Thiébaut Anne C M, Chajès Véronique, Gerber Mariette, Boutron-Ruault Marie-Christine, Joulin Virginie, Lenoir Gilbert, Berrino Franco, Riboli Elio, Bénichou Jacques, Clavel-Chapelon Françoise
INSERM, ERI-20, Institut Gustave Roussy, Villejuif Cedex, France.
Int J Cancer. 2009 Feb 15;124(4):924-31. doi: 10.1002/ijc.23980.
Experimental studies suggest detrimental effects of omega-6 polyunsaturated fatty acids (PUFA), and beneficial effects of omega-3 PUFAs on mammary carcinogenesis, possibly in interaction with antioxidants. However, PUFA food sources are diverse in human diets and few epidemiologic studies have examined whether associations between dietary PUFAs and breast cancer risk vary according to food sources or antioxidant intakes. The relationship between individual PUFA intakes estimated from diet history questionnaires and breast cancer risk was examined among 56,007 French women. During 8 years of follow-up, 1,650 women developed invasive breast cancer. Breast cancer risk was not related to any dietary PUFA overall; however, opposite associations were seen according to food sources, suggesting other potential effects than PUFA per se. Breast cancer risk was inversely associated with alpha-linolenic acid (ALA) intake from fruit and vegetables [highest vs. lowest quintile, hazard ratio (HR) 0.74; 95% confidence interval (CI) 0.63, 0.88; p trend < 0.0001], and from vegetable oils (HR 0.83; 95% CI 0.71, 0.97; p trend 0.017). Conversely, breast cancer risk was positively related to ALA intake from nut mixes (p trend 0.004) and processed foods (p trend 0.068), as was total ALA intake among women in the highest quintile of dietary vitamin E (p trend 0.036). A significant interaction was also found between omega-6 and long-chain omega-3 PUFAs, with breast cancer risk inversely related to long-chain omega-3 PUFAs in women belonging to the highest quintile of omega-6 PUFAs (p interaction 0.042). These results emphasize the need to consider food sources, as well as interactions between fatty acids and with antioxidants, when evaluating associations between PUFA intakes and breast cancer risk.
实验研究表明，ω-6多不饱和脂肪酸（PUFA）具有有害作用，而ω-3多不饱和脂肪酸对乳腺癌发生具有有益作用，这可能与抗氧化剂存在相互作用。然而，在人类饮食中，PUFA的食物来源多种多样，很少有流行病学研究探讨膳食PUFA与乳腺癌风险之间的关联是否会因食物来源或抗氧化剂摄入量的不同而有所差异。在56007名法国女性中，研究了通过饮食史问卷估算的个体PUFA摄入量与乳腺癌风险之间的关系。在8年的随访期间，有1650名女性患浸润性乳腺癌。总体而言，乳腺癌风险与任何膳食PUFA均无关联；然而，根据食物来源观察到了相反的关联，这表明除了PUFA本身之外还存在其他潜在影响。乳腺癌风险与水果和蔬菜中的α-亚麻酸（ALA）摄入量呈负相关[最高五分位数与最低五分位数相比，风险比（HR）为0.74；95%置信区间（CI）为0.63，0.88；P趋势<0.0001]，与植物油中的ALA摄入量也呈负相关（HR为0.83；95%CI为0.71，0.97；P趋势为0.017）。相反，乳腺癌风险与坚果混合物中的ALA摄入量呈正相关（P趋势为0.004），与加工食品中的ALA摄入量也呈正相关（P趋势为0.068），膳食维生素E最高五分位数女性的总ALA摄入量与乳腺癌风险也呈正相关（P趋势为0.036）。此外，还发现ω-6和长链ω-3多不饱和脂肪酸之间存在显著的相互作用，在ω-6多不饱和脂肪酸最高五分位数的女性中，乳腺癌风险与长链ω-3多不饱和脂肪酸呈负相关（P相互作用为0.042）。这些结果强调，在评估PUFA摄入量与乳腺癌风险之间的关联时，需要考虑食物来源以及脂肪酸之间及其与抗氧化剂的相互作用。
