绝经后女性血清类胡萝卜素、视黄醇和生育酚浓度与乳腺癌风险关系的纵向研究。
Longitudinal study of serum carotenoid, retinol, and tocopherol concentrations in relation to breast cancer risk among postmenopausal women.
作者信息
Kabat Geoffrey C, Kim Mimi, Adams-Campbell Lucile L, Caan Bette J, Chlebowski Rowan T, Neuhouser Marian L, Shikany James M, Rohan Thomas E
机构信息
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
出版信息
Am J Clin Nutr. 2009 Jul;90(1):162-9. doi: 10.3945/ajcn.2009.27568. Epub 2009 May 27.
BACKGROUND
Prospective studies have examined the association of serum and plasma carotenoids and micronutrients and breast cancer; however, to date, studies have only assessed exposure at one point in time.
OBJECTIVE
This study analyzed baseline and repeated serum measurements of carotenoids, retinol, and tocopherols to assess their associations with postmenopausal breast cancer risk.
DESIGN
Serum concentrations of alpha-carotene, beta-carotene, beta-cryptoxanthin, lycopene, lutein + zeaxanthin, retinol, alpha-tocopherol, and gamma-tocopherol were measured in a 6% sample of women in the Women's Health Initiative clinical trials at baseline and at years 1, 3, and 6 and in a 1% sample of women in the observational study at baseline and at year 3. The association of baseline compounds and breast cancer risk was estimated by Cox proportional hazards models. In addition, repeated measurements were analyzed as time-dependent covariates. Of 5450 women with baseline measurements, 190 incident cases of breast cancer were ascertained over a median of 8.0 y of follow-up.
RESULTS
After multivariable adjustment, risk of invasive breast cancer was inversely associated with baseline serum alpha-carotene concentrations (hazard ratio for highest compared with the lowest tertile: 0.55; 95% CI: 0.34, 0.90; P = 0.02) and positively associated with baseline lycopene (hazard ratio: 1.47; 95% CI: 0.98, 2.22; P = 0.06). Analysis of repeated measurements indicated that alpha-carotene and beta-carotene were inversely associated with breast cancer and that gamma-tocopherol was associated with increased risk.
CONCLUSIONS
The present study, which was the first to assess repeated measurements of serum carotenoids and micronutrients in relation to breast cancer, adds to the evidence of an inverse association of specific carotenoids with breast cancer. The positive associations observed for lycopene and gamma-tocopherol require confirmation. This trial was registered at ClinicalTrials.gov as NCT00000611.
背景
前瞻性研究已探讨血清和血浆类胡萝卜素及微量营养素与乳腺癌之间的关联；然而，迄今为止，研究仅评估了某一时刻的暴露情况。
目的
本研究分析类胡萝卜素、视黄醇和生育酚的基线及重复血清测量值，以评估它们与绝经后乳腺癌风险的关联。
设计
在女性健康倡议临床试验中，对6%的女性样本在基线、第1年、第3年和第6年测量血清中α-胡萝卜素、β-胡萝卜素、β-隐黄质、番茄红素、叶黄素+玉米黄质、视黄醇、α-生育酚和γ-生育酚的浓度；在观察性研究中，对1%的女性样本在基线和第3年测量上述指标。通过Cox比例风险模型估计基线化合物与乳腺癌风险的关联。此外，将重复测量值作为时间依存性协变量进行分析。在5450名有基线测量值的女性中，随访中位时间8.0年期间确定了190例乳腺癌发病病例。
结果
多变量调整后，浸润性乳腺癌风险与基线血清α-胡萝卜素浓度呈负相关（最高三分位数与最低三分位数相比的风险比：0.55；95%可信区间：0.34，0.90；P = 0.02），与基线番茄红素呈正相关（风险比：1.47；95%可信区间：0.98，2.22；P = 0.06）。重复测量分析表明，α-胡萝卜素和β-胡萝卜素与乳腺癌呈负相关，γ-生育酚与风险增加相关。
结论
本研究首次评估血清类胡萝卜素和微量营养素重复测量值与乳腺癌的关系，进一步证明特定类胡萝卜素与乳腺癌存在负相关。番茄红素和γ-生育酚的正相关关系有待证实。本试验在ClinicalTrials.gov注册，注册号为NCT00000611。
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