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@ARTICLE{Zhang:277436,
      author       = {H. Zhang and Y. Yao and X. Zhong and F. Meng and K.
                      Hemminki$^*$ and J. Qiu and X. Shu},
      title        = {{A}ssociation between intake of the n-3 polyunsaturated
                      fatty acid docosahexaenoic acid (n-3 {PUFA} {DHA}) and
                      reduced risk of ovarian cancer: {A} systematic {M}endelian
                      {R}andomization study.},
      journal      = {Clinical nutrition},
      volume       = {42},
      number       = {8},
      issn         = {0261-5614},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier},
      reportid     = {DKFZ-2023-01373},
      pages        = {1379 - 1388},
      year         = {2023},
      abstract     = {Whether the intake of docosahexaenoic acid (DHA), an n-3
                      polyunsaturated fatty acid, is beneficial for ovarian cancer
                      (OC) remains controversial and we hope to disentangle this
                      puzzle using genetic data from large-scale populations in
                      European and Asian.We employed, for the first time, a
                      systematic Mendelian randomization (MR) design to
                      comprehensively evaluate the causal effect of plasma DHA
                      levels, an objective biomarker of DHA intake, on OC risk in
                      European and then verified the extrapolation of the results
                      in the Asian. Data in the analysis included genetic
                      association data obtained from large-scale genome-wide
                      association studies with 13,499 individuals for plasma DHA
                      measurements and 66,450 individuals for OC in the European
                      population, and 1361 individuals for plasma DHA measurements
                      and 61,457 individuals for OC in the Asian population. The
                      causal relationship between DHA and OC was estimated using
                      the inverse-variance weighted approach, together with
                      extensive validation and sensitivity analyses to verify the
                      main results.In the European population, MR evidence
                      suggested a causal relationship between higher plasma DHA
                      levels and lower OC risk (OR, 0.89 for OC per one-SD
                      increment in DHA; $95\%$ CI, 0.83 to 0.96; P = 0.003).
                      Subgroup analysis by histological type of OC indicated that
                      this observed association was stronger among endometrioid
                      ovarian cancer (EOC) (OR, 0.82; $95\%$ CI, 0.69 to 0.96; P =
                      0.014). A similar causal association of borderline
                      significance was reached in the Asian replication set. The
                      above results were consistently supported by a series of
                      validation and sensitivity analyses.Our study provided
                      robust genetic evidence for a protective association between
                      plasma DHA levels and lower risk of OC, especially EOC, in
                      the European population. These findings may inform
                      prevention strategies and interventions directed towards DHA
                      intake and OC.},
      keywords     = {Docosahexaenoic acid (DHA) (Other) / Genome-wide
                      association study (GWAS) (Other) / Mendelian randomization
                      (MR) (Other) / Ovarian cancer (Other) / n-3 polyunsaturated
                      fatty acid (PUFA) (Other)},
      cin          = {C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37421851},
      doi          = {10.1016/j.clnu.2023.06.028},
      url          = {https://inrepo02.dkfz.de/record/277436},
}