Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, EPS, Room 8111, 6120 Executive Boulevard, Rockville, MD, 20852-7244, USA.
Cancer Causes Control. 2010 Jun;21(6):889-96. doi: 10.1007/s10552-010-9517-6. Epub 2010 Mar 5.
It has been estimated that 65,980 individuals were diagnosed with non-Hodgkin lymphoma (NHL) and 19,500 died from NHL in the United States in 2009. Although established risk factors such as immunodeficiency and viral infections may be responsible for a portion of the cases, the majority of NHL cases remain unexplained. Dietary nitrate and nitrite intake are exposures of particular interest for NHL risk as they are precursors in the endogenous formation of N-nitroso compounds, which cause lymphomas in animal studies. We investigated NHL risk overall and by histologic type in relation to dietary nitrate and nitrite intake in a population-based case-control study of 1,304 women in Connecticut. Nitrate and nitrite intake were assessed using a 120-item food frequency questionnaire. We found no association between risk of NHL overall and dietary nitrate and a slightly increased risk of NHL with higher dietary nitrite intake (highest vs. lowest intake quartile OR = 1.4; 95% CI: 0.9-2.2). When we evaluated intake by subtype, a significant positive trend was observed for follicular lymphoma and nitrate (p-trend = 0.04) and nitrite (p-trend < 0.01) with an over twofold risk in the highest nitrite intake quartile (OR = 2.3; 95% CI: 1.1-4.9). An increased risk in the highest quartile of nitrite intake was also observed for T-cell lymphoma (OR = 3.4; 95% CI: 1.0-11.9). Animal products containing nitrite were more strongly associated with risk of follicular lymphoma; whereas, both animal and plant sources of nitrite were associated with elevated ORs for T-cell lymphoma. Our results confirm a previous finding for nitrite intake and NHL risk and highlight the importance of evaluating histologic type. We conclude that these results should be replicated in a larger study with data on drinking water as well as dietary sources of nitrate intake.
据估计，2009 年美国有 65980 人被诊断患有非霍奇金淋巴瘤（NHL），有 19500 人死于 NHL。尽管免疫缺陷和病毒感染等已确定的危险因素可能是部分病例的原因，但大多数 NHL 病例仍无法解释。饮食硝酸盐和亚硝酸盐的摄入是 NHL 风险的特别关注因素，因为它们是内源性形成 N-亚硝基化合物的前体，动物研究表明 N-亚硝基化合物会导致淋巴瘤。我们在康涅狄格州的一项基于人群的病例对照研究中，对 1304 名女性进行了 NHL 总体风险以及与饮食硝酸盐和亚硝酸盐摄入相关的组织学类型研究。通过 120 项食物频率问卷评估硝酸盐和亚硝酸盐的摄入量。我们发现 NHL 总体风险与饮食硝酸盐之间没有关联，而较高的饮食亚硝酸盐摄入与 NHL 风险略有增加（最高与最低摄入量四分位 OR = 1.4；95%CI：0.9-2.2）。当我们按亚型评估摄入量时，发现滤泡性淋巴瘤与硝酸盐（p 趋势 = 0.04）和亚硝酸盐（p 趋势<0.01）之间存在显著的正趋势，在最高亚硝酸盐摄入四分位数中风险增加两倍以上（OR = 2.3；95%CI：1.1-4.9）。在最高亚硝酸盐摄入四分位数中，T 细胞淋巴瘤的风险也增加（OR = 3.4；95%CI：1.0-11.9）。含有亚硝酸盐的动物产品与滤泡性淋巴瘤的风险相关性更强；而动物和植物来源的硝酸盐都与 T 细胞淋巴瘤的 OR 升高相关。我们的研究结果证实了先前关于亚硝酸盐摄入与 NHL 风险的发现，并强调了评估组织学类型的重要性。我们得出结论，这些结果应该在一项更大的研究中复制，该研究应包含关于饮用水以及硝酸盐摄入的饮食来源的数据。
