Relationship between glucosamine use and the risk of lung cancer: data from a nationwide prospective cohort study
Authors: Xin Huang
Junguo Zhang
Lehana Thabane
Guowei Li
Likang Li
Yingxin Liu
Gregory Y H Lip
Xuhui Zhang
Journal: European Respiratory Journal (2021)
Discipline: CLINICAL MEDICINE
Keywords: glucosamine; lung cancer; mortality; risk; cohort study
Affiliations: Center for Clinical Epidemiology and Methodology (CCEM), Guangdong Second Provincial General Hospital, Guangzhou, China., Department of Oncology No.2, Guangdong Second Provincial General Hospital, Guangzhou, China., Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada., Liverpool Centre for Cardiovascular Science, University of Liverpool, United Kingdom.

Abstract:  Background: Research on glucosamine shows anti-inflammatory and anti-cancer benefits with minimal adverse effects. We aimed to explore the relationship between use of glucosamine and risk of lung cancer and lung cancer mortality based on data from the large-scale nationwide prospective UK Biobank cohort study. Methods: Participants were enrolled between 2006 and 2010 and followed-up to 2020. The Cox proportional hazards model was used to assess the relationship between glucosamine use and risk of lung cancer and lung cancer mortality. Subgroup analyses and sensitivity analyses were performed to explore the potential effect modifications and the robustness of the main findings. Results: 439 393 participants (mean age 56 years; 53% females) with a mean follow-up of 11 years were included for analyses. 82 603 (18.80%) participants reported regular use of glucosamine at baseline. During follow-up, 1971 (0.45%) lung cancer events were documented. Glucosamine use was significantly associated with a decreased risk of lung cancer (hazard ratio (HR) 0.84, 95% CI 0.75-0.92; p&lt;0.001) and lung cancer mortality (HR 0.88, 95% CI 0.81-0.96; p=0.002) in fully adjusted models. A stronger association between glucosamine use and decreased lung cancer risk was observed in participants with a family history of lung cancer when compared with those without a family history. Conclusion: Regular use of glucosamine was significantly related with decreased risk of lung cancer and lung cancer mortality, based on data from this nationwide prospective cohort study. 

Retracted: No

PubPeer comments:
 On 29 July 2021, the article entitled u201cRelationship between glucosamine use and the risk of lung cancer: data from a nationwide prospective cohort studyu201d was published in European Respiratory Journal. The manuscript revealed that regular use of glucosamine was significantly related with decreased risk of lung cancer and lung cancer mortality. That manuscript, however, may contain some flaws in statistical methods that could influence the authorsu2019 conclusion. In that manuscript, the authors indicated that the censoring date of participants from UK biobank wasu00a021 May 2020. Although the UK data applied at different time had different censoring dates, I am confused as to why the authors used the date ofu00a021 May 2020u00a0as the cut-off time. The latest website of UK biobank showed that cancer cases including lung cancer were ascertained until 31 July 2019 for England and Wales, and 31 October 2015 for Scotland.u00a0 , which are both prior to 21 May 2020. Furthermore, supplemental figure 1 showed cumulative incidences of lung cancer either in glucosamine non-users or users stopped growing after u22488 yearsuff0cwhich is unreasonable. Therefore I doubt that the authors have used a wrong censoring date in their survival analysis. Using that incorrect censoring date could lead to huge errors in results, such as fault associations or inaccurately HRs. Also, using the UK-biobank data (censoring date was set asu00a021 May 2020), I tried to repeat the authorsu2019 analyses as they described in their manuscript, but I failed to get the same positive results. I believe that the authors should double check the censoring date according to their specific UK-biobank data and guidelines, and provide the audience with a sound explanation. I hope to see their final results and the statistical codes where possible. ,