Vitamin B6 catabolism and lung cancer risk: Results from the Lung Cancer Cohort Consortium (LC3)

H. Zuo*, P. M. Ueland, Midttun, G. S. Tell, A. Fanidi, W. Zheng, X. Shu, Y. Xiang, J. Wu, R. Prentice, M. Pettinger, C. A. Thomson, G. G. Giles, A. Hodge, Q. Cai, W. J. Blot, M. Johansson, J. Hultdin, K. Grankvist, V. L. StevensM. L. McCullough, S. J. Weinstein, D. Albanes, R. G. Ziegler, N. D. Freedman, N. E. Caporaso, A. Langhammer, K. Hveem, M. Næss, J. E. Buring, I. Lee, J. M. Gaziano, G. Severi, X. Zhang, M. J. Stampfer, J. Han, A. Zeleniuch-Jacquotte, L. L. Marchand, J. Yuan, R. Wang, W. Koh, Y. Gao, U. Ericson, K. Visvanathan, M. R. Jones, C. Relton, P. Brennan, M. Johansson, A. Ulvik

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Background: Increased vitamin B6 catabolism related to inflammation, as measured by the PAr index (the ratio of 4-pyridoxic acid over the sum of pyridoxal and pyridoxal -5'-phosphate), has been positively associated with lung cancer risk in two prospective European studies. However, the extent to which this association translates to more diverse populations is not known.

Materials and methods:
For this study, we included 5,323 incident lung cancer cases and 5,323 controls individually matched by age, sex, and smoking status within each of 20 prospective cohorts from the Lung Cancer Cohort Consortium. Cohort-specific odds ratios (ORs) and 95% confidence intervals (CIs) for the association between PAr and lung cancer risk were calculated using conditional logistic regression and pooled using random-effects models.

Results: PAr was positively associated with lung cancer risk in a dose-response fashion. Comparing the fourth versus first quartiles of PAr resulted in an OR of 1.38 (95% CI: 1.19-1.59) for overall lung cancer risk. The association between PAr and lung cancer risk was most prominent in former smokers (OR: 1.69, 95% CI: 1.36- 2.10), men (OR: 1.60, 95% CI: 1.28-2.00), and for cancers diagnosed within 3 years of blood draw (OR: 1.73, 95% CI: 1.34-2.23).

Conclusion: Based on pre-diagnostic data from 20 cohorts across 4 continents, this study confirms that increased vitamin B6 catabolism related to inflammation and immune activation is associated with a higher risk of developing lung cancer. Moreover, PAr may be a pre-diagnostic marker of lung cancer rather than a causal factor.
Original languageEnglish
Article numbermdz002
Pages (from-to)478-485
Number of pages8
JournalAnnals of Oncology
Issue number3
Early online date30 Jan 2019
Publication statusPublished - 30 Jan 2019

Bibliographical note

© The Author(s) 2019. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email:


  • PAr
  • nested case-control study
  • inflammation
  • Lung Cancer Cohort Consortium
  • lung cancer
  • vitamin B6


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