Chavarro Jorge E, Stampfer Meir J, Campos Hannia, Kurth Tobias, Willett Walter C, Ma Jing
Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA.
Cancer Epidemiol Biomarkers Prev. 2008 Jan;17(1):95-101. doi: 10.1158/1055-9965.EPI-07-0673.
Previous studies suggest a positive association between markers of trans-fatty acid intake and prostate cancer. We therefore prospectively evaluated the association between blood trans-fatty acid levels and risk of prostate cancer.
We conducted a nested case-control study among 14,916 apparently healthy men who provided blood samples in 1982. Blood fatty acid levels were determined for 476 men diagnosed with prostate cancer during a 13-year follow-up and their matched controls. Controls were individually matched to cases according to age and smoking status at baseline. Conditional logistic regression was used to estimate the relative risk and 95% confidence interval of total, nonaggressive (stage A/B and low grade), and aggressive (stage C/D, high grade, subsequent distant metastasis or death) prostate cancer associated with blood levels of specific trans-fatty acids.
Blood levels of all the trans-fatty acids examined were unrelated to total prostate cancer risk. When results were divided according to tumor aggressiveness, blood levels of 18:1n-9t, all the 18:2t examined, and total trans-fatty acids were positively associated to nonaggressive tumors. The relative risks (95% confidence intervals; P trend) comparing top with bottom quintile trans-fatty acid levels were 2.16 (1.12-4.17; 0.11) for 18:1n-9t, 1.97 (1.03-3.75; 0.01) for total 18:2t, and 2.21 (1.14-4.29; 0.06) for total trans-fatty acids. None of the trans fats examined was associated with aggressive prostate tumors.
Blood levels of trans isomers of oleic and linoleic acids are associated with an increased risk of nonaggressive prostate tumors. As this type of tumors represents a large proportion of prostate cancer detected using prostate-specific antigen screening, these findings may have implications for the prevention of prostate cancer.
既往研究表明反式脂肪酸摄入标志物与前列腺癌之间存在正相关。因此,我们前瞻性评估了血液中反式脂肪酸水平与前列腺癌风险之间的关联。
我们在1982年提供血样的14916名看似健康的男性中开展了一项巢式病例对照研究。对476名在13年随访期间被诊断为前列腺癌的男性及其匹配对照测定了血液脂肪酸水平。对照根据基线时的年龄和吸烟状况与病例进行个体匹配。采用条件逻辑回归估计与特定反式脂肪酸血液水平相关的总前列腺癌、非侵袭性(A/B期和低级别)前列腺癌以及侵袭性(C/D期、高级别、随后远处转移或死亡)前列腺癌的相对风险和95%置信区间。
所检测的所有反式脂肪酸的血液水平与总前列腺癌风险无关。根据肿瘤侵袭性划分结果时,18:1n-9t、所检测的所有18:2t以及总反式脂肪酸的血液水平与非侵袭性肿瘤呈正相关。比较反式脂肪酸水平最高与最低五分位数的相对风险(95%置信区间;P趋势),18:1n-9t为2.16(1.12 - 4.17;0.11),总18:2t为1.97(1.03 - 3.75;0.01),总反式脂肪酸为2.21(1.14 - 4.29;0.06)。所检测的反式脂肪均与侵袭性前列腺肿瘤无关。
油酸和亚油酸的反式异构体血液水平与非侵袭性前列腺肿瘤风险增加相关。由于这类肿瘤在使用前列腺特异性抗原筛查检测出的前列腺癌中占很大比例,这些发现可能对前列腺癌的预防具有启示意义。