Division of Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, Connecticut, USA.
Am J Epidemiol. 2010 Feb 1;171(3):312-22. doi: 10.1093/aje/kwp371. Epub 2009 Dec 30.
The relation between diet, lifestyle, and acute myeloid leukemia was assessed in a US cohort of 491,163 persons from the NIH-AARP Diet and Health Study (1995-2003). A total of 338 incident cases of acute myeloid leukemia were ascertained. Multivariate Cox models were utilized to estimate hazard ratios and 95% confidence intervals. Compared with those for never smokers, hazard ratios were 1.29 (95% confidence interval: 0.95, 1.75), 1.79 (95% confidence interval: 1.32, 2.42), 2.42 (95% confidence interval: 1.63, 3.57), and 2.29 (85% confidence interval: 1.38, 3.79) for former smokers who smoked < or =1 or >1 pack/day and for current smokers who smoked < or =1 or >1 pack/day, respectively. Higher meat intake was associated with an increased risk of acute myeloid leukemia (hazard ratio = 1.45, 95% confidence interval: 1.02, 2.07 for the fifth vs. first quintile; P for trend = 0.06); however, there were no clear effects of meat-cooking method or doneness level. Individuals who did not drink coffee appeared to have a higher risk of acute myeloid leukemia than those who drank various quantities of coffee. Neither fruit nor vegetable intake was associated with acute myeloid leukemia. This large prospective study identified smoking and meat intake as risk factors for acute myeloid leukemia.
在美国 NIH-AARP 饮食与健康研究(1995-2003 年)中,对来自 491,163 名个体的饮食、生活方式与急性髓系白血病之间的关系进行了评估。共确定了 338 例急性髓系白血病新发病例。利用多变量 Cox 模型估计了风险比和 95%置信区间。与从不吸烟者相比,风险比分别为 1.29(95%置信区间:0.95,1.75)、1.79(95%置信区间:1.32,2.42)、2.42(95%置信区间:1.63,3.57)和 2.29(95%置信区间:1.38,3.79),分别对应于每日吸烟量为 1 包或以下的前吸烟者、每日吸烟量为 1 包以上的前吸烟者、当前吸烟者中每日吸烟量为 1 包或以下的吸烟者以及每日吸烟量为 1 包以上的吸烟者。较高的肉类摄入量与急性髓系白血病风险增加相关(第五五分位与第一五分位相比的风险比=1.45,95%置信区间:1.02,2.07;趋势检验 P=0.06);然而,肉类烹饪方法或熟度水平的影响并不明显。不喝咖啡的个体似乎比喝咖啡量不同的个体患急性髓系白血病的风险更高。水果或蔬菜摄入量与急性髓系白血病无关。这项大型前瞻性研究确定了吸烟和肉类摄入是急性髓系白血病的危险因素。