West D W, Slattery M L, Robison L M, Schuman K L, Ford M H, Mahoney A W, Lyon J L, Sorensen A W
Northern California Cancer Center, Belmont.
Am J Epidemiol. 1989 Nov;130(5):883-94. doi: 10.1093/oxfordjournals.aje.a115421.
A case-control study was conducted in Utah between July 1979 and June 1983 in which 231 cases of colon cancer identified through the Utah Cancer Registry and 391 controls identified through random digit dialing were interviewed. Odds ratios (OR) were calculated comparing the highest exposure categories with the lowest exposure categories. The highest quintile of body mass index (weight (kg)/height (m)2 for males; weight (kg)/height (m)1.5 for females) was associated with increased risk in both males (OR = 2.1) and females (OR = 2.3). In females, total dietary fat (OR = 1.9) and energy intake (OR = 1.5) were associated with an increased colon cancer risk after adjusting for age, body mass index, and crude fiber. Fiber was protective in females (OR = 0.5) after adjusting for age, body mass index, and energy intake, as was beta-carotene (OR = 0.5) after also adjusting for crude fiber. Adjusted risk estimates in males were 2.0 for total dietary fat, 3.8 for polyunsaturated fat, 2.1 for monounsaturated fat, 2.1 for energy intake, 2.5 for protein, 0.3 for fiber, 0.4 for beta-carotene, and 0.3 for cruciferous vegetables. Risk estimates differed by site of cancer within the colon. In males, protein (OR = 3.8) was a risk factor for cancer of the descending colon, while fats (OR = 2.7-8.8) increased the risk of cancer of the ascending colon. The hypotheses that dietary fat increases colon cancer risk while dietary fiber decreases colon cancer risk and that fat and protein may be independently associated with colon cancer risk are supported.
1979年7月至1983年6月期间，在犹他州开展了一项病例对照研究，对通过犹他癌症登记处确定的231例结肠癌病例和通过随机数字拨号确定的391名对照进行了访谈。计算了最高暴露类别与最低暴露类别相比的优势比（OR）。体重指数的最高五分位数（男性为体重（千克）/身高（米）²；女性为体重（千克）/身高（米）1.5）与男性（OR = 2.1）和女性（OR = 2.3）的风险增加相关。在女性中，调整年龄、体重指数和粗纤维后，总膳食脂肪（OR = 1.9）和能量摄入（OR = 1.5）与结肠癌风险增加相关。调整年龄、体重指数和能量摄入后，纤维对女性具有保护作用（OR = 0.5），调整粗纤维后β-胡萝卜素也是如此（OR = 0.5）。男性的调整后风险估计值为：总膳食脂肪2.0，多不饱和脂肪3.8，单不饱和脂肪2.1，能量摄入2.1，蛋白质2.5，纤维0.3，β-胡萝卜素0.4，十字花科蔬菜0.3。结肠癌不同部位的风险估计值有所不同。在男性中，蛋白质（OR = 3.8）是降结肠癌的危险因素，而脂肪（OR = 2.7 - 8.8）会增加升结肠癌的风险。膳食脂肪会增加结肠癌风险而膳食纤维会降低结肠癌风险以及脂肪和蛋白质可能与结肠癌风险独立相关的假设得到了支持。
