Associations of serum carotenoid concentrations with all-cause mortality in cancer survivors

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-08-14 DOI:10.1016/j.clnesp.2025.08.014

Jing Han , Ruiyun Wang , Lijuan Bai , Yun Liu , Man Liao , Liting Zhang , Lihua Liu , Benling Qi

{"title":"Associations of serum carotenoid concentrations with all-cause mortality in cancer survivors","authors":"Jing Han , Ruiyun Wang , Lijuan Bai , Yun Liu , Man Liao , Liting Zhang , Lihua Liu , Benling Qi","doi":"10.1016/j.clnesp.2025.08.014","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Cancer is the second leading cause of mortality in the United States, surpassed only by cardiovascular disease. As of January 1, 2019, approximately 16.9 million Americans were living with a history of cancer. Current evidence regarding the effect of serum carotenoids on all-cause mortality in cancer populations is limited. This study aims to investigate the association between serum carotenoid concentrations and survival among cancer survivors in the United States.</div></div><div><h3>Methods</h3><div>This prospective study examines the association between serum concentrations of five major carotenoids (α-carotene, β-carotene, β-cryptoxanthin, lycopene, lutein/zeaxanthin) and all-cause mortality risk among cancer survivors in a nationally representative cohort. Data were obtained from the National Health and Nutrition Examination Survey (NHANES) III and Continuous NHANES (2001–2006). Multivariable Cox proportional hazards regression models assessed the relationship between carotenoid levels and all-cause mortality outcomes, adjusting for relevant confounders. Restricted cubic spline (RCS) analyses were performed to determine the association between carotenoid concentrations and outcomes.</div></div><div><h3>Results</h3><div>During a mean follow-up of 15.2 years, 1089 deaths were recorded. In adjusted models, elevated serum concentrations of α-carotene, β-carotene, lycopene, and lutein/zeaxanthin were significantly associated with reduced risk of all-cause mortality (P trends <0.05). In contrast, β-cryptoxanthin showed no significant association. RCS plots revealed L-shaped associations for α-carotene, β-carotene, and lycopene, and U-shaped associations for lutein/zeaxanthin and β-cryptoxanthin.</div></div><div><h3>Conclusions</h3><div>Elevated serum α-carotene, β-carotene, lycopene, and lutein/zeaxanthin levels are associated with lower all-cause mortality in cancer survivors. These findings suggest that serum carotenoids could serve as important biomarkers for assessing long-term mortality risk and may inform dietary recommendations for cancer survivors.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 165-173"},"PeriodicalIF":2.6000,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical nutrition ESPEN","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2405457725029006","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Cancer is the second leading cause of mortality in the United States, surpassed only by cardiovascular disease. As of January 1, 2019, approximately 16.9 million Americans were living with a history of cancer. Current evidence regarding the effect of serum carotenoids on all-cause mortality in cancer populations is limited. This study aims to investigate the association between serum carotenoid concentrations and survival among cancer survivors in the United States.

Methods

This prospective study examines the association between serum concentrations of five major carotenoids (α-carotene, β-carotene, β-cryptoxanthin, lycopene, lutein/zeaxanthin) and all-cause mortality risk among cancer survivors in a nationally representative cohort. Data were obtained from the National Health and Nutrition Examination Survey (NHANES) III and Continuous NHANES (2001–2006). Multivariable Cox proportional hazards regression models assessed the relationship between carotenoid levels and all-cause mortality outcomes, adjusting for relevant confounders. Restricted cubic spline (RCS) analyses were performed to determine the association between carotenoid concentrations and outcomes.

Results

During a mean follow-up of 15.2 years, 1089 deaths were recorded. In adjusted models, elevated serum concentrations of α-carotene, β-carotene, lycopene, and lutein/zeaxanthin were significantly associated with reduced risk of all-cause mortality (P trends <0.05). In contrast, β-cryptoxanthin showed no significant association. RCS plots revealed L-shaped associations for α-carotene, β-carotene, and lycopene, and U-shaped associations for lutein/zeaxanthin and β-cryptoxanthin.

Conclusions

Elevated serum α-carotene, β-carotene, lycopene, and lutein/zeaxanthin levels are associated with lower all-cause mortality in cancer survivors. These findings suggest that serum carotenoids could serve as important biomarkers for assessing long-term mortality risk and may inform dietary recommendations for cancer survivors.

查看原文本刊更多论文

血清类胡萝卜素浓度与癌症幸存者全因死亡率的关系

背景：癌症是美国第二大死亡原因，仅次于心血管疾病。截至2019年1月1日，约有1690万美国人患有癌症病史。目前关于血清类胡萝卜素对癌症人群全因死亡率影响的证据有限。本研究旨在调查美国癌症幸存者血清类胡萝卜素浓度与生存之间的关系。方法：这项前瞻性研究在全国代表性队列中研究了五种主要类胡萝卜素（α-胡萝卜素、β-胡萝卜素、β-隐黄质、番茄红素、叶黄素/玉米黄质）的血清浓度与癌症幸存者全因死亡风险之间的关系。数据来自国家健康和营养检查调查（NHANES） III和连续NHANES（2001-2006）。多变量Cox比例风险回归模型评估了类胡萝卜素水平与全因死亡率结果之间的关系，并对相关混杂因素进行了调整。限制性三次样条（RCS）分析确定类胡萝卜素浓度与结果之间的关系。结果：在平均15.2年的随访期间，记录了1089例死亡。在调整后的模型中，血清α-胡萝卜素、β-胡萝卜素、番茄红素和叶黄素/玉米黄质浓度升高与全因死亡率降低显著相关（P趋势）。结论：血清α-胡萝卜素、β-胡萝卜素、番茄红素和叶黄素/玉米黄质水平升高与癌症幸存者全因死亡率降低相关。这些发现表明，血清类胡萝卜素可以作为评估长期死亡风险的重要生物标志物，并可能为癌症幸存者提供饮食建议。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.