Skjelbred Camilla F, Saebø Mona, Hjartåker Anette, Grotmol Tom, Hansteen Inger-Lise, Tveit Kjell M, Hoff Geir, Kure Elin H
Department of Laboratory Medicine, Section of Medical Genetics, Telemark Hospital, N-3710 Skien, Norway.
BMC Cancer. 2007 Dec 19;7:228. doi: 10.1186/1471-2407-7-228.
The risk of sporadic colorectal cancer (CRC) is mainly associated with lifestyle factors, particularly dietary factors. Diets high in red meat and fat and low in fruit and vegetables are associated with an increased risk of CRC. The dietary effects may be modulated by genetic polymorphisms in biotransformation genes. In this study we aimed to evaluate the role of dietary factors in combination with genetic factors in the different stages of colorectal carcinogenesis in a Norwegian population.
We used a case-control study design (234 carcinomas, 229 high-risk adenomas, 762 low-risk adenomas and 400 controls) to test the association between dietary factors (meat versus fruit, berries and vegetables) genetic polymorphisms in biotransformation genes (GSTM1, GSTT1, GSTP1 Ile105Val, EPHX1 Tyr113His and EPHX1 His139Arg), and risk of colorectal carcinomas and adenomas. Odds ratio (OR) and 95% confidence interval (95% CI) were estimated by binary logistic regression.
A higher ratio of total meat to total fruit, berry and vegetable intake was positively associated with both high and low-risk adenomas, with approximately twice the higher risk in the 2nd quartile compared to the lowest quartile. For the high-risk adenomas this positive association was more obvious for the common allele (Tyr allele) of the EPHX1 codon 113 polymorphism. An association was also observed for the EPHX1 codon 113 polymorphism in the low-risk adenomas, although not as obvious.
Although, the majority of the comparison groups are not significant, our results suggest an increased risk of colorectal adenomas in individuals for some of the higher ratios of total meat to total fruit, berry and vegetable intake. In addition the study supports the notion that the biotransformation enzymes GSTM1, GSTP1 and EPHX1 may modify the effect of dietary factors on the risk of developing colorectal carcinoma and adenoma.
散发性结直肠癌(CRC)的风险主要与生活方式因素相关,尤其是饮食因素。红肉和脂肪含量高、水果和蔬菜含量低的饮食与CRC风险增加有关。饮食影响可能会受到生物转化基因中基因多态性的调节。在本研究中,我们旨在评估挪威人群中饮食因素与遗传因素在结直肠癌发生不同阶段的联合作用。
我们采用病例对照研究设计(234例癌、229例高危腺瘤、762例低危腺瘤和400例对照),以检验饮食因素(肉类与水果、浆果和蔬菜)、生物转化基因(GSTM1、GSTT1、GSTP1 Ile105Val、EPHX1 Tyr113His和EPHX1 His139Arg)中的基因多态性与结直肠癌和腺瘤风险之间的关联。通过二元逻辑回归估计比值比(OR)和95%置信区间(95%CI)。
总肉类与总水果、浆果和蔬菜摄入量的较高比值与高危和低危腺瘤均呈正相关,与最低四分位数相比,第二四分位数的风险约高出两倍。对于高危腺瘤,EPHX1密码子113多态性的常见等位基因(Tyr等位基因)的这种正相关更为明显。在低危腺瘤中也观察到EPHX1密码子113多态性的关联,尽管不那么明显。
虽然大多数比较组无显著差异,但我们的结果表明,总肉类与总水果、浆果和蔬菜摄入量的某些较高比值的个体患结直肠腺瘤的风险增加。此外,该研究支持生物转化酶GSTM1、GSTP1和EPHX1可能改变饮食因素对结直肠癌和腺瘤发生风险影响的观点。