Interplay Of Serum Bilirubin and Tobacco Smoking with Lung and Head and Neck Cancers in a Diverse, EHR-linked Los Angeles Biobank

Vidhya Venkateswaran; Ella Petter; Kristin Boulier; Yi Ding; Arjun Bhattacharya; Bogdan Pasaniuc

doi:10.1101/2023.09.29.23296364

Interplay Of Serum Bilirubin and Tobacco Smoking with Lung and Head and Neck Cancers in a Diverse, EHR-linked Los Angeles Biobank

medRxiv [Preprint]. 2023 Oct 3:2023.09.29.23296364. doi: 10.1101/2023.09.29.23296364.

Authors

Vidhya Venkateswaran^{1

2}, Ella Petter^{1

3}, Kristin Boulier^{4

5}, Yi Ding^{1

4}, Arjun Bhattacharya⁶, Bogdan Pasaniuc^{1

4

7

8

9}

Affiliations

¹ Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA.
² Department of Oral Biology, School of Dentistry, University of California, Los Angeles, Los Angeles, CA 90095, USA.
³ Department of Computer Science, University of California, Los Angeles, Los Angeles, CA 90095, USA.
⁴ Bioinformatics Interdepartmental Program, University of California, Los Angeles, Los Angeles, CA 90095, USA.
⁵ Department of Medicine, Division of Cardiology, University of California, Los Angeles, Los Angeles, CA 90095, USA.
⁶ Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
⁷ Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA.
⁸ Department of Computational Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA.
⁹ Institute for Precision Health, University of California, Los Angeles, Los Angeles, CA 90095, USA.

Abstract

Background: Bilirubin is a potent antioxidant with a protective role in many diseases. We examined the relationships between serum bilirubin (SB) levels, tobacco smoking (a known cause of low SB), and aerodigestive cancers, grouped as lung (LC) and head and neck (HNC).

Methods: We examined the associations between SB, LC and HNC using data from 393,210 participants from UCLA Health, employing regression models, propensity score matching, and polygenic scores.

Results: Current tobacco smokers showed lower SB (-0.04mg/dL, 95% CI: [-0.04, -0.03]), compared to never-smokers. Lower SB levels were observed in HNC and LC cases (-0.10 mg/dL, [-0.13, -0.09] and -0.09 mg/dL, CI [-0.1, -0.07] respectively) compared to cancer-free controls with the effect persisting after adjusting for smoking. SB levels were inversely associated with HNC and LC risk (ORs per SD change in SB: 0.64, CI [0.59,0.69] and 0.57, CI [0.43,0.75], respectively). Lastly, a polygenic score (PGS) for SB was associated with LC (OR per SD change of SB-PGS: 0.71, CI [0.67, 0.76]).

Conclusions: Low SB levels are associated with an increased risk of both HNC and LC, independent of the effect of tobacco smoking with tobacco smoking demonstrating a strong interaction with SB on LC risk. Additionally, genetically predicted low SB (from polygenic scores) is negatively associated with LC.

Impact: These findings suggest that SB could serve as a potential early biomarker for LC and HNC.

Publication types

Preprint

Abstract

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