Feskanich D, Willett W C, Hunter D J, Colditz G A
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
Br J Cancer. 2003 May 6;88(9):1381-7. doi: 10.1038/sj.bjc.6600882.
Within the two Nurses' Health Study cohorts of US women, we examined whether higher intakes of vitamin C, vitamin E, retinol, or individual tocopherols or carotenoids are associated with a lower risk of melanoma. We confirmed 414 cases of invasive melanoma among over 162,000 Caucasian women aged 25-77 years during more than 1.6 million person-years of follow-up. Diet was measured every 4 years with a food frequency questionnaire and supplement use was reported every 2 years. Several measures of sun sensitivity were assessed and included in proportional hazards models. We found that vitamins A, C, E and their individual components were not associated with a lower risk of melanoma. Only retinol intake from foods plus supplements appeared protective within a subgroup of women who were otherwise at low risk based on nondietary factors (relative risk (RR)=0.39, 95% confidence interval (CI) 0.22-0.71 for >/=1,800 vs 400 microg day(-1), P for linear trend=0.01). Contrary to expectation, we observed higher risks of melanoma with greater intakes of vitamin C from food only (RR=1.43, 95% CI 1.01-2.00 for >/=175 vs <90 mg day(-1), P for linear trend=0.05) and a significant positive dose-response with frequency of orange juice consumption (P=0.008). Further research is needed to determine whether another component in foods such as orange juice may contribute to an increase in risk.
在美国女性的两项护士健康研究队列中，我们研究了较高剂量的维生素C、维生素E、视黄醇、或单一生育酚或类胡萝卜素的摄入是否与较低的黑色素瘤风险相关。在超过16.2万名年龄在25 - 77岁的白人女性长达160多万人年的随访期间，我们确诊了414例侵袭性黑色素瘤病例。每4年用食物频率问卷测量饮食情况，每2年报告补充剂的使用情况。评估了几种对阳光敏感的指标，并将其纳入比例风险模型。我们发现维生素A、C、E及其单一成分与较低的黑色素瘤风险无关。仅在基于非饮食因素处于低风险的女性亚组中，食物加补充剂中的视黄醇摄入似乎具有保护作用（相对风险（RR）=0.39，95%置信区间（CI）0.22 - 0.71，摄入量≥1800微克/天与400微克/天相比，线性趋势P = 0.01）。与预期相反，我们观察到仅从食物中摄入较多维生素C会增加黑色素瘤风险（RR = 1.43，95% CI 1.01 - 2.00，摄入量≥175毫克/天与<90毫克/天相比，线性趋势P = 0.05），并且橙汁饮用频率与风险呈显著正剂量反应关系（P = 0.008）。需要进一步研究以确定橙汁等食物中的其他成分是否可能导致风险增加。
