Slattery Martha L, Caan Bette J, Benson Joan, Murtaugh Maureen
Health Research Center, University of Utah, Salt Lake City, UT 84108, USA.
Nutr Cancer. 2003;46(2):166-71. doi: 10.1207/S15327914NC4602_09.
Lack of energy balance, or greater energy intake than expenditure as indicated by a large body mass index (BMI), has been associated with colon cancer, although less is known about its association with rectal cancer. In this study, we examined the association between BMI, energy intake, and energy expenditure and their combined effect on rectal cancer risk. A population-based case-control study was conducted in Utah and Northern California. Incident cases (n = 952) of rectal cancer and population-based controls (n = 1205) were interviewed between 1997 and 2002 to obtain detailed information on body size, dietary intake, and physical activity patterns. BMI (kg/m(2)) was not associated with rectal cancer in either men or women. Participation in vigorous leisure-time physical activity over the past 20 yr was associated with a significant 40% reduction in rectal cancer risk. Energy intake was associated significantly with increased risk of rectal cancer, especially among people whose diagnosis was prior to age 60 yr (odds ratio [OR] = 3.9; 95% confidence interval [CI] = 1.7-9.1 for men; OR = 2.8; 95% CI = 1.1-7.2 for women). There was a significant interaction between energy intake and energy expenditure, although not between BMI and either energy intake or energy expenditure. These data suggest that large BMI, an indicator of lack of energy balance, is not an important component of the etiology of rectal cancer. However, both physical activity and energy intake were significantly associated with rectal cancer risk. These data suggest that energy expenditure and energy intake alter rectal cancer risk through mechanisms other than energy balance.
能量失衡，即如高体重指数（BMI）所示的能量摄入超过能量消耗，与结肠癌有关，尽管其与直肠癌的关联尚鲜为人知。在本研究中，我们考察了BMI、能量摄入和能量消耗之间的关联及其对直肠癌风险的综合影响。在犹他州和北加利福尼亚州开展了一项基于人群的病例对照研究。1997年至2002年间，对直肠癌的新发病例（n = 952）和基于人群的对照者（n = 1205）进行了访谈，以获取有关体型、饮食摄入和身体活动模式的详细信息。BMI（kg/m²）在男性和女性中均与直肠癌无关。过去20年中参与剧烈休闲体育活动与直肠癌风险显著降低40%相关。能量摄入与直肠癌风险增加显著相关，尤其是在诊断年龄小于60岁的人群中（男性的优势比[OR] = 3.9；95%置信区间[CI] = 1.7 - 9.1；女性的OR = 2.8；95% CI = 1.1 - 7.2）。能量摄入与能量消耗之间存在显著交互作用，尽管BMI与能量摄入或能量消耗之间不存在交互作用。这些数据表明，高BMI作为能量失衡的一个指标，并非直肠癌病因的重要组成部分。然而，体育活动和能量摄入均与直肠癌风险显著相关。这些数据表明，能量消耗和能量摄入通过能量平衡以外的机制改变直肠癌风险。
