维生素、类胡萝卜素、膳食纤维与胃癌风险：6.3年随访后的前瞻性研究结果

Vitamins, carotenoids, dietary fiber, and the risk of gastric carcinoma: results from a prospective study after 6.3 years of follow-up.

作者信息

Botterweck A A, van den Brandt P A, Goldbohm R A

机构信息

Maastricht University, Department of Epidemiology, Maastricht, The Netherlands.

出版信息

Cancer. 2000 Feb 15;88(4):737-48.

PMID:10679641

Abstract

BACKGROUND

Numerous components of fruit and vegetables are considered to decrease the risk of gastric carcinoma. In the current prospective study, the authors examined the association between the intake of vitamins, carotenoids, and dietary fiber and vitamin supplement use and the incidence rate of gastric carcinoma.

METHODS

The Netherlands Cohort Study began in 1986 with 120,852 men and women ages 55-69 years. Data regarding diet and other covariates were collected by means of a self-administered questionnaire. After 6.3 years of follow-up, data regarding 282 incident cases of gastric carcinoma and 3123 subcohort members were available for case-cohort analyses.

RESULTS

In analyses adjusted for age, gender, smoking history, education, stomach disorders, and family history of gastric carcinoma, an inverse association with vitamin C intake (relative risk [RR] for highest vs. lowest intake category, 0.7; 95% confidence interval [95% CI], 0.5-1.0) was observed, with a borderline significant trend across three intake categories (P = 0. 06). After the exclusion of cases diagnosed in the first and second follow-up years, the RR was 0.9 (95% CI, 0.6-1.2; P trend = 0.44). Intake of retinol and beta-carotene were associated positively with gastric carcinoma risk with highest versus lowest quintile RRs of 1. 6 (95% CI, 1.0-2.5; P trend = 0.02) and 1.6 (95% CI, 1.0-2.6; P trend = 0.13), respectively, after the exclusion of first-year and second-year cases. Intake of folate, vitamin E, alpha-carotene, lutein plus zeaxanthin, beta-cryptoxanthin, lycopene, and dietary fiber was not associated with gastric carcinoma. Patients who used vitamin A-containing supplements had a lower risk of gastric carcinoma than nonusers (RR = 0.4; 95% CI, 0.2-0.9).

CONCLUSIONS

No clear inverse associations were found between the intake of vitamins, carotenoids, and dietary fiber and the risk of gastric carcinoma after adjustment for confounding variables and the exclusion of first-year and second-year cases.

摘要

背景

水果和蔬菜的众多成分被认为可降低胃癌风险。在当前这项前瞻性研究中，作者研究了维生素、类胡萝卜素和膳食纤维的摄入量及维生素补充剂的使用与胃癌发病率之间的关联。

方法

荷兰队列研究始于1986年，共有120852名年龄在55至69岁之间的男性和女性。通过自填问卷收集饮食及其他协变量的数据。经过6.3年的随访，有282例胃癌发病病例和3123名队列成员的数据可用于病例队列分析。

结果

在对年龄、性别、吸烟史、教育程度、胃部疾病和胃癌家族史进行校正的分析中，观察到维生素C摄入量与胃癌呈负相关（最高摄入量组与最低摄入量组的相对风险[RR]为0.7；95%置信区间[95%CI]，0.5 - 1.0），在三个摄入量类别中呈边缘显著趋势（P = 0.06）。排除在第一年和第二年随访中诊断出的病例后，RR为0.9（95%CI，0.6 - 1.2；P趋势 = 0.44）。排除第一年和第二年的病例后，视黄醇和β-胡萝卜素的摄入量与胃癌风险呈正相关，最高五分位数与最低五分位数的RR分别为1.6（95%CI，1.0 - 2.5；P趋势 = 0.02）和1.6（95%CI，1.0 - 2.6；P趋势 = 0.13）。叶酸、维生素E、α-胡萝卜素、叶黄素加玉米黄质、β-隐黄质、番茄红素和膳食纤维的摄入量与胃癌无关。使用含维生素A补充剂的患者患胃癌的风险低于未使用者（RR = 0.4；95%CI，0.2 - 0.9）。