Assessment of Macro and Micronutrient Levels Associated with Gallbladder Cancer among Women of Eastern Uttar Pradesh and Western Bihar: A Case-control Study

Abstract

Introduction: Gallbladder Cancer (GBC) is highly fatal due to late-stage diagnosis and poor prognosis. Women are more prone to GBC than men. Imbalanced nutrient intake is cited as a risk factor for GBC. Association of nutrients with GBC incidence assessed using 24-hour recall method may mislead as food intake is altered in disease condition. The Food Frequency Questionnaire (FFQ) method that assesses usual nutrient intake pattern would be a better approach. Aim: To evaluate the association of macro and micronutrients in women with GBC using the FFQ method. Materials and Methods: This case-control study was carried out at a tertiary care hospital of Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India, from September 2018 to August 2019. A total of 82 women with GBC, aged 40 years and above, considered as cases and 164 healthy controls were included in the study. Data was collected regarding food intake, following the FFQ method, which included breakfast, lunch, dinner, and other extra intakes. Macro and micronutrients were computed using a raw database of food. A multivariate statistical approach was adopted as the nutrients were correlated. Results: The mean age of the controls (45.7±10.1 years) was significantly lower than the GBC cases (55.2±11.0 years). Preponderance in both cases and controls was of Hindus, rural and Other Backward Class (OBC) women. Illiterate patients were more than twice than the controls. Intake of 12 nutrients i.e., protein, fat, phosphorus, zinc, manganese, and carotene were higher and of calcium, potassium, selenium, vitamin-C, vitamin-E, and fibre were lower in cases than the controls. These 12 nutrients completely separated cases and controls. However, zinc, manganese, potassium, and fibre whose contributions were lowest when ignored, the separation ability to cases and controls remained the same as of 12 nutrients. Conclusion: Protein, fat, phosphorus, carotene, calcium, selenium, vitamin-C and vitamin-E, were found to be associated with GBC risk. Therefore, further understanding the role of nutrients in bringing about the right intervention to reduce the incidence of GBC is needed.