Palli D, Russo A, Decarli A
Sezione Epidemiologia Analitica, U.O. Epidemiologia, Centro per lo Studio e la Prevenzione Oncologica, Florence, Italy.
Cancer Causes Control. 2001 Feb;12(2):163-72. doi: 10.1023/a:1008970310963.
To better understand the role of overall dietary patterns and major energy-providing components in gastric cancer etiology.
In a population-based case-control study conducted in a high-risk area in central Italy, 382 gastric cancer cases and 561 controls were available for analysis. Multivariate models based on energy-adjusted residuals and completely partitioned logistic models were used; dietary patterns were evaluated by factor analysis and multiple correspondence analysis.
Gastric cancer risk was inversely related to high energy-adjusted intakes of vegetable fat, sugar, beta-carotene, vitamin C, alpha-tocopherol, and nitrates. In contrast, significant positive associations emerged with high intake of protein, nitrite, and sodium. According to energy decomposition models, gastric cancer risk increased with increasing intake of protein and decreased with increasing intake of sugar and total fat. The pattern analysis identified four dietary profiles, overall explaining 75% of total dietary variability. Two patterns, named "traditional" and "vitamin-rich", were strongly associated with gastric cancer risk and overall accounted for 44% of estimated gastric cancer attributable risk. The other two patterns, "refined" and "fat-rich", were not consistently associated with gastric cancer.
Innovative methodological approaches may contribute to better evaluation of the complex relationship between diet and cancer risk and to planning dietary interventions.
更好地了解总体饮食模式和主要能量供应成分在胃癌病因学中的作用。
在意大利中部一个高危地区进行的一项基于人群的病例对照研究中，有382例胃癌病例和561例对照可供分析。使用基于能量调整残差的多变量模型和完全分割逻辑模型；通过因子分析和多重对应分析评估饮食模式。
胃癌风险与蔬菜脂肪、糖、β-胡萝卜素、维生素C、α-生育酚和硝酸盐的高能量调整摄入量呈负相关。相反，蛋白质、亚硝酸盐和钠的高摄入量与显著的正相关。根据能量分解模型，胃癌风险随着蛋白质摄入量的增加而增加，随着糖和总脂肪摄入量的增加而降低。模式分析确定了四种饮食概况，总体解释了75%的总饮食变异性。两种模式，即“传统”和“富含维生素”，与胃癌风险密切相关，总体占估计胃癌归因风险的44%。另外两种模式，“精制”和“富含脂肪”，与胃癌没有一致的关联。
创新的方法学方法可能有助于更好地评估饮食与癌症风险之间的复杂关系，并有助于规划饮食干预措施。
