included 65 hospitalized patients with oral cancer and 85 matched controls. In comparing the highest to the lowest tertiles, the risk was odds ratio (OR) = 0.3 [95% confidence interval (CI) = 0.1–0.6] for iron; 3.2 (95% CI = 1.3–8.1) for total iron binding capacity (TIBC), which measures the concentration of the iron delivery protein transferrin; and 0.4 (95% CI = 0.2–0.9) for transferrin saturation (iron/TIBC × 100). These associations were stronger in never smokers than in ever smokers. The risk associated with the iron storage protein ferritin was significantly elevated, but this association could reflect disease-related inflammation or comorbidity. The OR for GSH was 0.4 (95% CI = 0.1–0.9), and the OR for GSH reductase activity coefficient (indicative of riboflavin deficiency) was 1.6 (95% CI = 1.3–3.7). These findings suggest that mild iron deficiency and low GSH levels, which are associated with increased oxidative stress, increase the risk of oral cavity cancer.

ACKNOWLEDGMENTS

This work was supported in part by National Institute of Health Grants DE09514, CA68384, and K07 CA104231. We thank Dr Elliot Strong, former Chief of the Head and Neck Service at MSKCC for his assistance in recruiting and enrolling patients.

Notes

^a Values are mean ± SD. Abbreviation is as follows: TIBC, total iron binding capacity.

^b ∗P < 0.02.

^c P < 0.001.

^a Values are mean ± SD. Abbreviation is as follows: TIBC, total iron binding capacity.

^a Values are mean ± SD. Abbreviations are as follows: TIBC, total iron binding capacity; NS, not significant; RBC, red blood cells; AC, activity coefficient.

^a Abbreviations are as follows: OR, odds ratio; CI, confidence interval; TIBC, total iron binding capacity.

^b Adjusted for age, sex, and smoking status.

^a Abbreviations are as follows: OR, odds ratio; CI, confidence interval; AC, activity coefficient. Adjusted for age, sex, and smoking status.

^† Deceased.