Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
Int J Cancer. 2013 Mar 1;132(5):1114-24. doi: 10.1002/ijc.27701. Epub 2012 Jul 24.
Inconsistent results for the role of dairy food intake in relation to ovarian cancer risk may reflect the potential adverse effects of lactose, which has been hypothesized to increase gonadotropin levels, and the beneficial antiproliferative effects of calcium and vitamin D. Using data from the New England case-control study (1,909 cases and 1,989 controls), we examined dairy foods and nutrients in relation to risk of ovarian cancer overall, histological subtypes and rapidly fatal versus less aggressive disease. We used logistic regression and polytomous logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs). In models that were simultaneously adjusted for total (dietary plus supplements) calcium, total vitamin D and lactose, we observed a decreased overall risk of ovarian cancer with high intake of total calcium [Quartile 4 (Q4, >1,319 mg/day) vs. Quartile 1 (Q1, <655 mg/day), OR = 0.62, 95% CI = 0.49-0.79]; the inverse association was strongest for serous borderline and mucinous tumors. High intake of total vitamin D was not associated overall with ovarian cancer risk, but was inversely associated with risk of serous borderline (Q4, >559 IU/day vs. Q1, <164 IU/day, OR = 0.51, 95% CI = 0.34-0.76) and endometrioid tumors (Q4 vs. Q1, OR = 0.55, 95% CI = 0.39-0.80). We found no evidence that lactose intake influenced ovarian cancer risk or that risk varied by tumor aggressiveness in the analyses of intake of dairy foods and nutrients. The overall inverse association with high intake of calcium and the inverse associations of calcium and vitamin D with specific histological subtypes warrant further investigation.
乳制品摄入与卵巢癌风险之间的关系结果不一致,这可能反映了乳糖的潜在不良影响,乳糖被认为会增加促性腺激素水平,而钙和维生素 D 具有有益的抗增殖作用。利用新英格兰病例对照研究(1909 例病例和 1989 例对照)的数据,我们研究了乳制品和营养素与卵巢癌总体风险、组织学亚型以及快速致命与侵袭性较弱疾病的关系。我们使用逻辑回归和多项逻辑回归来估计比值比(OR)和 95%置信区间(CI)。在同时调整总(饮食加补充剂)钙、总维生素 D 和乳糖的模型中,我们观察到高总钙摄入与卵巢癌总体风险降低相关[第 4 四分位(Q4,>1319mg/天)与第 1 四分位(Q1,<655mg/天)相比,OR=0.62,95%CI=0.49-0.79];这种负相关在浆液性交界性和黏液性肿瘤中最强。高总维生素 D 摄入与卵巢癌风险总体上无相关性,但与浆液性交界性肿瘤(Q4,>559IU/天与 Q1,<164IU/天,OR=0.51,95%CI=0.34-0.76)和子宫内膜样肿瘤(Q4 与 Q1,OR=0.55,95%CI=0.39-0.80)的风险呈负相关。我们没有发现证据表明乳糖摄入会影响卵巢癌风险,也没有发现在分析乳制品和营养素摄入时,风险因肿瘤侵袭性而异。高钙摄入的总体负相关以及钙和维生素 D 与特定组织学亚型的负相关值得进一步研究。