红肉和加工肉类摄入量与乳腺癌风险之间的前瞻性关联：SU.VI.MAX随机对照试验中抗氧化剂补充剂的调节作用
Prospective association between red and processed meat intakes and breast cancer risk: modulation by an antioxidant supplementation in the SU.VI.MAX randomized controlled trial.
作者信息
Pouchieu Camille, Deschasaux Mélanie, Hercberg Serge, Druesne-Pecollo Nathalie, Latino-Martel Paule, Touvier Mathilde
机构信息
Sorbonne Paris Cité, Epidemiology and Biostatistics Research Center, Nutritional Epidemiology Research Team (EREN), Inserm U1153; Inra U1125; Cnam; Paris 13,7 and 5 Universities, Bobigny, France and Public Health Department, Avicenne Hospital, Bobigny, France
Sorbonne Paris Cité, Epidemiology and Biostatistics Research Center, Nutritional Epidemiology Research Team (EREN), Inserm U1153; Inra U1125; Cnam; Paris 13,7 and 5 Universities, Bobigny, France and Public Health Department, Avicenne Hospital, Bobigny, France.
出版信息
Int J Epidemiol. 2014 Oct;43(5):1583-92. doi: 10.1093/ije/dyu134. Epub 2014 Jul 3.
BACKGROUND
The level of evidence regarding the association between red and processed meat intakes and breast cancer risk is still low, due to insufficient prospective studies. Moreover, mechanistic data suggest that some antioxidants may modulate this relationship but epidemiological evidence is lacking. Our objectives were to investigate relationships between red and processed meat intakes and breast cancer risk, and to study whether an antioxidant supplementation modulates these associations, which, to our knowledge, has never been investigated before.
METHODS
The SU.VI.MAX study was a randomized, double-blind, placebo-controlled trial in which participants received a combination of low-dose antioxidants or a placebo from 1994 to 2002. This observational prospective analysis included 4684 women among whom 190 developed a first incident breast cancer between 1994 and 2007 [mean (range) follow-up=11.3 (0-13)years]. Baseline dietary data were assessed by repeated dietary records in 1994-1995. Associations between quartiles of red and processed meat intakes and breast cancer risk were characterized by multivariate Cox proportional hazards models.
RESULTS
Breast cancer risk was directly associated with processed meat intake [hazard ratio (HR)Q4vsQ1=1.45 (0.92-2.27), Ptrend=0.03] and this association was stronger when excluding cooked ham [HRQ4vsQ1=1.90 (1.18-3.05), Ptrend=0.005]. In stratified analyses, processed meat intake was directly associated with breast cancer risk in the placebo group only [HRQ4vsQ1=2.46 (1.28-4.72), Ptrend=0.001], but not in the supplemented group [HRQ4vsQ1=0.86 (0.45-1.63), Ptrend=0.7].
CONCLUSION
Processed meat intake was prospectively associated with increased breast cancer risk. This study also suggests that antioxidants may modulate this association by counteracting the potential pro-carcinogenic effects of processed meat on breast cancer.
背景
由于前瞻性研究不足，关于红肉和加工肉类摄入量与乳腺癌风险之间关联的证据水平仍然较低。此外，机制数据表明一些抗氧化剂可能调节这种关系，但缺乏流行病学证据。我们的目标是研究红肉和加工肉类摄入量与乳腺癌风险之间的关系，并研究抗氧化剂补充剂是否能调节这些关联，据我们所知，此前从未对此进行过研究。
方法
SU.VI.MAX研究是一项随机、双盲、安慰剂对照试验，参与者在1994年至2002年期间接受低剂量抗氧化剂组合或安慰剂。这项观察性前瞻性分析纳入了4684名女性，其中190名在1994年至2007年间首次发生乳腺癌[平均（范围）随访时间=11.3（0 - 13）年]。1994 - 1995年通过重复饮食记录评估基线饮食数据。红肉和加工肉类摄入量四分位数与乳腺癌风险之间的关联通过多变量Cox比例风险模型进行表征。
结果
乳腺癌风险与加工肉类摄入量直接相关[风险比（HR）Q4对Q1 = 1.45（0.92 - 2.27），P趋势 = 0.03]，排除熟火腿后这种关联更强[HRQ4对Q1 = 1.90（1.18 - 3.05），P趋势 = 0.005]。在分层分析中，仅在安慰剂组中加工肉类摄入量与乳腺癌风险直接相关[HRQ4对Q1 = 2.46（1.28 - 4.72），P趋势 = 0.001]，而在补充组中不相关[HRQ4对Q1 = 0.86（0.45 - 1.63），P趋势 = 0.7]。
结论
加工肉类摄入量与乳腺癌风险增加呈前瞻性关联。这项研究还表明，抗氧化剂可能通过抵消加工肉类对乳腺癌的潜在致癌作用来调节这种关联。
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