Wilson Robin Taylor, Wang Jiangyue, Chinchilli Vernon, Richie John P, Virtamo Jarmo, Moore Lee E, Albanes Demetrius
Epidemiology Division, Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania 17033-0855, USA.
Am J Epidemiol. 2009 Sep 15;170(6):717-29. doi: 10.1093/aje/kwp178. Epub 2009 Aug 3.
Fish, vitamin D, flavonoids, and flavonoid-containing foods may have cardiovascular benefits and therefore may also reduce the risk of renal cell cancer. Risk was prospectively assessed in the Alpha-Tocopherol Beta-Carotene Cancer Prevention Study (1985-2002) cohort (N = 27,111; 15.2 mean person-years of follow-up). At enrollment, demographic, health, and dietary history information was recorded. Individuals who smoked less than 5 cigarettes/day, with chronic renal insufficiency or prior cancer, were excluded. Hazard ratios and 95% confidence intervals from Cox regression were used to compare upper quartiles (quartiles 2-4) with the lowest quartile (quartile 1) of dietary intake. Among 228 cases, risk (quartile 4 vs. quartile 1) was associated with consumption of the flavonoid quercetin (hazard ratio = 0.6, 95% confidence interval: 0.4, 0.9; P(trend) = 0.015) and Baltic herring (hazard ratio = 2.0, 95% confidence interval: 1.4, 3.0; P(trend) < 0.001), with adjustment for age, body mass index, smoking, blood pressure, alcohol use, physical activity, urban residence, and education. In geographically stratified models, the risks associated with herring and total fish intake appeared to be highest in the urban coast region, although the interaction was not statistically significant. These results suggest that the flavonoid quercetin may prevent renal cell cancer among male smokers. The possible risk associated with fish intake warrants further investigation before conclusions may be drawn.
鱼类、维生素D、类黄酮以及富含类黄酮的食物可能对心血管有益，因此也可能降低肾细胞癌的风险。在α-生育酚β-胡萝卜素癌症预防研究（1985 - 2002年）队列（N = 27111；平均随访15.2人年）中对风险进行了前瞻性评估。在入组时，记录了人口统计学、健康状况和饮食史信息。排除了每天吸烟少于5支、患有慢性肾功能不全或既往患癌的个体。使用Cox回归的风险比和95%置信区间来比较饮食摄入量的上四分位数（第2 - 4四分位数）与最低四分位数（第1四分位数）。在228例病例中，风险（第4四分位数与第1四分位数相比）与类黄酮槲皮素的摄入量有关（风险比 = 0.6，95%置信区间：0.4，0.9；P趋势 = 0.015）以及波罗的海鲱鱼（风险比 = 2.0，95%置信区间：1.4，3.0；P趋势 < 0.001），并对年龄、体重指数、吸烟、血压、饮酒、身体活动、城市居住情况和教育程度进行了调整。在地理分层模型中，鲱鱼和鱼类总摄入量相关的风险在城市沿海地区似乎最高，尽管这种相互作用没有统计学意义。这些结果表明，类黄酮槲皮素可能预防男性吸烟者患肾细胞癌。在得出结论之前，鱼类摄入可能存在的风险值得进一步研究。
