The Relationship Between Dinner-to-bed Time, Alcohol Flushing Response And Gastric Cardia Adenocarcinoma

Background:Gastric cancer remains the second cause of cancer-related death worldwide. GCA is generally considered as a specific subtype of gastric cancer. Because of the high mortality and poor response to treatments of GCA, early intervention on behavioral and environmental risk factors seems to be imperative. The aim of the study was to investigate the effects of shorter dinner-to-bed time, post-dinner walk and obesity on gastric cardia adenocarcinoma (GCA) risk.Methods:The study subjects consist of146GCA patients and166healthy controls roughly matched by gender and age. We used a structured questionnaire regarding dinner-to-bed time,, post-dinner walk, smoking habits, drinking habits, body weight, body height, reflux symptoms and dietary habits. Conditional logistic regression was used to calculated odds ratio (OR) and95%confidence intervals (95%CI).Results:1. Shorter dinner-to-bed time (<3h) had a strong effect on the development of GCA. The post-dinner walk, obesity, drinking habits, smoking habits and dietary habits adjusted ORs of GCA for subjects with shorter dinner-to-bed time were4.18(95%CI=2.10-8.33) relative to those with longer dinner-to-bed time (≥4h). Post-dinner walk was associated with a significantly decreased GCA risk (adjusted OR=0.54,95%CI=0.31-0.94). When reflux symptom was added into the adjusted models, the adjusted OR for shorter dinner to bed time decreased from4.18to2.86; while the OR of post-dinner walk changed lightly.2. When subjects were analyzed according to post-dinner walk, the adjusted OR of GCA for shorter dinner-to-bed time relative to longer dinner-to-bed time was much higher for non-walking subjects (adjusted OR=20.21;95%CI=5.86-69.77) than walking people (adjusted OR=1.39;95%CI=0.56-3.43). When subjects were analyzed according to obesity, the adjusted ORs of GCA for shorter dinner-to-bed time relative to longer dinner-to-bed time was2fold higher for the obese (adjusted OR=7.74;95%CI=1.76-34.09) than the non-obese (adjusted OR=3.46;95%CI=1.58-7.55). The OR for the variables interaction between shorter dinner-to-bed time and post-dinner walk was0.07(95%CI=0.01-0.323; p=0.001).Conclusions:We found that shorter dinner-to-bed time was associated with significantly increased GCA risk, partly depending on reflux symptom. While post-dinner walk was related to a significantly decreased GCA risk and could greatly attenuated the GCA risk attributable to shorter dinner-to-bed time. Background:The relationship between the development of gastric cardia cancer (GCA) and alcohol consumption remains unclear. Alcohol flushing response reflects an accumulation of the carcinogenic acetaldehyde, and has been proved to be a risk factor for many cancers. The main objective of the present study was to assess the impact of alcohol flushing response on GCA risk in a Chinese population in conjunction with lifetime alcohol consumption.Methods:The study subjects consist of281male patients (130with GCA and151with esophageal squamous cell carcinoma (ESCC)) and160non-cancer male controls, matched with respect to age. Conditional logistic regression was used to calculate odds ratios (ORs) and95%confidence intervals (95%CI).Results:1. When compared with non-drinkers in a multiple-adjusted model, either moderate drinkers or heavy drinkers experienced a significantly increased GCA risk. However, the subjects reporting ever/current flushing response had a2.03-fold risk (95%CI1.15-3.56; p=0.014) to develop GCA, compared with those reporting never flushing. In the drinkers, only heavy drinkers (≥1,800g-year) experienced a significant risk to develop ESCC (adjusted OR:2.63;95%CI1.42-4.86; p=0.002). The subjects reporting ever/current flushing response had a2.32-fold risk (95%CI1.34-4.03; p=0.003) to develop ESCC. Both moderate smoking (<30pack-year) and heavy smoking (≥30pack-year) were significantly associated with the development of ESCC, compared with non-smoking. Subjects with a special dietary habit experienced a3.62-fold risk (95%CI2.08-6.28; p<0.001) to develop GCA and a3.23-fold risk (95%CI1.91-5.46; p<0.001) to develop ESCC.2. After matched for age and adjusted for smoking and diet, we estimated the combined effect of alcohol consumption and flushing response on GCA risk and ESCC risk (Table4). We used non-drinkers as the reference category. Both heavy and moderate drinkers with current/former flushing experienced a high risk (Heavy: OR=2.59;95%CI=1.06-6.31, p=0.037; Moderate:OR=3.11;95%CI=1.17-8.26, p=0.023) to develop GCA. While drinkers reporting never flushing did not experience significant GCA risk. Similarly, both heavy and moderate drinkers with current/former flushing experienced a high risk (Heavy:OR=4.87;95%CI=2.05-11.61, p<0.001; Moderate:OR=3.83;95%CI=1.47-10.03, p=0.006) to develop ESCC, and the drinkers reporting never flushing had no significant ESCC risk.Conclusions:The present study found a significant association between the risk of GCA and alcohol flushing response, and the flushing response significantly increased the risk when combined with alcohol drinking. Our study suggests that alcohol flushing response may serve as a hazard biomarker of gastric cardia adenocarcinoma for drinkers, which may help doctors with their clinical decisions in the future.