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维生素D与降低乳腺癌风险:一项基于人群的病例对照研究。

Vitamin D and reduced risk of breast cancer: a population-based case-control study.

作者信息

Knight Julia A, Lesosky Maia, Barnett Heidi, Raboud Janet M, Vieth Reinhold

机构信息

Samuel Lunenfeld Research Institute, Mount Sinai Hospital, 60 Murray Street, Box 18, Toronto, Ontario, Canada M5T 3L9.

出版信息

Cancer Epidemiol Biomarkers Prev. 2007 Mar;16(3):422-9. doi: 10.1158/1055-9965.EPI-06-0865.

Abstract

BACKGROUND

Vitamin D, antiproliferative and proapoptotic in breast cancer cell lines, can reduce the development of mammary tumors in carcinogen-exposed rats. Current evidence in humans is limited with some suggestion that vitamin D-related factors may reduce the risk of breast cancer. We conducted a population-based case-control study to assess the evidence for a relationship between sources of vitamin D and breast cancer risk.

METHODS

Women with newly diagnosed invasive breast cancer were identified from the Ontario Cancer Registry. Women without breast cancer were identified through randomly selected residential telephone numbers. Telephone interviews were completed for 972 cases and 1,135 controls. Odds ratios (OR) and 95% confidence intervals (CI) for vitamin D-related variables were estimated using unconditional logistic regression with adjustment for potential confounders.

RESULTS

Reduced breast cancer risks were associated with increasing sun exposure from ages 10 to 19 (e.g., OR, 0.65; 95% CI, 0.50-0.85 for the highest quartile of outdoor activities versus the lowest; P for trend = 0.0006). Reduced risk was also associated with cod liver oil use (OR, 0.76; 95% CI, 0.62-0.92) and increasing milk consumption (OR, 0.62 95% CI 0.45-0.86 for >or=10 glasses per week versus none; P for trend = 0.0004). There was weaker evidence for associations from ages 20 to 29 and no evidence for ages 45 to 54.

CONCLUSION

We found strong evidence to support the hypothesis that vitamin D could help prevent breast cancer. However, our results suggest that exposure earlier in life, particularly during breast development, maybe most relevant. These results should be confirmed.

摘要

背景

维生素D在乳腺癌细胞系中具有抗增殖和促凋亡作用,可减少致癌物暴露大鼠乳腺肿瘤的发生。目前关于人类的证据有限,有一些迹象表明维生素D相关因素可能降低乳腺癌风险。我们开展了一项基于人群的病例对照研究,以评估维生素D来源与乳腺癌风险之间关系的证据。

方法

从安大略癌症登记处识别出新诊断为浸润性乳腺癌的女性。通过随机选择的住宅电话号码识别出无乳腺癌的女性。对972例病例和1135例对照完成了电话访谈。使用无条件逻辑回归估计维生素D相关变量的比值比(OR)和95%置信区间(CI),并对潜在混杂因素进行调整。

结果

乳腺癌风险降低与10至19岁期间阳光暴露增加相关(例如,最高四分位数的户外活动与最低四分位数相比,OR为0.65;95%CI为0.50 - 0.85;趋势P值 = 0.0006)。风险降低还与使用鱼肝油(OR为0.76;95%CI为0.62 - 0.92)和牛奶摄入量增加相关(每周饮用≥10杯与不饮用相比,OR为0.62,95%CI为0.45 - 0.86;趋势P值 = 0.0004)。20至29岁之间关联的证据较弱,45至54岁之间则无关联证据。

结论

我们发现有力证据支持维生素D可帮助预防乳腺癌这一假设。然而,我们的结果表明,生命早期尤其是乳腺发育期间的暴露可能最为相关。这些结果应予以证实。

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