Department of Epidemiology and Program on Genomics and Nutrition, Fielding School of Public Health, University of California-Los Angeles, Los Angeles, CA, USA.
J Nutr. 2013 Feb;143(2):189-96. doi: 10.3945/jn.112.168484. Epub 2012 Dec 19.
Previous studies have associated higher milk intake with greater prostate cancer (PCa) incidence, but little data are available concerning milk types and the relation between milk intake and risk of fatal PCa. We investigated the association between intake of dairy products and the incidence and survival of PCa during a 28-y follow-up. We conducted a cohort study in the Physicians' Health Study (n = 21,660) and a survival analysis among the incident PCa cases (n = 2806). Information on dairy product consumption was collected at baseline. PCa cases and deaths (n = 305) were confirmed during follow-up. The intake of total dairy products was associated with increased PCa incidence [HR = 1.12 (95% CI: 0.93, 1.35); >2.5 servings/d vs. ≤0.5 servings/d]. Skim/low-fat milk intake was positively associated with risk of low-grade, early stage, and screen-detected cancers, whereas whole milk intake was associated only with fatal PCa [HR = 1.49 (95% CI: 0.97, 2.28); ≥237 mL/d (1 serving/d) vs. rarely consumed]. In the survival analysis, whole milk intake remained associated with risk of progression to fatal disease after diagnosis [HR = 2.17 (95% CI: 1.34, 3.51)]. In this prospective cohort, higher intake of skim/low-fat milk was associated with a greater risk of nonaggressive PCa. Most importantly, only whole milk was consistently associated with higher incidence of fatal PCa in the entire cohort and higher PCa-specific mortality among cases. These findings add further evidence to suggest the potential role of dairy products in the development and prognosis of PCa.
先前的研究表明，牛奶摄入量与前列腺癌（PCa）的发病率较高有关，但有关牛奶类型以及牛奶摄入量与致命性 PCa 风险之间的关系的数据却很少。我们在 28 年的随访期间调查了乳制品摄入量与 PCa 的发生和生存之间的关系。我们在医师健康研究（n=21660）中进行了一项队列研究，并对新确诊的 PCa 病例（n=2806）进行了生存分析。在基线时收集了有关乳制品消费的信息。在随访期间确认了 PCa 病例和死亡（n=305）。总乳制品的摄入量与 PCa 的发病率增加有关[HR=1.12（95%CI：0.93，1.35）；>2.5 份/天与≤0.5 份/天]。脱脂/低脂牛奶的摄入量与低级别、早期和筛查发现的癌症的风险呈正相关，而全脂牛奶的摄入量仅与致命性 PCa 有关[HR=1.49（95%CI：0.97，2.28）；≥237 毫升/天（1 份/天）与很少食用]。在生存分析中，全脂牛奶的摄入量与确诊后进展为致命疾病的风险仍然相关[HR=2.17（95%CI：1.34，3.51）]。在这项前瞻性队列研究中，脱脂/低脂牛奶的摄入量较高与侵袭性较低的 PCa 风险增加有关。最重要的是，只有全脂牛奶与整个队列中致命性 PCa 的发生率增加以及病例中 PCa 特异性死亡率增加始终相关。这些发现进一步证明了乳制品在 PCa 的发展和预后中的潜在作用。
