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抗氧化剂补充剂与绝经后女性乳腺癌复发风险及乳腺癌相关死亡率

Antioxidant supplements and risk of breast cancer recurrence and breast cancer-related mortality among postmenopausal women.

作者信息

Fleischauer Aaron T, Simonsen Neal, Arab Lenore

机构信息

Department of Epidemiology, University of North Carolina, Chapel Hill, NC 27599, USA.

出版信息

Nutr Cancer. 2003;46(1):15-22. doi: 10.1207/S15327914NC4601_02.

Abstract

Despite widespread use, only a few clinical or epidemiological studies have examined the relationship between antioxidant supplements and risk of breast cancer recurrence or breast cancer-related mortality. We used proportional hazards and logistic regression modeling to estimate rate ratios and odds ratios (ORs) for recurrence and mortality among 385 postmenopausal women diagnosed with breast cancer between 1986 and 1988 enrolled into a case-control study on diet and cancer. Women were recontacted with a single questionnaire to ascertain the use of nutritional supplements during 12-14 yr of follow-up time. In multivariable models, antioxidant supplement users compared with nonusers were less likely to have a breast cancer recurrence or breast cancer-related death (OR = 0.54, 95% CI = 0.27-1.04). Vitamin E supplements showed a modest protective effect when used for more than 3 yr (OR = 0.33, 95% CI = 0.10-1.07). Premorbid dietary intake of vitamins C or E from diet, supplements, or both showed no relationship with risk. Risks of recurrence and disease-related mortality were reduced among women using vitamin C and vitamin E supplements for more than 3 yr. Recall bias among proxy respondents for women who died during follow-up may have contributed to these findings. This study provides limited support for the hypothesis that antioxidant supplements may reduce the risk of breast cancer recurrence or breast cancer-related mortality.

摘要

尽管抗氧化剂补充剂被广泛使用,但仅有少数临床或流行病学研究探讨了其与乳腺癌复发风险或乳腺癌相关死亡率之间的关系。我们使用比例风险模型和逻辑回归模型,对1986年至1988年间确诊为乳腺癌的385名绝经后女性进行病例对照研究,以估计复发率和死亡率的比率及比值比(OR)。这些女性参与了一项关于饮食与癌症的病例对照研究。我们通过一份单一问卷再次联系这些女性,以确定她们在12至14年随访期间营养补充剂的使用情况。在多变量模型中,与未使用抗氧化剂补充剂的女性相比,使用抗氧化剂补充剂的女性乳腺癌复发或乳腺癌相关死亡的可能性较小(OR = 0.54,95%置信区间 = 0.27 - 1.04)。维生素E补充剂使用超过3年时显示出适度的保护作用(OR = 0.33,95%置信区间 = 0.10 - 1.07)。病前从饮食、补充剂或两者中摄入的维生素C或E与风险无关。使用维生素C和维生素E补充剂超过3年的女性复发风险和疾病相关死亡率降低。随访期间死亡女性的代理受访者存在的回忆偏倚可能导致了这些结果。本研究为抗氧化剂补充剂可能降低乳腺癌复发风险或乳腺癌相关死亡率这一假设提供了有限的支持。

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