欧洲癌症与营养前瞻性调查队列中血浆类胡萝卜素、维生素C、生育酚、视黄醇与乳腺癌风险
Plasma carotenoids, vitamin C, tocopherols, and retinol and the risk of breast cancer in the European Prospective Investigation into Cancer and Nutrition cohort.
作者信息
Bakker Marije F, Peeters Petra Hm, Klaasen Veronique M, Bueno-de-Mesquita H Bas, Jansen Eugene Hjm, Ros Martine M, Travier Noémie, Olsen Anja, Tjønneland Anne, Overvad Kim, Rinaldi Sabina, Romieu Isabelle, Brennan Paul, Boutron-Ruault Marie-Christine, Perquier Florence, Cadeau Claire, Boeing Heiner, Aleksandrova Krasimira, Kaaks Rudolf, Kühn Tilman, Trichopoulou Antonia, Lagiou Pagona, Trichopoulos Dimitrios, Vineis Paolo, Krogh Vittorio, Panico Salvatore, Masala Giovanna, Tumino Rosario, Weiderpass Elisabete, Skeie Guri, Lund Eiliv, Quirós J Ramón, Ardanaz Eva, Navarro Carmen, Amiano Pilar, Sánchez María-José, Buckland Genevieve, Ericson Ulrika, Sonestedt Emily, Johansson Matthias, Sund Malin, Travis Ruth C, Key Timothy J, Khaw Kay-Tee, Wareham Nick, Riboli Elio, van Gils Carla H
机构信息
Julius Center for Health Sciences and Primary Care and
Julius Center for Health Sciences and Primary Care and Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom;
出版信息
Am J Clin Nutr. 2016 Feb;103(2):454-64. doi: 10.3945/ajcn.114.101659. Epub 2016 Jan 20.
BACKGROUND
Carotenoids and vitamin C are thought to be associated with reduced cancer risk because of their antioxidative capacity.
OBJECTIVE
This study evaluated the associations of plasma carotenoid, retinol, tocopherol, and vitamin C concentrations and risk of breast cancer.
DESIGN
In a nested case-control study within the European Prospective Investigation into Cancer and Nutrition cohort, 1502 female incident breast cancer cases were included, with an oversampling of premenopausal (n = 582) and estrogen receptor-negative (ER-) cases (n = 462). Controls (n = 1502) were individually matched to cases by using incidence density sampling. Prediagnostic samples were analyzed for α-carotene, β-carotene, lycopene, lutein, zeaxanthin, β-cryptoxanthin, retinol, α-tocopherol, γ-tocopherol, and vitamin C. Breast cancer risk was computed according to hormone receptor status and age at diagnosis (proxy for menopausal status) by using conditional logistic regression and was further stratified by smoking status, alcohol consumption, and body mass index (BMI). All statistical tests were 2-sided.
RESULTS
In quintile 5 compared with quintile 1, α-carotene (OR: 0.61; 95% CI: 0.39, 0.98) and β-carotene (OR: 0.41; 95% CI: 0.26, 0.65) were inversely associated with risk of ER- breast tumors. The other analytes were not statistically associated with ER- breast cancer. For estrogen receptor-positive (ER+) tumors, no statistically significant associations were found. The test for heterogeneity between ER- and ER+ tumors was statistically significant only for β-carotene (P-heterogeneity = 0.03). A higher risk of breast cancer was found for retinol in relation to ER-/progesterone receptor-negative tumors (OR: 2.37; 95% CI: 1.20, 4.67; P-heterogeneity with ER+/progesterone receptor positive = 0.06). We observed no statistically significant interaction between smoking, alcohol, or BMI and all investigated plasma analytes (based on tertile distribution).
CONCLUSION
Our results indicate that higher concentrations of plasma β-carotene and α-carotene are associated with lower breast cancer risk of ER- tumors.
背景
由于类胡萝卜素和维生素C具有抗氧化能力，人们认为它们与降低癌症风险有关。
目的
本研究评估了血浆类胡萝卜素、视黄醇、生育酚和维生素C浓度与乳腺癌风险之间的关联。
设计
在欧洲癌症与营养前瞻性调查队列中的一项巢式病例对照研究中，纳入了1502例新发女性乳腺癌病例，其中对绝经前病例（n = 582）和雌激素受体阴性（ER-）病例（n = 462）进行了过度抽样。通过发病密度抽样将对照（n = 1502）与病例进行个体匹配。对诊断前样本分析α-胡萝卜素、β-胡萝卜素、番茄红素、叶黄素、玉米黄质、β-隐黄质、视黄醇、α-生育酚、γ-生育酚和维生素C。根据激素受体状态和诊断时年龄（绝经状态的替代指标），使用条件逻辑回归计算乳腺癌风险，并进一步按吸烟状况、饮酒量和体重指数（BMI）进行分层。所有统计检验均为双侧检验。
结果
与第1五分位数相比，第5五分位数中的α-胡萝卜素（比值比：0.61；95%置信区间：0.39，0.98）和β-胡萝卜素（比值比：0.41；95%置信区间：0.26，0.65）与ER-乳腺肿瘤风险呈负相关。其他分析物与ER-乳腺癌无统计学关联。对于雌激素受体阳性（ER+）肿瘤，未发现统计学上的显著关联。仅β-胡萝卜素在ER-和ER+肿瘤之间的异质性检验具有统计学意义（P-异质性 = 0.03）。发现视黄醇与ER-/孕激素受体阴性肿瘤的乳腺癌风险较高相关（比值比：2.37；95%置信区间：1.20，4.67；与ER+/孕激素受体阳性的P-异质性 = 0.06）。我们未观察到吸烟、饮酒或BMI与所有研究的血浆分析物之间存在统计学上的显著交互作用（基于三分位数分布）。
结论
我们的结果表明，血浆β-胡萝卜素和α-胡萝卜素浓度较高与ER-肿瘤的乳腺癌风险较低相关。
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