The relationship between reduced vitamin antioxidant concentrations and the systemic inflammatory response in patients with common solid tumours

Background and Aims: The majority of patients with advanced cancer have reduced circulating concentrations of the vitamin antioxidants including retinol, alpha-tocopherol and carotenoids. However, the basis of this reduction is not known. Vitamin antioxidant concentrations have been reported to be correlated with a systemic inflammatory response (as evidenced by C-reactive protein) in normal subjects and in patients with lung cancer. In order to determine whether this relationship was independent of tumour type patients other common solid tumours were studied. Methods: Fasting circulating concentrations of vitamin antioxidants and C-reactive protein were measured in normal subjects (n = 30) and patients with breast (n = 15), prostate (n = 15) and colorectal cancer (n = 11). Results: Concentrations of C-reactive protein were higher (P < 0.0001) and vitamin antioxidants lower (P < 0.0001) in the cancer patients. In normal subjects and cancer patients, C-reactive protein concentrations were inversely correlated with circulating concentrations of retinol (r(2) = 0.162), alpha-tocopherol (r(2) = 0.297), lutein (r(2) = 0.256), lycopene (r(2) = -0.171), alpha-(r(2) = 0.140) and beta-carotene (r(2) = 0.254): (all P < 0.001). Conclusions: Concentrations of retinol, alpha-tocopherol and carotenoids are inversely associated with the magnitude of the systemic inflammatory response. These relationships appear to be independent of the presence and type of cancer. (C) 2002 Elsevier Science Ltd.