Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA.
Br J Cancer. 2013 Jan 15;108(1):183-7. doi: 10.1038/bjc.2012.534. Epub 2013 Jan 8.
This is the largest prospective cohort analysis to assess how dietary factors involved in one-carbon metabolism are associated with endometrial cancer incidence, using 26 years of follow-up data from the Nurses' Health Study.
The prospective cohort analysis of one-carbon metabolism dietary factors used the Cox proportional hazards model, and incorporated 788 incident endometrial cancer events from 1980 to 2006. Genotyping and unconditional logistic regression were performed on 572 endometrial cancer cases and their matched controls to examine 29 mostly non-synonymous single-nucleotide polymorphisms involved in one-carbon metabolism.
There were no significant dose-response relationships between intake of any of the one-carbon metabolism dietary factors and endometrial cancer incidence, but alcohol consumption of <1 drink a day was significantly protective (hazard ratio: 0.80; 95% CI: 0.68, 0.94). Those with the MTHFR 677 TT or MTHFR 1298 CC genotype had more protective associations for many of the dietary factors and endometrial cancer, but statistical power was limited in this analysis.
Dietary levels of folate, choline, methionine, vitamin B2, vitamin B6 or vitamin B12 do not appear to influence endometrial cancer incidence. Moderate alcohol intake may protect against developing endometrial cancer.
这是一项最大规模的前瞻性队列分析,旨在评估涉及一碳代谢的饮食因素与子宫内膜癌发病率之间的关系,研究使用了护士健康研究(Nurses' Health Study)26 年的随访数据。
采用 Cox 比例风险模型进行一碳代谢饮食因素的前瞻性队列分析,纳入了 1980 年至 2006 年期间发生的 788 例子宫内膜癌事件。对 572 例子宫内膜癌病例及其匹配对照进行基因分型和非条件逻辑回归分析,以检测涉及一碳代谢的 29 个主要非同义单核苷酸多态性。
摄入任何一种一碳代谢饮食因素与子宫内膜癌发病率之间均无显著的剂量反应关系,但每天饮酒<1 杯具有显著的保护作用(风险比:0.80;95%置信区间:0.68,0.94)。MTHFR677 TT 或 MTHFR1298 CC 基因型的个体与许多饮食因素和子宫内膜癌的相关性更具保护作用,但在这项分析中统计效能有限。
饮食中叶酸、胆碱、蛋氨酸、维生素 B2、维生素 B6 或维生素 B12 的水平似乎不会影响子宫内膜癌的发病率。适量饮酒可能有助于预防子宫内膜癌的发生。