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Fukushima N, Masuda T, Furukawa K, Tsuboi K, Takahashi K, Yuda M, Tsunematsu M, Ikegami T, Yano F, Eto K. Preoperative occult vertebral fracture is a stronger predictor than osteopenia of the clinical outcomes after gastrectomy for gastric cancer. Oncol Lett 2025; 29:179. [PMID: 39990809 PMCID: PMC11843434 DOI: 10.3892/ol.2025.14925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2024] [Accepted: 11/27/2024] [Indexed: 02/25/2025] Open
Abstract
Osteopenia is a potential prognostic factor in patients with cancer. Occult vertebral fracture, the most common complication of osteopenia, has recently been associated with cancer. The present study aimed to investigate the prognostic value of occult vertebral fracture after gastrectomy in patients with gastric cancer. The current retrospective study included 222 patients who underwent gastrectomy for gastric cancer between October 2013 and February 2023. Occult vertebral fracture was quantitatively evaluated using preoperative sagittal computed tomography images from the 11th thoracic to 5th lumbar vertebrae. Multivariate analysis showed that occult vertebral fracture (P<0.01, P=0.02, respectively), stage II or III (P<0.01, P<0.01, respectively), and R1 or R2 curability (P<0.01, P=0.03, respectively) were independent and significant predictors of disease-free and overall survival rates. Additionally, patients with both occult vertebral fracture and osteopenia had significantly lower disease-free and overall survival rates than those with either osteopenia or occult vertebral fracture (P<0.01, P<0.01, respectively). In conclusion, occult vertebral fracture may be considered a strong predictor of poor clinical outcomes in patients undergoing gastrectomy for gastric cancer.
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Affiliation(s)
- Naoko Fukushima
- Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan
- Department of Surgery, Fuji City General Hospital Fuji, Shizuoka 417-8567, Japan
| | - Takahiro Masuda
- Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Kenei Furukawa
- Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Kazuto Tsuboi
- Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan
- Department of Surgery, Fuji City General Hospital Fuji, Shizuoka 417-8567, Japan
| | - Keita Takahashi
- Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Masami Yuda
- Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Masashi Tsunematsu
- Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Toru Ikegami
- Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Fumiaki Yano
- Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Ken Eto
- Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan
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2
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Săsăran MO, Mărginean CO, Lupu A, Koller AM. Vitamin D and Its Association with H. pylori Prevalence and Eradication: A Comprehensive Review. Nutrients 2023; 15:3549. [PMID: 37630738 PMCID: PMC10459106 DOI: 10.3390/nu15163549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Taking into account previous data that sustain a relationship between vitamin D deficiency and higher H. pylori infection positivity rates, this review aims to assess the influence of vitamin D deficiency and/or insufficiency upon the prevalence of H. pylori infection and its eradication success. Three major databases were searched for articles that analyzed a relationship between vitamin D status and H. pylori infection. The literature search retrieved a total of 37 reports, after the article selection process. Hypovitaminosis D emerged as a potential risk factor for H. pylori infection, given the higher prevalence of vitamin D deficiency and/or insufficiency among H. pylori-positive subjects. Furthermore, the same type of micronutrient deficiency has been directly linked to H. pylori eradication failure. An inverse linear relationship between vitamin D status and gastric cancer risk exists, but the additional involvement of H. pylori in this correlation is still in question. The potential benefit of oral supplements in enhancing the success of classical therapeutic regimens of H. pylori still requires future research. Future population-based studies from larger geographical areas are warranted to address this subject in more depth.
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Affiliation(s)
- Maria Oana Săsăran
- Department of Pediatrics 3, University of Medicine, Pharmacy, Sciences and Technology George Emil Palade from Târgu Mureș, Gheorghe Marinescu Street No. 38, 540136 Târgu Mureș, Romania;
| | - Cristina Oana Mărginean
- Department of Pediatrics 1, University of Medicine, Pharmacy, Sciences and Technology George Emil Palade from Târgu Mureș, Gheorghe Marinescu Street No. 38, 540136 Târgu Mureș, Romania
| | - Ancuta Lupu
- Department of Pediatrics, University of Medicine and Pharmacy Gr. T. Popa Iași, Universității Street No. 16, 700115 Iași, Romania;
| | - Ana Maria Koller
- Clinics of Pediatrics, Emergency County Clinical Hospital, Gheorghe Marinescu Street No. 50, 540136 Târgu Mureș, Romania;
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3
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Qadir J, Majid S, Khan MS, Wani MD, Naikoo NA. Vitamin D receptor gene variations and their haplotypic association: Possible impact on gastric cancer risk. J Cancer Res Ther 2023; 19:1115-1125. [PMID: 37787272 DOI: 10.4103/jcrt.jcrt_1479_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Vitamin D receptor (VDR) gene alterations have been associated with the occurrence and prognosis of various types of cancers, but only few studies have focussed on gastric cancer (GC) risk. Objectives This case-control study was conceived to evaluate possible association of VDR polymorphisms (Fok1, Taq1, and Cdx2) with GC risk. Materials and Methods A total of 293 subjects, including 143 GC patients and 150 controls were included in this study. The genotypes were elucidated by polymerase chain reaction-restriction fragment length polymorphism followed by DNA sequencing. Results The frequency of Fok1 genotypes (TC and TT) was found higher in GC cases compared to controls (P ≤ 0.05). In the stratified analysis, we observed a significant association of the (CT + TT) variant with GC risk in males, rural dwellers, smokers, and preobese cases, and those having no family history of Gastrointestinal cancer (P ≤ 0.05). In silico analysis predicted that the Fok1 variant impacts the stability and functional efficiency of the protein. Some exact haplotypes (CCG and CCA) of the VDR gene may act as low penetrance alleles in inclination to GC. Conclusion VDR Fok1 polymorphism is significantly associated with GC risk in the Kashmiri population. Specific haplotypes in the VDR gene could act synergistically in the development of GC.
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Affiliation(s)
- Jasiya Qadir
- Department of Biochemistry, Associated SMHS and Super Speciality Hospital and Research Centre, Government Medical College, University of Kashmir, Srinagar, Jammu and Kashmir, India
| | - Sabhiya Majid
- Department of Biochemistry, Associated SMHS and Super Speciality Hospital and Research Centre, Government Medical College, University of Kashmir, Srinagar, Jammu and Kashmir, India
| | - Mosin Saleem Khan
- Department of Biochemistry, Associated SMHS and Super Speciality Hospital and Research Centre, Government Medical College, University of Kashmir, Srinagar, Jammu and Kashmir, India
| | - Mumtaz Din Wani
- Department of Surgery, Associated SMHS and Super Speciality Hospital, Government Medical College, Srinagar, Jammu and Kashmir, India
| | - Niyaz A Naikoo
- Department of Biotechnology, Government College for Women, Cluster University, Srinagar, Jammu and Kashmir, India
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Fukushima N, Tsuboi K, Nyumura Y, Hoshino M, Masuda T, Suzuki T, Kajimoto T, Yano F, Eto K. Prognostic significance of preoperative osteopenia on outcomes after gastrectomy for gastric cancer. Ann Gastroenterol Surg 2023; 7:255-264. [PMID: 36998304 PMCID: PMC10043770 DOI: 10.1002/ags3.12635] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/21/2022] [Indexed: 11/11/2022] Open
Abstract
Aim Osteopenia, characterized by low bone mineral density, is a potential prognostic factor for patients with cancer. The aim of this study was to clarify the impact of preoperative osteopenia in patients with gastric cancer (GC) after gastrectomy. Methods We included 224 patients with GC who underwent gastrectomy between August 2013 and May 2022. Osteopenia was evaluated by measuring the pixel density in the mid-vertebral core of the 11th thoracic vertebra using computed tomography. Results Osteopenia was identified in 68 patients (30%). The osteopenia group had significantly worse overall survival (OS) and disease-free survival (DFS) than the non-osteopenia group (P < .01, P < .01, respectively). The postoperative hospital stay was significantly longer, and the occurrence of postoperative complications (Clavien-Dindo grade ≥ III) was significantly higher in the osteopenia group (P = .04, P < .01, respectively). In multivariate analysis, osteopenia (P < .01), stage ≥II (P < .01), and R1 or R2 curability (P < .01) were independent and significant predictors of DFS. Additionally, osteopenia (P < .01), intraoperative blood loss (P = .04), stage ≥II (P < .01), and R1 or R2 curability (P < .01) were independent and significant predictors of OS. Conclusion Preoperative osteopenia was independently associated with a poor prognosis and recurrence in patients who underwent gastrectomy for GC.
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Affiliation(s)
- Naoko Fukushima
- Department of SurgeryThe Jikei University School of MedicineTokyoJapan
- Department of SurgeryFuji City General HospitalShizuokaJapan
| | - Kazuto Tsuboi
- Department of SurgeryThe Jikei University School of MedicineTokyoJapan
- Department of SurgeryFuji City General HospitalShizuokaJapan
| | - Yuya Nyumura
- Department of SurgeryThe Jikei University School of MedicineTokyoJapan
- Department of SurgeryFuji City General HospitalShizuokaJapan
| | - Masato Hoshino
- Department of SurgeryThe Jikei University School of MedicineTokyoJapan
| | - Takahiro Masuda
- Department of SurgeryThe Jikei University School of MedicineTokyoJapan
| | - Toshimasa Suzuki
- Department of SurgeryThe Jikei University School of MedicineTokyoJapan
- Department of SurgeryFuji City General HospitalShizuokaJapan
| | - Tetsuya Kajimoto
- Department of SurgeryThe Jikei University School of MedicineTokyoJapan
- Department of SurgeryFuji City General HospitalShizuokaJapan
| | - Fumiaki Yano
- Department of SurgeryThe Jikei University School of MedicineTokyoJapan
| | - Ken Eto
- Department of SurgeryThe Jikei University School of MedicineTokyoJapan
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Liu X, Zhou Y, Zou X. Correlation between Serum 25-Hydroxyvitamin D Levels and Gastric Cancer: A Systematic Review and Meta-Analysis. Curr Oncol 2022; 29:8390-8400. [PMID: 36354721 PMCID: PMC9689382 DOI: 10.3390/curroncol29110661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/29/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022] Open
Abstract
The purpose of this meta-analysis was to evaluate the relationship between serum 25-hydroxyvitamin D[25(OH)D] levels and gastric cancer. PubMed, Embase, Cochrane Library, Web of Science, The China Academic Journals full-text database, Wanfang Database of Chinese Academic Journals, VIP Chinese Science and Technology Periodicals database, and Chinese Biomedical Literature database were systematically searched. Case-control studies on the correlation between serum 25-hydroxyvitamin D levels and gastric cancer were retrieved, and the data extracted were analyzed. The results of 9 case-control studies containing 671 patients showed that serum 25(OH)D levels in the gastric cancer group were lower than those in the control group (weighted mean difference (WMD) = -8.90, 95% confidence interval (CI): -11.5, -6.32, p < 0.01); the risk of vitamin D deficiency in the gastric cancer group was higher than that in the control group (Odds ratio = 3.09, 95% CI: 1.96, 4.87, p < 0.01). The serum 25(OH)D levels in patients with well and moderately differentiated gastric cancer were higher than those in patients with poorly differentiated gastric cancer (WMD = -3.58, 95% CI: -6.41, -0.74, p = 0.01). Thus, low levels of vitamin D may increase the risk of gastric cancer. Systematic review registration: PROSPERO CRD42022327942.
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Affiliation(s)
- Xing Liu
- Correspondence: ; Tel.: +86-24-87970052
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6
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Pastukhova Y, Luzza F, Shevel S, Savchuk O, Ostapchenko L, Falalyeyeva T, Molochek N, Kuryk O, Korotkyi O, Kobyliak N. Changes in Metabolic Parameters in Patients with Diabetic Kidney Disease Depending on the Status of D3. Rev Recent Clin Trials 2022; 17:280-290. [PMID: 35319388 DOI: 10.2174/1574887117666220321152855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Type 2 diabetes is a metabolic disease characterized by hyperglycemia as a result of insulin resistance and decreased insulin secretion. A relatively large number of patients with this type of diabetes have abdominal obesity, which also affects insulin resistance development. Chronic hyperglycemia can lead to damage and dysfunction of various organs, and a striking example is diabetic nephropathy. Diabetic nephropathy is a specific kind of kidney damage that occurs due to complications of diabetes and is accompanied by the formation of diffuse or nodular glomerulosclerosis, which can lead to terminal renal failure and requires immediate substitution through renal therapy or renal transplantation. Diabetic nephropathy is diagnosed with albuminuria and a decrease in the rate of glomerular filtration. METHODS This review was based on a literature search for the most important evidence of vitamin D as a possible method of prevention for obesity, type 2 diabetes, and diabetic nephropathy. Collected published articles were summarized according to their overall themes. RESULTS In this review, we considered vitamin D as a possible method of treatment for type 2 diabetes, as well as its complications, including diabetic nephropathy. CONCLUSION Studies show that vitamin D inhibits the renin-angiotensin-aldosterone system, resulting in improved renal function in diabetic nephropathy. Vitamin D also has antiinflammatory, antiproliferative, and anti-metastatic effects, which improve endothelial function.
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Affiliation(s)
| | | | | | | | | | | | | | - Olena Kuryk
- Bogomolets National Medical University, Kyiv, Ukraine
| | | | - Nazarii Kobyliak
- Bogomolets National Medical University, Kyiv, Ukraine.,Medical Laboratory CSD, Kyiv, Ukraine
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7
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Chen LW, Chang LC, Hua CC, Cheng TC, Lee CC. Comparing the Expressions of Vitamin D Receptor, Cell Proliferation, and Apoptosis in Gastric Mucosa With Gastritis, Intestinal Metaplasia, or Adenocarcinoma Change. Front Med (Lausanne) 2021; 8:766061. [PMID: 34881266 PMCID: PMC8645899 DOI: 10.3389/fmed.2021.766061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 10/27/2021] [Indexed: 12/20/2022] Open
Abstract
Background: This study aimed to compare the expression of vitamin D receptor (VDR), cell proliferation, and apoptosis in the gastric mucosa of patients with gastritis, intestinal metaplasia (IM), and adenocarcinoma using artificial intelligence. Material and Methods: This study retrospectively enrolled patients at the Keelung Chang Gung Memorial Hospital from November of 2016 to June, 2017, who were diagnosed with gastric adenocarcinoma. The inclusion criteria were patients' pathologic reports that revealed all compartments of Helicobacter pylori infection, gastritis, IM, and adenocarcinoma simultaneously in the same gastric sample. Tissue slides after immunohistochemical (IHC) staining were transformed into digital images using a scanner and counted using computer software (QuPath and ImageJ). IHC staining included PA1-711 antibody for VDR, Ki67 antigen for proliferation, and M30 antibody CK18 for apoptosis. Results: Twenty-nine patients were included in the IHC staining quantitative analysis. The mean age was 69.1 ± 11.3 y/o. Most (25/29, 86.2%) patients had poorly differentiated adenocarcinoma. The mean expression of Ki67 and CK18 increased progressively from gastritis and IM to adenocarcinoma, with statistical significance (P < 0.05). VDR expression did not correlate with Ki67 or CK18 expression. Survival time was only correlated with tumor stage (correlation coefficient = −0.423, P value < 0.05), but was not correlated with the expression of VDR, Ki67, and CK18. Conclusion: Ki67 expression and CK18 expression progressively increased in the areas of gastritis, IM, and adenocarcinoma. No correlation between VDR expression and Ki67 or CK18 expression was found in this study.
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Affiliation(s)
- Li-Wei Chen
- Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital and University at Keelung, Keelung, Taiwan.,Community Medicine Research Center, Chang-Gung Memorial Hospital and University at Keelung, Keelung, Taiwan
| | - Liang-Che Chang
- Department of Pathology, Pathology Chang-Gung Memorial Hospital and University at Keelung, Keelung, Taiwan
| | - Chung-Ching Hua
- Department of Internal Medicine, Internal Medicine Chang-Gung Memorial Hospital and University at Keelung, Keelung, Taiwan
| | - Tzu-Chien Cheng
- Department of Pathology, Pathology Chang-Gung Memorial Hospital and University at Keelung, Keelung, Taiwan
| | - Chin-Chan Lee
- Community Medicine Research Center, Chang-Gung Memorial Hospital and University at Keelung, Keelung, Taiwan.,Department of Internal Medicine, Internal Medicine Chang-Gung Memorial Hospital and University at Keelung, Keelung, Taiwan
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8
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Bader-Larsen KS, Larson EA, Dalamaga M, Magkos F. A Narrative Review of the Safety of Anti-COVID-19 Nutraceuticals for Patients with Cancer. Cancers (Basel) 2021; 13:cancers13236094. [PMID: 34885202 PMCID: PMC8656592 DOI: 10.3390/cancers13236094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 11/28/2021] [Accepted: 12/01/2021] [Indexed: 12/22/2022] Open
Abstract
Simple Summary Dietary supplement use has increased more than 35% globally since the COVID-19 outbreak. While some nutraceuticals are potentially efficacious against severe disease from COVID-19, their indiscriminate use by patients with cancer without medical supervision is concerning. The aim of this narrative review was to evaluate the data on safety of “anti-COVID-19” nutraceuticals for patients with cancer. We found that the use of vitamin C, vitamin D, and selenium supplements is likely safe and even potentially beneficial at typically recommended doses. However, caution is advised regarding the use of omega-3 fatty acids and zinc, as risks from their use may outweigh the benefits. Abstract Interest in dietary supplements and their efficacy in treating and preventing disease has increased greatly since the outbreak of the COVID-19 pandemic. Due to the risk of severe COVID-19 in patients with cancer, we conducted a narrative review aiming to better understand the data on the safety of the most efficacious “anti-COVID-19” nutraceuticals for patients with cancer. We conducted a PubMed database search aimed at identifying the most effective nutrients for use against COVID-19. For the identified nutraceuticals, we searched PubMed again regarding their safety for patients with cancer. Fifty-four total records (52 independent studies) were retrieved, pertaining to vitamin D, vitamin C, selenium, omega-3 fatty acids, and zinc. Vitamin D results from 23 articles indicated safe use, but two articles indicated potential harm. All 14 articles for vitamin C and five out of six articles for selenium indicated the safety of use (one study for selenium suggested harm with high-dose supplementation). Results for omega-3 fatty acids (seven articles) and zinc (one article), however, were rather mixed regarding safety. We conclude that vitamin D, vitamin C, and selenium supplements are likely safe or even beneficial at typically recommended doses; however, caution is urged with omega-3 fatty acid supplements, and zinc supplements should likely be avoided. More experimental research is needed, and nutraceutical use by patients with cancer should always be under the supervision of a healthcare team.
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Affiliation(s)
- Karlen Stade Bader-Larsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 Frederiksberg, Denmark; (K.S.B.-L.); (E.A.L.)
| | - Elisabeth Anne Larson
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 Frederiksberg, Denmark; (K.S.B.-L.); (E.A.L.)
| | - Maria Dalamaga
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Faidon Magkos
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 Frederiksberg, Denmark; (K.S.B.-L.); (E.A.L.)
- Correspondence: ; Tel.: +45-3533-3671
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9
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Kim HG, Lee DB, Lee TH, Choi BY, Han MS, Lee SH, Kim TH. Upregulation of the Vitamin D Receptor in the Nasal Mucosa of Patients With Allergic Rhinitis. JOURNAL OF RHINOLOGY 2021. [DOI: 10.18787/jr.2021.00364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background and Objectives: Vitamin D modulates immunity, including that of allergic diseases, and plays its roles through contact with vitamin D receptors (VDR). Recent studies have shown that patients with allergic rhinitis have low systemic serum vitamin D level. However, the expression of VDR in local tissue such as human nasal mucosa has not been investigated. Our study demonstrated that, in nasal mucosa of normal controls and patients with allergic rhinitis.Materials and Methods: Nasal mucosa were harvested from twenty-five patients who had normal nasal mucosa and twenty-five patients with allergic rhinitis. After the total RNA isolation, we performed reverse transcriptase-polymerase chain reaction, immunohistochemical staining and western blot analysis.Results: VDR were expressed in submucosal glands and the superficial layer of epithelial cell, and that inflammatory cells are expressed more highly in the nasal mucosa of patients with allergic rhinitis compared to those without. In the mucosa of patients with allergic rhinitis, VDR expression level was upregulated compared to that in normal nasal mucosa.Conclusion: This findings suggest that VDR plays a role in the pathogenesis of allergic rhinitis. Additional research is needed to determine the mechanism and consequences of VDR upregulation.
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10
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Han L, Han Y. Network Pharmacology-Based Study on the Active Component and Mechanism of the Anti-Gastric-Cancer Effect of Herba Sarcandrae. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:3001131. [PMID: 34840695 PMCID: PMC8626172 DOI: 10.1155/2021/3001131] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/02/2021] [Accepted: 11/08/2021] [Indexed: 11/18/2022]
Abstract
Background Herba Sarcandrae is used in the clinical practice of traditional Chinese medicine to deal with gastric cancer. However, there are few studies on its precise mechanism. Method In this study, a network pharmacological approach was utilized to construct a molecular/target/pathway molecular regulatory network for the anti-gastric-cancer effect of Herba Sarcandrae. The active components of Herba Sarcandrae and their potential mechanisms were explored. Chemical components of the Herba Sarcandrae were identified through a database, and they were evaluated and screened based on oral bioavailability and drug similarity. Results Genes related to gastric cancer were found in the Gene Expression Omnibus (GEO) database, and gene targets related to anti-gastric-cancer were chosen by comparison. Using annotation, visualization, and a comprehensive discovery database, the function and related pathways of target genes were analyzed and screened. Cytoscape software was utilized to construct a component/target/pathway network for the antitumor effect of Herba Sarcandrae. Finally, 6 drug ingredients and 29 target genes related to gastric cancer were detected. IL-17 signaling pathway, NF-kappa B signaling pathway, and other signaling pathways were significantly enriched. Many signaling pathways that directly act on tumors and indirect pathways inhibit the development of gastric cancer. Conclusion This study provides a scientific basis for further elucidating the mechanism of the anti-gastric-cancer effect of Herba Sarcandrae.
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Affiliation(s)
- Li Han
- The Third Hospital of Hebei Medical University, Pharmacy Department, Shijiazhuang, China
| | - Ying Han
- The Third Hospital of Hebei Medical University, Department of Chinese Medicine, Shijiazhuang, China
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11
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Shah S, Iqbal Z, Alharbi MG, Kalra HS, Suri M, Soni N, Okpaleke N, Yadav S, Hamid P. Vitamin D and Gastric Cancer: A Ray of Sunshine? Cureus 2021; 13:e18275. [PMID: 34722053 PMCID: PMC8545571 DOI: 10.7759/cureus.18275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 09/25/2021] [Indexed: 12/31/2022] Open
Abstract
Gastric cancer (GC) is one of the most aggressive malignancies, currently ranking third among cancers leading to death worldwide. Despite the recent advancements in GC research, it is most often diagnosed during the terminal stages and with limited treatment modalities contributing to its poor prognosis and a lower survival rate. Much research has provided conflicting results between a vitamin D deficient status and the development of GC. Vitamin D is a well-known and essential hormone classically known to regulate calcium and phosphate absorption, enabling adequate mineralization of the skeletal system. However, the function of vitamin D is multidimensional. It possesses unique roles, including acting as antioxidants or immunomodulators while crossing the cell membrane, performing several intracellular functions, participating in gene regulation, and controlling the proliferation and invasion of cancer cells, including those of GC. In light of this, it is imperative to analyze the causes of GC, review the factors that can be used to enhance the effectiveness of treatments, and discover the tools to determine prognosis, reduce mortality, and prevent GC development. In this review, we have summarized recent investigations on multiple associations between vitamin D and GC, emphasizing genetic associations, vitamin D receptors, and the prevalence of hormone deficiency in those developing this aggressive malignancy.
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Affiliation(s)
- Suchitra Shah
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Zafar Iqbal
- Emergency Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Mohammed G Alharbi
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Harjeevan S Kalra
- Internal Medicine/Emergency Medicine/Oncology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Megha Suri
- Pediatrics/Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Nitin Soni
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Nkiruka Okpaleke
- Psychiatry and Behavioral Sciences, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Shikha Yadav
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Pousette Hamid
- Neurology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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12
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Gallardo Martin E, Cousillas Castiñeiras A. Vitamin D modulation and microRNAs in gastric cancer: prognostic and therapeutic role. Transl Cancer Res 2021; 10:3111-3127. [PMID: 35116620 PMCID: PMC8797897 DOI: 10.21037/tcr-20-2813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 10/10/2020] [Indexed: 12/11/2022]
Abstract
Gastric adenocarcinoma arises after a complex interaction between the host and environmental factors. Tumor location and TNM are the tools that currently guide treatment decisions. Surgery is the only curative treatment, but relapse is common. After relapse or advanced staged disease survival is poor and systemic treatment has modestly improved survival. An association between sun exposure, vitamin D status and gastric cancer (GC) incidence and mortality has been reported. The molecular differences of the histological subtypes and the new molecular classifications account for the great heterogeneity of this disease and are the basis for the discovery of new therapeutic targets. New prognostic and predictive factors are essential and microRNAs (miRNAs) are endogenous small non-coding RNA molecules with a great potential for diagnosis, prognosis and treatment of cancer. There are hundreds of miRNAs with altered expression in tumor gastric tissue when compared to normal gastric tissue. Many of these miRNAs are associated with clinicopathological variables and survival in patients with GC. Furthermore, the expression of some of these miRNAs with prognostic importance in CG is influenced by vitamin D and others are mediators of some of the actions of this vitamin. This review aims to update the evidence on several miRNAs with prognostic value and therapeutic potential in GC, whose expression may be influenced by vitamin D or may regulate vitamin D signaling.
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Affiliation(s)
- Elena Gallardo Martin
- Medical Oncology Department in Complejo Hospitalario Universitario de Pontevedra, University Hospital of Pontevedra, CP 36001 Pontevedra, Spain
| | - Antia Cousillas Castiñeiras
- Medical Oncology Department in Complejo Hospitalario Universitario de Pontevedra, University Hospital of Pontevedra, CP 36001 Pontevedra, Spain
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Association of Vitamin D receptor gene variations with Gastric cancer risk in Kashmiri population. Mol Biol Rep 2021; 48:3313-3325. [PMID: 33942233 DOI: 10.1007/s11033-021-06376-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 04/24/2021] [Indexed: 12/12/2022]
Abstract
Vitamin D receptor (VDR) mediates cellular processes like cell cycle arrest and apoptosis which effect cancer susceptibility. VDR single nucleotide polymorphisms (SNPs) have a significant influence on functioning of VDR protein and subsequently contribute to the risk of cancer occurrence and progression. The present case-control study was carried out between 2016 and 2020 to investigate the association of VDR BsmI/ApaITaqI SNPs with Gastric Cancer (GC) risk in ethnic Kashmiri population not only for establishing a molecular marker for GC but also to facilitate the outcomes of personalized medicine in future. The polymorphisms of BsmI and ApaI of the VDR gene were evaluated using Polymerase Chain Reaction-Restriction Fragment Length Polymorphism followed by Di-Deoxy Sanger sequencing in 143 GC cases and 150 controls. The mean age (in years) was 53.5 ± 7.92 and 51.2 ± 8.25 and mean Body mass index was 22.68 ± 4.27 kg/m2 and 23.81 ± 3.71 kg/m2 for cases and controls respectively. The mean CEA levels of GC cases was 40.2 ± 10.9 ng/ml. Genotypic distribution of VDR BsmI differed significantly between GC cases and controls (GG vs GA + AA; adjusted P = 0.014) and followed dominant mode of inheritence. Stratification of VDR BsmI revealed that frequency of variant genotype (GA + AA) was significantly higher in Preobese GC cases (P = 0.001), GC patients consuming < 5 cups of salt tea/day (P < 0.0001) and with no family history of gastrointestinal cancer (P = 0.014) compared to healthy controls. ATC haplotype associated with high GC risk. In conclusion, our study suggests that VDR BsmI SNP has a significant association with increased risk of GC especially in preobese population and BsmI/ApaITaqI SNPs significantly decreased the overall survival in GC patients of Kashmiri population.
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Association between serum 25-hydroxy vitamin D level and gastric adenocarcinoma - a cross sectional study. GASTROENTEROLOGY REVIEW 2020; 16:155-160. [PMID: 34276843 PMCID: PMC8275964 DOI: 10.5114/pg.2020.100659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 09/21/2020] [Indexed: 12/24/2022]
Abstract
Introduction Vitamin D is found to have anti-cancer properties. Although the preventive role of vitamin D in cancer is proven, its role in gastric cancer is equivocal. Aim To evaluate vitamin D deficiency in patients with gastric adenocarcinoma and its relationship with the disease characteristics. Material and methods This single-centre, prospective, cross sectional study was carried out from February 2017 to December 2018. Serum 25-hydroxy vitamin D levels of 94 patients with gastric adenocarcinoma and 94 age- and sex-matched healthy controls were estimated. Among cases, vitamin D levels and disease characteristics such as TNM stage, tumour grade, clinical stage and patient demographics were analysed. Results The vitamin D levels among cases (13.83 ±5.97 ng/ml) were significantly lower (p < 0.0001) than the control group (29.15 ±4.13 ng/ml). Vitamin D deficiency was found in 88% of cases and in 3% of controls. Among cases, age, T stage and clinical stage had a significant inverse relationship with vitamin D levels. Cases with distant metastasis and cases with pain had significantly lower levels of vitamin D compared to the cases without distant metastasis and without pain respectively. Other study parameters did not have a significant relationship with vitamin D. Conclusions Vitamin D deficiency is associated with occurrence of gastric adenocarcinoma and correlates with the disease severity. However, to assign a causal relationship and to study the beneficial effect of vitamin D in gastric cancer, further research is needed.
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Assessment of expression of vitamin D receptor-associated lncRNAs in gastric cancer. Meta Gene 2020. [DOI: 10.1016/j.mgene.2020.100737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Vitamin D Status and Gastric Cancer: A Cross-Sectional Study in Koreans. Nutrients 2020; 12:nu12072004. [PMID: 32640566 PMCID: PMC7400919 DOI: 10.3390/nu12072004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/06/2020] [Accepted: 07/01/2020] [Indexed: 02/07/2023] Open
Abstract
Sufficient vitamin D levels are associated with reduced Helicobacter pylori infections, which can cause gastric carcinogenesis. We examined associations between vitamin D concentrations and gastric cancer (GC) prevalence in a Korean population. We analyzed data of 33,119 adults using serum 25-hydroxyvitamin D (25(OH)D) concentrations as a biomarker of vitamin D status. Participants were classified with GC if previously diagnosed as such by a physician. After controlling for age, sex and body mass index (model A), odds ratio (OR) for GC was 0.81 (95% confidence interval [CI]: 0.70, 0.95), with a 5-ng/mL increment in total 25(OH)D concentrations. In fully adjusted models (model B), the OR for GC was 0.84 (95% CI: 0.72, 0.98), with a 5-ng/mL increment in total vitamin D. Following the classification of vitamin D concentrations into three categories or for GC in model A was 0.52 (95% CI: 0.30, 0.92) comparing between higher (≥20 ng/mL) and lower (<12 ng/mL) total 25(OH)D concentrations. In model B OR for GC was 0.57 (95% CI: 0.32, 1.00) comparing between higher and lower total 25(OH)D concentrations. Our results suggested that high vitamin D concentration was associated with lower ORs of GC in Korean adults.
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A Review of the Potential Benefits of Increasing Vitamin D Status in Mongolian Adults through Food Fortification and Vitamin D Supplementation. Nutrients 2019; 11:nu11102452. [PMID: 31615079 PMCID: PMC6835745 DOI: 10.3390/nu11102452] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 10/02/2019] [Accepted: 10/07/2019] [Indexed: 02/06/2023] Open
Abstract
Serum 25-hydroxyvitamin D (25(OH)D) concentrations are low in Mongolia, averaging 22 ng/mL in summer and only 8 ng/mL in winter. Mongolians have high incidence and/or prevalence of several diseases linked to low 25(OH)D concentrations, including ischemic heart disease, malignant neoplasms, cirrhosis of the liver, ischemic stroke, lower respiratory tract infections, preterm birth complications, and diabetes mellitus. Fortifying regularly consumed foods such as flour, milk, and edible oils with vitamin D3 could raise 25(OH)D concentrations by about 10 ng/mL. However, to achieve 25(OH)D concentrations of 30–40 ng/mL in adults, vitamin D intakes of 1000 to 4000 IU/day would be required, making personal supplement use necessary. On the basis of prospective observational studies and clinical trials of disease incidence or known mortality rates and adverse pregnancy and birth outcomes, raising mean serum 25(OH)D concentrations to 40 ng/mL would likely reduce incidence and mortality rates for those and other diseases, reduce the rate of adverse pregnancy and birth outcomes, and increase mean life expectancy by one year or more.
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The effects of serum levels, and alterations in the genes of binding protein and receptor of vitamin D on gastric cancer. Mol Biol Rep 2019; 46:6413-6420. [PMID: 31549372 DOI: 10.1007/s11033-019-05088-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 09/18/2019] [Indexed: 12/18/2022]
Abstract
Due to many biological cell functions of vitamin D including regulation of cell survival, proliferation and differentiation, the metabolism of itself gains importance in the development of several types of cancer. This case-control study was designed to evaluate the risk of gastric cancer development in terms of VDR rs2228570 & rs731236, and VDBP rs7041 polymorphisms, and serum levels of vitamin D. The study consists of 77 gastric cancer patients and 84 healthy individuals. VDR and VDBP gene polymorphisms and vitamin D levels were determined by using PCR-RFLP and HPLC methods. The distribution of VDR or VDBP gene variants were not different in study groups. The serum level of 25-hydroxyvitamin D was significantly lower in gastric cancer patients versus controls (16 ± 6 → 11 ± 6 ng/ml) in which male patients have higher levels than females. Although the whole study population lacks normal levels of 25-hydroxyvitamin D, it was found that the risk of the development of gastric cancer was approximately fourfold higher in cases with severe vitamin D (< 10 ng/ml) deficiency. Our results indicate that VDR rs731236 & rs2228570 or VDBP rs7041 polymorphisms were not risk factors for the development of gastric cancer individually, however, lower serum levels of vitamin D may be a contributory risk for both predisposition and development of gastric cancer.
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A Narrative Role of Vitamin D and Its Receptor: With Current Evidence on the Gastric Tissues. Int J Mol Sci 2019; 20:ijms20153832. [PMID: 31387330 PMCID: PMC6695859 DOI: 10.3390/ijms20153832] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 07/30/2019] [Accepted: 08/01/2019] [Indexed: 02/06/2023] Open
Abstract
Vitamin D is a major steroid hormone that is gaining attention as a therapeutic molecule. Due to the general awareness of its importance for the overall well-being, vitamin D deficiency (VDD) is now recognized as a major health issue. The main reason for VDD is minimal exposure to sunlight. The vitamin D receptor (VDR) is a member of the steroid hormone receptors that induces a cascade of cell signaling to maintain healthy Ca2+ levels that serve to regulate several biological functions. However, the roles of vitamin D and its metabolism in maintaining gastric homeostasis have not yet been completely elucidated. Currently, there is a need to increase the vitamin D status in individuals worldwide as it has been shown to improve musculoskeletal health and reduce the risk of chronic illnesses, including some cancers, autoimmune and infectious diseases, type 2 diabetes mellitus, neurocognitive disorders, and general mortality. The role of vitamin D in gastric homeostasis is crucial and unexplored. This review attempts to elucidate the central role of vitamin D in preserving and maintaining the overall health and homeostasis of the stomach tissue.
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Jing J, Ge M, Yang Z, Li P. Spatial distribution characteristics of tumor marker CA724 reference values in China. Cancer Med 2019; 8:4465-4474. [PMID: 31199587 PMCID: PMC6675733 DOI: 10.1002/cam4.2176] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 04/01/2019] [Accepted: 04/03/2019] [Indexed: 12/16/2022] Open
Abstract
Objects This study aims to explore the Cancer antigen 724 (CA724) reference values spatial distribution characteristics in healthy Chinese adults. The study can provide regional reference for medical diagnosis. Study Design The relationship between CA724 and 25 geographical environmental factors was analyzed firstly. Artificial neural network simulation training was used to construct the prediction model. The national forecast distribution map of the CA724 reference values was obtained by the geostatistical mapping method. Analyzing and exploring the influence mechanism of geographical environment factors on CA724 reference values. Methods Collecting 34470 cases from more than 106 cities healthy adults CA724 reference values via several paper databases in 10 recent years. Correlation analysis, RBF artificial neural networks and trend surface analysis were applied to explore if there was any tendency of spatial variation. The Kriging interpolation of geostatistical analysis was developed to reveal the spatial distribution characteristics of the CA724 reference values. Results The distribution of CA724 reference values of Chinese healthy adults shows a downward trend from south to north. CA724 reference values have negative correlations with latitude, annual sunshine duration and topsoil cation exchange capacity in clay. CA724 have positive correlations with annual mean air temperature, annual mean relative humidity, and annual precipitation amount. High temperature and high humidity environment will reduce gastrointestinal function and breeze various mold bacteria. Lack of sunshine can easily lead to vitamin C deficiency in the body. These will increase the incidence of gastrointestinal diseases and gastric cancer, then increase the CA724 value. Conclusion CA724 reference values show spatial autocorrelation and regional variation. There are some geographical environment factors effected Chinese healthy adults CA724 reference values. Geographic factors such as sunshine, temperature, and humidity have effects on CA724 reference values can provide new ideas and directions of prevention and clinical diagnosis in the future.
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Affiliation(s)
- Jing Jing
- Institute of Healthy Geography, College of Geography and Tourism, Shaanxi Normal University, Xi'an, Shaanxi, China.,Baoji University of Arts and Sciences, Baoji, Shaanxi, China
| | - Miao Ge
- Institute of Healthy Geography, College of Geography and Tourism, Shaanxi Normal University, Xi'an, Shaanxi, China
| | - Ziqi Yang
- Baoji University of Arts and Sciences, Baoji, Shaanxi, China
| | - Peng Li
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong Unversity Health Science Center, Xi'an, Shaanxi, China
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Association of TLR4 Polymorphisms, Expression, and Vitamin D with Helicobacter pylori Infection. J Pers Med 2019; 9:jpm9010002. [PMID: 30641993 PMCID: PMC6463146 DOI: 10.3390/jpm9010002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 01/03/2019] [Indexed: 12/16/2022] Open
Abstract
Helicobacter pylori (H. pylori) infection is the strongest recognized risk factor for gastric adenocarcinoma. Since previous observations have shown that polymorphisms in innate immune system genes, as well as vitamin D (VitD) levels, could modify the risk of infection with Helicobacterpylori (H. pylori), we analyzed the relation between single nucleotide polymorphisms (SNPs) in TLRs (TLR1, TLR2, TLR4) CD14, RUNX3 and VitD levels with H. pylori infection. A case-control study on four hundred sixty Lebanese individuals was conducted. Eleven SNPs in total were genotyped and gene expression analysis using real-time PCR was performed in white blood cells of a subsample of eight individuals. A total of 49% of the participants were affected. Although no direct association was found between the SNPs and H. pylori infection, rs4986790G>A and rs4986791T>C in TLR4 were negatively associated with VitD levels (β = −0.371, p = 5 × 10−3 and β = −0.4, p = 2 × 10−3, respectively), which was negatively associated with H. pylori infection (OR = 0.01, p < 1 × 10−3). TLR4 expression was 3× lower in individuals with H. pylori compared with non-infected (p = 0.01). TLR4 polymorphisms, expression, and VitD could be implicated in H. pylori infection and further development of gastric adenocarcinoma.
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Eom SY, Yim DH, Kim DH, Yun HY, Song YJ, Youn SJ, Hyun T, Park JS, Kim BS, Kim YD, Kim H. Dietary vitamin D intake and vitamin D related genetic polymorphisms are not associated with gastric cancer in a hospital-based case-control study in Korea. J Biomed Res 2018; 32:257-263. [PMID: 30008463 PMCID: PMC6117605 DOI: 10.7555/jbr.32.20170089] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
There have been few studies on the association between vitamin D levels and gastric cancer in Asian populations, but no studies have been performed on the interactions between vitamin D intake and polymorphisms in the vitamin D pathway. The effects of vitamin D intake, vitamin D related genetic polymorphisms, and their association with the incidence of gastric cancer were investigated in a hospital case-control study, including 715 pairs of newly diagnosed gastric cancer patients and controls matched for age and sex. Correlations between vitamin D intake and plasma vitamin D concentrations were also assessed in a subset of subjects. No statistically significant difference was observed in the dietary intake of vitamin D between the patients and controls, nor were there any evident associations between vitamin D intake and risk of gastric cancer in multivariate analyses. Vitamin D intake significantly correlated with the circulating 25-hydroxyvitamin D levels, but not with the active form of the vitamin, 1,25-dihydroxyvitamin D. There were no statistically significant interactions between vitamin D intake, and VDR or TXNIP polymorphisms. This study suggests that dietary vitamin D intake is not associated with gastric cancer risk, and the genetic polymorphisms of vitamin D-related genes do not modulate the effect of vitamin D with respect to gastric carcinogenesis.
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Affiliation(s)
- Sang-Yong Eom
- Departments of Preventive Medicine and Medical Research Institute, Chungbuk National University, Cheongju 28644, Korea
| | - Dong-Hyuk Yim
- Departments of Preventive Medicine and Medical Research Institute, Chungbuk National University, Cheongju 28644, Korea
| | - Dae-Hoon Kim
- Departments of Surgery, Chungbuk National University, Cheongju 28644, Korea
| | - Hyo-Yung Yun
- Departments of Surgery, Chungbuk National University, Cheongju 28644, Korea
| | - Young-Jin Song
- Departments of Surgery, Chungbuk National University, Cheongju 28644, Korea
| | - Sei-Jin Youn
- Internal Medicine, College of Medicine, Chungbuk National University, Cheongju 28644, Korea
| | - Taisun Hyun
- Department of Food and Nutrition, Chungbuk National University, Cheongju 28644, Korea
| | - Joo-Seung Park
- Department of Surgery, College of Medicine, Eulji University, Daejon 301746, Korea
| | - Byung Sik Kim
- Department of Surgery, Asan Medical Center, College of Medicine, Ulsan University, Seoul 138736, Korea
| | - Yong-Dae Kim
- Departments of Preventive Medicine and Medical Research Institute, Chungbuk National University, Cheongju 28644, Korea
| | - Heon Kim
- Departments of Preventive Medicine and Medical Research Institute, Chungbuk National University, Cheongju 28644, Korea
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