Regular Glucosamine Use May Have Different Roles in the Risk of Site-Specific Cancers: Findings from a Large Prospective Cohort

Li, Fu-Xiao; Zhao, Hou-Yu; Lin, Tengfei; Jiang, Yi-Wen; Liu, Di; Wei, Chang; Zhao, Zi-Yi; Yang, Zu‐Yao; Sha, Feng; Yang, Zhirong; Tang, Jin‐Ling

doi:10.1158/1055-9965.epi-22-1134

Cited by 4 publications

(1 citation statement)

References 38 publications

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“…The putative anti-inflammatory properties of glucosamine, coupled with its potential utility as a prophylactic agent in the context of malignancy, have been suggested by human and animal studies ( Kantor et al, 2012 ; Ibanez-Sanz et al, 2020 ; Lee et al, 2020 ; Kantor et al, 2022 ; Li et al, 2022 ; Mazzucchelli et al, 2022 ; Zhang et al, 2022 ; Li et al, 2023 ). Despite the numerous observational studies indicating a protective association between habitual glucosamine consumption and the risk of cancer and non-neoplastic diseases, the potential hazard and causal nature of this connection remain uncertain.…”

Section: Introductionmentioning

confidence: 99%

Association between genetically proxied glucosamine and risk of cancer and non-neoplastic disease: A Mendelian randomization study

Wu,

Che,

Zhang

et al. 2024

Front. Genet.

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IntroductionObservational investigations have examined the impact of glucosamine use on the risk of cancer and non-neoplastic diseases. However, the findings from these studies face limitations arising from confounding variables, reverse causation, and conflicting reports. Consequently, the establishment of a causal relationship between habitual glucosamine consumption and the risk of cancer and non-neoplastic diseases necessitates further investigation.MethodsFor Mendelian randomization (MR) investigation, we opted to employ single-nucleotide polymorphisms (SNPs) as instruments that exhibit robust associations with habitual glucosamine consumption. We obtained the corresponding effect estimates of these SNPs on the risk of cancer and non-neoplastic diseases by extracting summary data for genetic instruments linked to 49 varied cancer types amounting to 378,284 cases and 533,969 controls, as well as 20 non-neoplastic diseases encompassing 292,270 cases and 842,829 controls. Apart from the primary analysis utilizing inverse-variance weighted MR, we conducted two supplementary approaches to account for potential pleiotropy (MR-Egger and weighted median) and assessed their respective MR estimates. Furthermore, the results of the leave-one-out analysis revealed that there were no outlying instruments.ResultsOur results suggest divergence from accepted biological understanding, suggesting that genetically predicted glucosamine utilization may be linked to an increased vulnerability to specific illnesses, as evidenced by increased odds ratios and confidence intervals (95% CI) for diseases, such as malignant neoplasm of the eye and adnexa (2.47 [1.34–4.55]), benign neoplasm of the liver/bile ducts (2.12 [1.32–3.43]), benign neoplasm of the larynx (2.01 [1.36–2.96]), melanoma (1.74 [1.17–2.59]), follicular lymphoma (1.50 [1.06–2.11]), autoimmune thyroiditis (2.47 [1.49–4.08]), and autoimmune hyperthyroidism (1.93 [1.17–3.18]). In contrast to prior observational research, our genetic investigations demonstrate a positive correlation between habitual glucosamine consumption and an elevated risk of sigmoid colon cancer, lung adenocarcinoma, and benign neoplasm of the thyroid gland.ConclusionCasting doubt on the purported purely beneficial association between glucosamine ingestion and prevention of neoplastic and non-neoplastic diseases, habitual glucosamine ingestion exhibits dichotomous effects on disease outcomes. Endorsing the habitual consumption of glucosamine as a preventative measure against neoplastic and non-neoplastic diseases cannot be supported.

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Section: Introductionmentioning

confidence: 99%

Association between genetically proxied glucosamine and risk of cancer and non-neoplastic disease: A Mendelian randomization study

Wu,

Che,

Zhang

et al. 2024

Front. Genet.

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Glucosamine and Cancer Incidence in Osteoarthritis: A Prevalent New‐User Cohort Design

Suissa,

Dell'Aniello,

Comin

et al. 2024

Arthritis Care & Research

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BackgroundObservational studies have associated glucosamine, used to treat joint pain and osteoarthritis, with reductions in cancer incidence, though their study design was affected by selection bias. We assessed this association using a study design that mitigates this selection bias.MethodsWe used the UK Clinical Practice Research Datalink to identify a cohort of patients diagnosed with osteoarthritis during 1995‐2017. The prevalent new‐user cohort design was used to match glucosamine initiators with non‐users on time‐conditional propensity scores and followed until cancer incidence. Hazard ratios (HR) and 95% confidence intervals (CI) of cancer incidence were estimated to compare glucosamine use with non‐use.ResultsThe study cohort of osteoarthritis patients included 20,541 glucosamine initiators who were matched to 20,541 non‐users. Over an average follow‐up of 8 years, the overall incidence rate of any cancer was 16.4 per 1000 per year. The HR of any cancer incidence with glucosamine use was 0.97 (95% CI 0.91‐1.02), compared with non‐use. For lung cancer, the HR with glucosamine use was 0.99 (95% CI 0.83‐1.18), while it was 1.11 (95% CI 0.93‐1.33) for colorectal cancer, 1.07 (95% CI 0.93‐1.23) for breast cancer in women and 1.03 (95% CI 0.88‐1.22) for prostate cancer.ConclusionsIn this large, real‐world study of patients with osteoarthritis, designed to emulate a trial, treatment with glucosamine did not reduce the incidence of cancer. This finding reinforces that previous studies, not based on new users, were affected by selection bias. Our study does not support the use of glucosamine to prevent cancer in patients with osteoarthritis.image

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Habitual use of glucosamine and adverse liver outcomes among patients with type 2 diabetes and MASLD

Shen,

Wang,

et al. 2024

Liver International

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BackgroundGlucosamine is a dietary supplement commonly used to support joint health. However, there has been interest in exploring other effects of glucosamine on health outcomes due to its ant‐inflammation effect.ObjectiveThis study compared the risks of major adverse liver outcomes (MALOs) between regular users and non‐users of glucosamine among patients with type 2 diabetes and metabolic dysfunction associated steatotic liver disease (MASLD) using the data from a large prospective cohort study.MethodsDemographic, anthropometric, laboratory and medication prescription information among 18 753 patients with type 2 diabetes and MASLD was obtained from the UK Biobank. MASLD was identified based on hepatic steatosis defined by fatty liver index ≥60 plus the presence of any clues of metabolic dysregulation and cardio‐metabolic risk factors, excluding patients with moderate to severe alcohol consumption.ResultsDuring a mean follow‐up of 11.4 years, 826 incident MALOs events were recorded. Patients not regularly using glucosamine compared with patients using glucosamine showed a significantly higher risk of the composite MALOs (HR 1.36, 95% confidence interval [CI] 1.09–1.69) as well as most individual MALOs except for ascites. The multivariable‐adjusted HRs of MALOs within 3, 5 and 10 years among non‐users of glucosamine compared with regular users were 1.79 (95% CI .69–2.03), 1.88 (95% CI 1.21–2.54) and 1.32 (95% CI 1.05–1.72), respectively. Further subgroup analyses in participants with different baseline characteristics and sensitivity analyses excluding participants who regularly took any other supplements and participants who used self‐reports to diagnose diabetes confirmed the findings.ConclusionsThe present study indicated that habitual use of glucosamine was associated with a low risk of individual and composite MALOs among patients with type 2 diabetes and MASLD.

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Regular Glucosamine Use May Have Different Roles in the Risk of Site-Specific Cancers: Findings from a Large Prospective Cohort

Cited by 4 publications

References 38 publications

Association between genetically proxied glucosamine and risk of cancer and non-neoplastic disease: A Mendelian randomization study

Association between genetically proxied glucosamine and risk of cancer and non-neoplastic disease: A Mendelian randomization study

Glucosamine and Cancer Incidence in Osteoarthritis: A Prevalent New‐User Cohort Design

Habitual use of glucosamine and adverse liver outcomes among patients with type 2 diabetes and MASLD

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