Background: The field of quantifying the association between the intake of vitamin C and risk of glioma still has conflicts. Thus, we performed a comprehensive meta-analysis to test the hypothesis that a high intake of vitamin C may be a protective effect on glioma risk. Methods: Pertinent studies were identified by a search in PubMed and Web of Knowledge up to June 2014. The random-effect model was used to combine study-specific results. Publication bias was estimated using Begg' funnel plot and Egger's regression asymmetry test. Results: Thirteen articles with 15 studies (2 cohort study and 13 case-control studies) involving 3,409 glioma cases about vitamin C intake and glioma risk were used in this meta-analysis. The combined relative risks (RRs) of glioma associated with vitamin C intake was 0.86 (95% CIs = 0.75-0.99). Overall, significant protective associations were also found in the American population (RRs = 0.85, 95% CIs = 0.73-0.98) and case-control studies (RRs = 0.80, 95% CIs = 0.69-0.93). No publication bias was found. Conclusions: Our analysis indicated that vitamin C intake might decrease the risk of glioma, especially among the Americans.

Keywords:
Vitamin C, Glioma, Meta-analysis
1.
Ricard D, Idbaih A, Ducray F, Lahutte M, Hoang-Xuan K, Delattre JY: Primary brain tumours in adults. Lancet 2012;379:1984-1996.
2.
Wen PY, Kesari S: Malignant gliomas in adults. N Engl J Med 2008;359:492-507.
3.
Ohgaki H: Epidemiology of brain tumors. Methods Mol Biol 2009;472:323-342.
4.
Tao Y, Liang G: Quantitative assessment of the association between +61A>G polymorphism of epidermal growth factor gene and susceptibility to glioma. Tumour Biol 2013;35:369-377.
5.
Bellail AC, Hunter SB, Brat DJ, Tan C, Van Meir EG: Microregional extracellular matrix heterogeneity in brain modulates glioma cell invasion. Int J Biochem Cell Biol 2004;36:1046-1069.
6.
D'Archivio M, Santangelo C, Scazzocchio B, Vari R, Filesi C, Masella R, Giovannini C: Modulatory effects of polyphenols on apoptosis induction: relevance for cancer prevention. Int J Mol Sci 2008;9:213-228.
7.
Khoshyomn S, Nathan D, Manske GC, Osler TM, Penar PL: Synergistic effect of genistein and BCNU on growth inhibition and cytotoxicity of glioblastoma cells. J Neurooncol 2002;57:193-200.
8.
Pouliquen D, Olivier C, Hervouet E, Pedelaborde F, Debien E, Le Cabellec MT, Gratas C, Homma T, Meflah K, Vallette FM, Menanteau J: Dietary prevention of malignant glioma aggressiveness, implications in oxidant stress and apoptosis. Int J Cancer 2008;123:288-295.
9.
Howe GR, Burch JD, Chiarelli AM, Risch HA, Choi BC: An exploratory case-control study of brain tumors in children. Cancer Res 1989;49:4349-4352.
10.
Boeing H, Schlehofer B, Blettner M, Wahrendorf J: Dietary carcinogens and the risk for glioma and meningioma in Germany. Int J Cancer 1993;53:561-565.
11.
Bunin GR, Kuijten RR, Boesel CP, Buckley JD, Meadows AT: Maternal diet and risk of astrocytic glioma in children: a report from the Childrens Cancer Group (United States and Canada). Cancer Causes Control 1994;5:177-187.
12.
Giles GG, McNeil JJ, Donnan G, Webley C, Staples MP, Ireland PD, Hurley SF, Salzberg M: Dietary factors and the risk of glioma in adults: results of a case-control study in Melbourne, Australia. Int J Cancer 1994;59:357-362.
13.
Blowers L, Preston-Martin S, Mack WJ: Dietary and other lifestyle factors of women with brain gliomas in Los Angeles County (California, USA). Cancer Causes Control 1997;8:5-12.
14.
Lee M, Wrensch M, Miike R: Dietary and tobacco risk factors for adult onset glioma in the San Francisco Bay Area (California, USA). Cancer Causes Control 1997;8:13-24.
15.
Hu J, La Vecchia C, Negri E, Chatenoud L, Bosetti C, Jia X, Liu R, Huang G, Bi D, Wang C: Diet and brain cancer in adults: a case-control study in northeast China. Int J Cancer 1999;81:20-23.
16.
Schwartzbaum JA, Fisher JL, Goodman J, Octaviano D, Cornwell DG: Hypotheses concerning roles of dietary energy, cured meat, and serum tocopherols in adult glioma development. Neuroepidemiology 1999;18:156-166.
17.
Chen H, Ward MH, Tucker KL, Graubard BI, McComb RD, Potischman NA, Weisenburger DD, Heineman EF: Diet and risk of adult glioma in eastern Nebraska, United States. Cancer Causes Control 2002;13:647-655.
18.
Tedeschi-Blok N, Lee M, Sison JD, Miike R, Wrensch M: Inverse association of antioxidant and phytoestrogen nutrient intake with adult glioma in the San Francisco Bay Area: a case-control study. BMC Cancer 2006;6:148.
19.
Michaud DS, Holick CN, Batchelor TT, Giovannucci E, Hunter DJ: Prospective study of meat intake and dietary nitrates, nitrites, and nitrosamines and risk of adult glioma. Am J Clin Nutr 2009;90:570-577.
20.
DeLorenze GN, McCoy L, Tsai AL, Quesenberry CP Jr, Rice T, Il'yasova D, Wrensch M: Daily intake of antioxidants in relation to survival among adult patients diagnosed with malignant glioma. BMC Cancer 2010;10:215.
21.
Dubrow R, Darefsky AS, Park Y, Mayne ST, Moore SC, Kilfoy B, Cross AJ, Sinha R, Hollenbeck AR, Schatzkin A, Ward MH: Dietary components related to N-nitroso compound formation: a prospective study of adult glioma. Cancer Epidemiol Biomarkers Prev 2010;19:1709-1722.
22.
DerSimonian R, Laird N: Meta-analysis in clinical trials. Control Clin Trials 1986;7:177-188.
23.
Higgins JP, Thompson SG: Quantifying heterogeneity in a meta-analysis. Stat Med 2002;21:1539-1558.
24.
Higgins JP, Thompson SG, Deeks JJ, Altman DG: Measuring inconsistency in meta-analyses. BMJ 2003;327:557-560.
25.
Begg CB, Mazumdar M: Operating characteristics of a rank correlation test for publication bias. Biometrics 1994;50:1088-1101.
26.
Egger M, Davey Smith G, Schneider M, Minder C: Bias in meta-analysis detected by a simple, graphical test. BMJ 1997;315:629-634.
27.
Tobias A: Assessing the in fluence of a single study in the meta-analysis estimate. Stata Tech Bull 1999;47:15-17.
28.
Conklin KA: Chemotherapy-associated oxidative stress: impact on chemotherapeutic effectiveness. Integr Cancer Ther 2004;3:294-300.
29.
Lawenda BD, Kelly KM, Ladas EJ, Sagar SM, Vickers A, Blumberg JB: Should supplemental antioxidant administration be avoided during chemotherapy and radiation therapy? J Natl Cancer Inst 2008;100:773-783.
30.
Prentice RL: Dietary assessment and the reliability of nutritional epidemiology reports. Lancet 2003;362:182-183.
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2015
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