Department of Behavioural and Social Sciences, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia.
Br J Nutr. 2012 Sep 28;108(6):1077-85. doi: 10.1017/S0007114511006489. Epub 2011 Dec 20.
The association between renal cell cancer (RCC) and intake of fruit, vegetables and nutrients was examined in a population-based case-control study of 323 cases and 1827 controls; dietary intake was obtained using a mailed questionnaire. Cancer risks were estimated by OR and 95 % CI, adjusting for age, sex, smoking, obesity, hypertension, proxy status, alcohol consumption and dietary fat intake and energy. Intake of vegetables was associated with a decreased risk of RCC (OR 0·5; 95 % CI 0·3, 0·7; P trend = 0·002), (top compared to the bottom quartile of intake). When intake of individual nutrients was investigated, vegetable fibre intake was associated with decreased risks (OR 0·4; 95 % CI 0·2, 0·6; P < 0·001), but this was not the case with fruit fibre (OR 0·7; 95 % CI 0·4, 1·1) or grain fibre (OR 1·0; 95 % CI 0·6, 1·5). β-Cryptoxanthin and lycopene were also associated with decreased risks, but when both were included in a mutually adjusted backwards stepwise regression model, only β-cryptoxanthin remained significant (OR 0·5; 95 % CI 0·3, 0·8). When other micronutrients and types of fibre were investigated together, only vegetable fibre and β-cryptoxanthin had significant trends (P < 0·01) (OR 0·6; 95 % CI 0·3, 0·9) (OR 0·5; 95 % CI 0·3, 0·9), respectively. These findings were stronger in those aged over 65 years (P interaction = 0·001). Among non-smokers, low intake of cruciferous vegetables and fruit fibre was also associated with increased risk of RCC (P interaction = 0·03); similar inverse associations were found for β-cryptoxanthin, lycopene and vitamin C. When nutrients were mutually adjusted by backwards regression in these subgroups, only β-cryptoxanthin remained associated with lower RCC risk. These findings deserve further investigation in ongoing prospective studies when sample size becomes sufficient.
这项基于人群的病例对照研究纳入了 323 例病例和 1827 例对照,分析了肾癌(RCC)与水果、蔬菜和营养素摄入之间的关系;通过邮寄问卷获取饮食摄入数据。采用 OR 和 95%CI 估计癌症风险,调整因素包括年龄、性别、吸烟、肥胖、高血压、代理状况、饮酒和膳食脂肪摄入及能量。蔬菜摄入与 RCC 风险降低相关(OR 0·5;95%CI 0·3,0·7;P 趋势=0·002)(与摄入最低四分位数者相比)。当研究个体营养素摄入时,蔬菜纤维摄入与降低的风险相关(OR 0·4;95%CI 0·2,0·6;P<0·001),但水果纤维(OR 0·7;95%CI 0·4,1·1)或谷物纤维(OR 1·0;95%CI 0·6,1·5)并非如此。β-隐黄质和番茄红素也与降低的风险相关,但当将两者纳入相互调整的向后逐步回归模型时,只有 β-隐黄质仍具有显著意义(OR 0·5;95%CI 0·3,0·8)。当一起研究其他微量营养素和纤维类型时,只有蔬菜纤维和 β-隐黄质具有显著趋势(P<0·01)(OR 0·6;95%CI 0·3,0·9)(OR 0·5;95%CI 0·3,0·9)。在年龄大于 65 岁的人群中,这些发现更为显著(P 交互作用=0·001)。在不吸烟者中,十字花科蔬菜和水果纤维摄入不足也与 RCC 风险增加相关(P 交互作用=0·03);β-隐黄质、番茄红素和维生素 C 也存在类似的反比关系。在这些亚组中,当通过向后回归相互调整营养素时,只有 β-隐黄质与较低的 RCC 风险相关。当样本量足够大时,这些发现值得在正在进行的前瞻性研究中进一步调查。