Espejo-Herrera Nadia, Gracia-Lavedan Esther, Pollan Marina, Aragonés Nuria, Boldo Elena, Perez-Gomez Beatriz, Altzibar Jone M, Amiano Pilar, Zabala Ana Jiménez, Ardanaz Eva, Guevara Marcela, Molina Antonio J, Barrio Juan Pablo, Gómez-Acebo Ines, Tardón Adonina, Peiró Rosana, Chirlaque Maria Dolores, Palau Margarita, Muñoz Montse, Font-Ribera Laia, Castaño-Vinyals Gemma, Kogevinas Manolis, Villanueva Cristina M
ISGlobal Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
Environ Health Perspect. 2016 Jul;124(7):1042-9. doi: 10.1289/ehp.1510334. Epub 2016 Mar 4.
Ingested nitrate leads to endogenous formation of N-nitroso compounds that are breast carcinogens in animals, but human evidence is limited.
We evaluated ingested nitrate as a risk factor for breast cancer (BC) in a multicase-control study.
Hospital-based incident BC cases and population-based controls were recruited in eight Spanish regions in 2008-2013; participants provided residential and water consumption from 18 years of age and information on known BC risk factors. Long-term nitrate levels (1940-2010) were estimated and linked with residential histories and water consumption to calculate waterborne ingested nitrate (milligrams/day). Dietary ingested nitrate (milligrams/day) was calculated using food frequency questionnaires and published dietary nitrate contents. Interactions with endogenous nitrosation factors and other variables were evaluated. A total of 1,245 cases and 1,520 controls were included in the statistical analysis.
Among the study regions, average ± SD waterborne ingested nitrate ranged from 2.9 ± 1.9 to 13.5 ± 7.5 mg/day, and dietary ingested nitrate ranged from 88.5 ± 48.7 to 154 ± 87.8 mg/day. Waterborne ingested nitrate was not associated with BC overall, but among postmenopausal women, those with both high nitrate (> 6 vs. < 2.6 mg/day) and high red meat intake (≥ 20 vs. < 20 g/day) were more likely to be cases than women with low nitrate and low red meat intake (adjusted odds ratio = 1.64; 95% confidence interval: 1.08, 2.49; overall interaction p-value = 0.17). No association was found with dietary nitrate.
Waterborne ingested nitrate was associated with BC only among postmenopausal women with high red meat consumption. Dietary nitrate was not associated with BC regardless of the animal or vegetable source or of menopausal status.
Espejo-Herrera N, Gracia-Lavedan E, Pollan M, Aragonés N, Boldo E, Perez-Gomez B, Altzibar JM, Amiano P, Zabala AJ, Ardanaz E, Guevara M, Molina AJ, Barrio JP, Gómez-Acebo I, Tardón A, Peiró R, Chirlaque MD, Palau M, Muñoz M, Font-Ribera L, Castaño-Vinyals G, Kogevinas M, Villanueva CM. 2016. Ingested nitrate and breast cancer in the Spanish Multicase-Control Study on Cancer (MCC-Spain). Environ Health Perspect 124:1042-1049; http://dx.doi.org/10.1289/ehp.1510334.
摄入的硝酸盐会导致内源性亚硝基化合物的形成，这些化合物在动物体内是乳腺癌致癌物，但相关的人体证据有限。
在一项多病例对照研究中，我们评估了摄入硝酸盐作为乳腺癌（BC）的一个风险因素。
2008年至2013年期间，在西班牙的八个地区招募了以医院为基础的新发BC病例和以人群为基础的对照；参与者提供了自18岁起的居住情况和用水情况，以及已知的BC风险因素信息。估算了长期硝酸盐水平（1940年至2010年），并将其与居住史和用水情况相关联，以计算经水摄入的硝酸盐量（毫克/天）。使用食物频率问卷和已公布的膳食硝酸盐含量来计算膳食摄入的硝酸盐量（毫克/天）。评估了与内源性亚硝化因子和其他变量的相互作用。共有1245例病例和1520例对照纳入了统计分析。
在研究地区中，经水摄入硝酸盐的平均±标准差范围为2.9±1.9至13.5±7.5毫克/天，膳食摄入硝酸盐的范围为88.5±48.7至154±87.8毫克/天。经水摄入硝酸盐总体上与BC无关，但在绝经后女性中，硝酸盐摄入量高（>6与<2.6毫克/天）且红肉摄入量高（≥20与<20克/天）的女性比硝酸盐摄入量低且红肉摄入量低的女性更有可能是病例（调整后的优势比=1.64；95%置信区间：1.08，2.49；总体相互作用p值=0.17）。未发现与膳食硝酸盐有关联。
仅在红肉消费量高的绝经后女性中，经水摄入硝酸盐与BC有关。无论动物或植物来源以及绝经状态如何，膳食硝酸盐均与BC无关。
埃斯佩霍 - 埃雷拉N，格拉西亚 - 拉韦丹E，波兰M，阿拉戈内斯N，博尔多E，佩雷斯 - 戈麦斯B，阿尔齐巴尔JM，阿米亚诺P，萨巴拉AJ，阿尔达纳兹E，格瓦拉M，莫利纳AJ，巴里奥JP，戈麦斯 - 阿塞博I，塔尔东A，皮罗R，奇拉克MD，帕劳M，穆尼奥斯M，丰特 - 在西班牙癌症多病例对照研究（MCC - 西班牙）中摄入的硝酸盐与乳腺癌。环境健康展望124：1042 - 1049；http://dx.doi.org/10.1289/ehp.1510334。
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