Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
Cancer Epidemiol Biomarkers Prev. 2011 May;20(5):978-89. doi: 10.1158/1055-9965.EPI-10-1089. Epub 2011 Mar 10.
Macronutrients such as fat and fiber have been hypothesized to play a role in the etiology of endometrial cancer.
To investigate these associations, the authors analyzed data from the Nurses' Health Study. From 1980 to 2006, 669 invasive adenocarcinoma cases were identified over 1.3 million person-years of follow-up. Dietary intake was assessed in 1980 and updated every 2-4 years. Cox proportional hazard models were used to calculate relative risks (RRs), controlling for total energy and other risk factors.
Overall, the authors found no significant associations between most dietary factors and endometrial cancer risk. Total fat was associated with a borderline significant decreased risk (top vs. bottom quintile RR = 0.78; 95% CI = 0.60-0.99; P(trend) = 0.18). Findings for animal fat were similar. No inverse associations between dietary fibers and cancer risk were observed. Cereal fiber was modestly positively associated with risk (top vs. bottom quintile RR = 1.38, 95% CI = 1.07-1.79; P(trend) = 0.05). The inverse association with animal fat intake and a positive association with carbohydrate intake were observed among premenopausal but not among postmenopausal women.
In this large prospective study, no overall association was observed between dietary fat, fiber, and carbohydrates with endometrial cancer risk, although several of the relationships may vary by menopausal status.
Dietary fat and fiber intake do not seem to play a major role in endometrial cancer etiology overall. However, further evaluation of these associations, particularly in premenopausal women, is needed.
脂肪和纤维等宏量营养素已被假设在子宫内膜癌的病因学中发挥作用。
为了研究这些关联,作者分析了来自护士健康研究的数据。在 1980 年至 2006 年期间,在超过 130 万人年的随访中发现了 669 例侵袭性腺癌病例。在 1980 年和之后每 2-4 年进行一次饮食摄入评估。使用 Cox 比例风险模型计算相对风险 (RR),同时控制总能量和其他风险因素。
总体而言,作者发现大多数饮食因素与子宫内膜癌风险之间没有显著关联。总脂肪与风险呈临界显著降低相关(最高五分位与最低五分位 RR = 0.78;95%CI = 0.60-0.99;P(trend) = 0.18)。动物脂肪的结果相似。膳食纤维与癌症风险之间没有负相关。谷物纤维与风险呈适度正相关(最高五分位与最低五分位 RR = 1.38,95%CI = 1.07-1.79;P(trend) = 0.05)。这种与动物脂肪摄入量呈负相关而与碳水化合物摄入量呈正相关的关系仅见于绝经前妇女,而不在绝经后妇女中观察到。
在这项大型前瞻性研究中,饮食脂肪、纤维和碳水化合物与子宫内膜癌风险之间没有总体关联,但这些关系中的一些可能因绝经状态而异。
总的来说,饮食脂肪和纤维的摄入似乎在子宫内膜癌的病因学中不起主要作用。然而,需要进一步评估这些关联,特别是在绝经前妇女中。