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基于人群的病例对照研究中饮食丙烯酰胺摄入与食管癌风险的关系。

Dietary acrylamide intake and risk of esophageal cancer in a population-based case-control study in Sweden.

机构信息

Department of Molecular Medicine and Surgery, Upper Gastrointestinal Research, Karolinska Institutet, Stockholm, Sweden.

出版信息

Int J Cancer. 2011 Feb 1;128(3):676-81. doi: 10.1002/ijc.25608.

Abstract

Acrylamide is a potential carcinogen, which commonly occurs in some food items. The relation between acrylamide and esophageal cancer deserves attention. In a Swedish nationwide, population-based case-control study, data were collected on diet among other variables in 1995-1997 through personal interviews. Included were 189 cases of esophageal adenocarcinoma (participation rate 88%), 262 cases of gastroesophageal junctional adenocarcinoma (84%), 167 cases of esophageal squamous cell carcinoma (73%), and 820 control participants (73%). Dietary intake of acrylamide exposure was assessed from a food-frequency questionnaire and categorized into quartiles based on the consumption among the control participants. Unconditional logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals (CI), with multivariable adjustment for known risk factors. Among participants in the highest quartile of acrylamide exposure compared to the lowest, the adjusted risk of all esophageal tumors combined was increased (OR 1.23; 95% CI 1.02-1.75), particularly among overweight or obese persons (OR 1.88; 95% CI 1.06-3.34). Increased point risk estimates were found for each type of esophageal cancer, but the association with esophageal squamous cell carcinoma seemed stronger and was statistically significant, particularly among nonsmokers in the highest quartile of acrylamide exposure (adjusted OR 2.82; 95% CI 1.16-6.87). Regarding squamous cell carcinoma only, a dose-response association was identified (p for trend 0.01). Dietary intake of acrylamide might be a risk exposure for esophageal cancer, a stronger association among overweight or obese persons was indicated.

摘要

丙烯酰胺是一种潜在的致癌物质,通常存在于某些食品中。丙烯酰胺与食管癌之间的关系值得关注。在一项瑞典全国性、基于人群的病例对照研究中,通过个人访谈于 1995-1997 年收集了饮食等变量的数据。包括 189 例食管腺癌(参与率 88%)、262 例胃食管交界处腺癌(84%)、167 例食管鳞状细胞癌(73%)和 820 名对照参与者(73%)。丙烯酰胺暴露的饮食摄入量通过食物频率问卷进行评估,并根据对照参与者的消费情况分为四分位数。采用非条件逻辑回归计算比值比(OR)和 95%置信区间(CI),采用多变量调整已知危险因素。与最低四分位数相比,丙烯酰胺暴露量最高四分位数的参与者的所有食管肿瘤综合风险增加(OR 1.23;95%CI 1.02-1.75),超重或肥胖者的调整风险更高(OR 1.88;95%CI 1.06-3.34)。对于每种食管癌类型,点风险估计值都有所增加,但与食管鳞状细胞癌的关联似乎更强且具有统计学意义,尤其是在丙烯酰胺暴露量最高四分位数的不吸烟者中(调整后的 OR 2.82;95%CI 1.16-6.87)。仅针对鳞状细胞癌,发现了剂量反应关系(趋势检验 p 值为 0.01)。饮食摄入丙烯酰胺可能是食管癌的风险因素,超重或肥胖者的相关性更强。

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