Background
Numerous studies suggest a link between nutrients and lung cancer (LC) development, previous researches have produced conflicting results regarding the effects of diet-derived nutrient levels on LC risk. This study investigates the causal relationships between different types of lung cancer—including lung adenocarcinoma (LA), squamous cell lung cancer (SqCLC), and small cell lung cancer (SCLC)—and 12 dietary micronutrients, while also including calcium as an important mineral nutrient. We used National Health and Nutrition Examination Survey (NHANES) data to prove these associations, both in terms of diet and serum.
Methods
We selected instrumental variables (IVs) for the micronutrients based on recent genome-wide association studies (GWAS) and derived summary statistics for LC involving 33,057 cases and 545,462 controls. The causal inference analysis utilized the inverse-variance weighted (IVW) method, complemented by sensitivity analyses to validate the assumptions. The NHANES data, collected from 1988 to 2018, helped explore these associations, employing random forest imputation for missing data, propensity score analysis for confounding adjustment, and subgroup analyses to assess nutrient-cancer relationships. Machine learning techniques identified micronutrient most significantly associated with LC.
Results
Our findings suggest that higher dietary concentrations of vitamin B12 (OR: 0.30), zinc (OR: 0.06 for LA), vitamin D (OR: 0.60 for LA), and selenium (OR: 0.003 for SCLC) correlate with reduced LC risk. In the NHANES cohort of 14,421 participants, LC patients exhibited lower dietary intakes of the 12 micronutrients despite higher serum concentrations. Notably, machine learning results showed that elevated serum concentrations of calcium, zinc, and copper may also reduce the risk of LC.
Conclusions
These results indicate that zinc may protect against LC, particularly LA, while evidence for other nutrients is insufficient. The study also emphasizes the need for improved nutritional supplementation in LC patients.