Population Health Department, Queensland Institute of Medical Research, Royal Brisbane Hospital, Brisbane, QLD, 4029, Australia.
Int J Cancer. 2013 Jul;133(1):214-24. doi: 10.1002/ijc.28016. Epub 2013 Feb 12.
While dietary antioxidants are emerging as potentially modifiable risk factors for esophageal adenocarcinoma (EAC), studies on dietary antioxidants and its precursor Barrett's esophagus (BE) are limited. The present study extends previous work on BE by investigating risks of nondysplastic BE, dysplastic BE and EAC associated with intake of antioxidants such as vitamin C, vitamin E, β-carotene, and selenium. Age and sex matched control subjects (n=577 for BE; n=1,507 for EAC) were sampled from an Australian population register. Information on demography, and well established EAC risk factors were obtained using self-administered questionnaires. Intake of antioxidants for patients newly diagnosed with nondysplastic BE (n=266), dysplastic BE (n=101), or EAC (n=299), aged 18-79 years, were obtained using a food frequency questionnaire. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using multivariable adjusted logistic regression models. High intake of β-carotene from food and supplement sources combined was inversely associated with risk of dysplastic BE (OR Q4 vs. Q1=0.45; 95%CI: 0.20-1.00). High intake of vitamin E from food sources (OR Q4 vs. Q1=0.43; 95%CI: 0.28-0.67), from food and supplements combined (OR Q4 vs. Q1=0.64; 95%CI: 0.43-0.96), and a high antioxidant index score were inversely associated with risk of EAC. We found no significant trends between intake of β-carotene, vitamin C, vitamin E, and selenium and risk of nondysplastic or dysplastic BE. However, our data suggest that a high intake of β-carotene may be associated with decreased risk of dysplastic BE.
虽然饮食中的抗氧化剂正逐渐成为食管腺癌（EAC）的潜在可改变风险因素，但关于饮食抗氧化剂及其前体 Barrett 食管（BE）的研究有限。本研究通过调查非异型增生性 BE、异型增生性 BE 和 EAC 与维生素 C、维生素 E、β-胡萝卜素和硒等抗氧化剂摄入的相关性，扩展了之前关于 BE 的研究。在澳大利亚人口登记处抽取年龄和性别匹配的对照受试者（BE 组 n=577；EAC 组 n=1507）。通过自我管理问卷获取有关人口统计学和已确立的 EAC 风险因素的信息。使用食物频率问卷获取新诊断为非异型增生性 BE（n=266）、异型增生性 BE（n=101）或 EAC（n=299）患者 18-79 岁时的抗氧化剂摄入量。使用多变量调整的逻辑回归模型估计比值比（OR）和 95%置信区间（CI）。来自食物和补充剂的β-胡萝卜素的高摄入量与异型增生性 BE 的风险呈负相关（Q4 与 Q1 的 OR=0.45；95%CI：0.20-1.00）。来自食物的维生素 E 的高摄入量（Q4 与 Q1 的 OR=0.43；95%CI：0.28-0.67），来自食物和补充剂的组合（Q4 与 Q1 的 OR=0.64；95%CI：0.43-0.96），以及高抗氧化剂指数评分与 EAC 的风险呈负相关。我们没有发现β-胡萝卜素、维生素 C、维生素 E 和硒的摄入量与非异型增生性或异型增生性 BE 风险之间的显著趋势。然而，我们的数据表明，β-胡萝卜素的高摄入量可能与异型增生性 BE 的风险降低有关。
