Department of Epidemiology and Biostatistics, University of California-San Francisco, 3333 California Street, San Francisco, CA 94118, USA.
Cancer Causes Control. 2011 Jan;22(1):91-100. doi: 10.1007/s10552-010-9678-3. Epub 2010 Nov 12.
The aim of this study was to evaluate a complex association among intake of dietary vitamin D, calcium, and retinol, and pancreatic cancer risk.
Pancreatic cancer cases (n = 532) diagnosed in 1995-1999 were identified using rapid case ascertainment methods and were frequency matched to population-based controls (n = 1,701) in the San Francisco Bay Area. Detailed dietary data were collected during in-person interviews using a validated semi-quantitative food-frequency questionnaire. Adjusted unconditional logistic regression was used to estimate odds ratios (ORs) and confidence intervals.
In men, increased pancreatic cancer risk was associated with currently recommended dietary vitamin D intake levels (highest (≥450 IU/day) vs. lowest (<150 IU/day) intake, OR = 2.6, trend-p = 0.009) and total vitamin D intake from diet and supplements (for <800 IU/day). ORs for dietary vitamin D intake remained increased after adjustment for intake of retinol and calcium, although confidence intervals included unity. Stratified analyses showed that ORs were higher among men with lower intake of retinol and lower physical activity but there was no evidence of statistical interaction. No associations with vitamin D intake were observed among women, although ORs typically were elevated. ORs increased with increased dietary calcium intake among men (trend-p = 0.008) and not women.
Our results among men showing an increased risk of pancreatic cancer associated with dietary intake of vitamin D and of calcium require confirmation in further studies. Continued investigation is needed to clarify the complex role of vitamin D and calcium in pancreatic cancer risk and to determine their optimal intake level and preventive effects for pancreatic cancer.
本研究旨在评估饮食中维生素 D、钙和视黄醇的摄入与胰腺癌风险之间的复杂关联。
使用快速病例发现方法,于 1995-1999 年确定了胰腺癌病例(n=532),并与旧金山湾区基于人群的对照(n=1701)进行了频数匹配。在面对面访谈中,使用经过验证的半定量食物频率问卷收集了详细的饮食数据。采用调整后的非条件逻辑回归来估计比值比(OR)和置信区间。
在男性中,较高的胰腺癌风险与目前推荐的饮食维生素 D 摄入水平(最高(≥450IU/天)与最低(<150IU/天)摄入,OR=2.6,趋势-p=0.009)和饮食及补充剂中总维生素 D 摄入相关(<800IU/天)。在调整视黄醇和钙的摄入量后,饮食中维生素 D 的摄入量仍然与 OR 增加相关,尽管置信区间包含 1。分层分析表明,在视黄醇和体力活动摄入量较低的男性中,OR 更高,但没有统计学交互作用的证据。在女性中未观察到与维生素 D 摄入相关的关系,尽管 OR 通常升高。在男性中,随着饮食中钙摄入量的增加,OR 也随之增加(趋势-p=0.008),而在女性中则没有。
我们在男性中观察到的与饮食中维生素 D 和钙摄入相关的胰腺癌风险增加的结果需要在进一步的研究中得到证实。需要进一步的研究来阐明维生素 D 和钙在胰腺癌风险中的复杂作用,并确定其最佳摄入量和对胰腺癌的预防作用。