Prentice Ross L, Shaw Pamela A, Bingham Sheila A, Beresford Shirley A A, Caan Bette, Neuhouser Marian L, Patterson Ruth E, Stefanick Marcia L, Satterfield Suzanne, Thomson Cynthia A, Snetselaar Linda, Thomas Asha, Tinker Lesley F
Fred Hutchinson Cancer Research Center, Seattle, Washington 98109-1024, USA.
Am J Epidemiol. 2009 Apr 15;169(8):977-89. doi: 10.1093/aje/kwp008. Epub 2009 Mar 3.
The authors previously reported equations, derived from the Nutrient Biomarker Study within the Women's Health Initiative, that produce calibrated estimates of energy, protein, and percentage of energy from protein consumption from corresponding food frequency questionnaire estimates and data on other factors, such as body mass index, age, and ethnicity. Here, these equations were applied to yield calibrated consumption estimates for 21,711 women enrolled in the Women's Health Initiative dietary modification trial comparison group and 59,105 women enrolled in the observational study. These estimates were related prospectively to total and site-specific invasive cancer incidence (1993-2005). In combined cohort analyses that do not control for body mass, uncalibrated energy was not associated with total cancer incidence or site-specific cancer incidence for most sites, whereas biomarker-calibrated energy was positively associated with total cancer (hazard ratio = 1.18, 95% confidence interval: 1.10, 1.27, for 20% consumption increase), as well as with breast, colon, endometrial, and kidney cancer (respective hazard ratios of 1.24, 1.35, 1.83, and 1.47). Calibrated protein was weakly associated, and calibrated percentage of energy from protein was inversely associated, with total cancer. Calibrated energy and body mass index associations were highly interdependent. Implications for the interpretation of nutritional epidemiology studies are described.
作者之前报告了从女性健康倡议中的营养生物标志物研究得出的方程，这些方程可根据相应的食物频率问卷估计值以及其他因素（如体重指数、年龄和种族）的数据，对能量、蛋白质以及蛋白质摄入能量占比进行校准估计。在此，这些方程被用于对参与女性健康倡议饮食改善试验对照组的21,711名女性以及参与观察性研究的59,105名女性得出校准后的消费估计值。这些估计值与总体及特定部位的浸润性癌症发病率（1993 - 2005年）进行前瞻性关联。在未对体重进行控制的联合队列分析中，对于大多数部位，未校准的能量与总体癌症发病率或特定部位癌症发病率均无关联，而生物标志物校准后的能量与总体癌症呈正相关（每增加20%的摄入量，风险比 = 1.18，95%置信区间：1.10, 1.27），与乳腺癌、结肠癌、子宫内膜癌和肾癌也呈正相关（各自的风险比分别为1.24、1.35、1.83和1.47）。校准后的蛋白质与之呈弱关联，而校准后的蛋白质摄入能量占比与总体癌症呈负相关。校准后的能量与体重指数的关联高度相互依存。文中描述了对营养流行病学研究解释的影响。
