Cade Janet Elizabeth, Burley Victoria Jane, Greenwood Darren Charles
Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, UK.
Int J Epidemiol. 2007 Apr;36(2):431-8. doi: 10.1093/ije/dyl295. Epub 2007 Jan 24.
Reports of relationships between dietary fibre intake and breast cancer have been inconsistent. Previous cohort studies have been limited by a narrow range of intakes.
Women who developed invasive breast cancer, 350 post-menopausally and 257 pre-menopausally, during 240,959 person-years of follow-up in the UK Women's Cohort Study (UKWCS) were studied. This cohort has 35,792 subjects with a wide range of exposure to dietary fibre with intakes of total fibre in the lowest quintile of <20 g/day up to >30 g/day in the top quintile. Fibre and breast cancer relationships were explored using Cox regression modelling adjusted for measurement error. Effects of fibre, adjusting for confounders were examined for pre- and post-menopausal women separately.
In pre-menopausal, but not post-menopausal women a statistically significant inverse relationship was found between total fibre intake and risk of breast cancer (P for trend = 0.01). The top quintile of fibre intake was associated with a hazard ratio of 0.48 [95% confidence interval (CI) 0.24-0.96] compared with the lowest quintile. Pre-menopausally, fibre from cereals was inversely associated with risk of breast cancer (P for trend = 0.05) and fibre from fruit had a borderline inverse relationship (P for trend = 0.09). A further model including dietary folate strengthened the significance of the inverse relationship between total fibre and pre-menopausal breast cancer.
These findings suggest that in pre-menopausal women, total fibre is protective against breast cancer; in particular, fibre from cereals and possibly fruit.
关于膳食纤维摄入量与乳腺癌之间关系的报道并不一致。以往的队列研究受到摄入量范围狭窄的限制。
在英国女性队列研究(UKWCS)中,对在240,959人年随访期间发生浸润性乳腺癌的女性进行了研究,其中绝经后350例,绝经前257例。该队列有35,792名受试者,膳食纤维摄入量范围广泛,总纤维摄入量最低五分位数<20克/天,最高五分位数>30克/天。使用针对测量误差进行调整的Cox回归模型探索纤维与乳腺癌的关系。分别对绝经前和绝经后女性,在调整混杂因素后检查纤维的影响。
在绝经前女性而非绝经后女性中,发现总纤维摄入量与乳腺癌风险之间存在统计学上显著的负相关(趋势P值=0.01)。与最低五分位数相比,纤维摄入量最高五分位数的风险比为0.48 [95%置信区间(CI)0.24 - 0.96]。在绝经前,谷物纤维与乳腺癌风险呈负相关(趋势P值=0.05),水果纤维呈边缘负相关(趋势P值=0.09)。一个包含膳食叶酸的进一步模型加强了总纤维与绝经前乳腺癌之间负相关关系的显著性。
这些发现表明,在绝经前女性中,总纤维对乳腺癌有保护作用;特别是谷物纤维以及可能的水果纤维。