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钙摄入量与结直肠癌风险:护士健康研究及卫生专业人员随访研究的结果

Calcium intake and colorectal cancer risk: Results from the nurses' health study and health professionals follow-up study.

作者信息

Zhang Xuehong, Keum NaNa, Wu Kana, Smith-Warner Stephanie A, Ogino Shuji, Chan Andrew T, Fuchs Charles S, Giovannucci Edward L

机构信息

Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.

Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA.

出版信息

Int J Cancer. 2016 Nov 15;139(10):2232-42. doi: 10.1002/ijc.30293. Epub 2016 Aug 9.

Abstract

The relationship between calcium intake and colorectal cancer (CRC) risk remains inconclusive. We conducted this study to evaluate whether the association between calcium intake and CRC risk differs by anatomic subsite and determine the dose-response relationship for this association, as well as assess when in carcinogenesis calcium may play a role. We assessed calcium intake every 4 years and followed 88,509 women (1980-2012) in the Nurses' Health Study and 47,740 men (1986-2012) in the Health Professionals Follow-Up Study. We documented 3,078 incident CRC cases. Total calcium intake (≥1,400 vs. <600 mg/d) was associated with a statistically significant lower risk of colon cancer (multivariable relative risk: 0.78, 95%CI: 0.65-0.95). Similar results were observed by different sources of calcium (from all foods or dairy products only). The inverse association was linear and suggestively stronger for distal colon cancer (0.65, 0.43-0.99) than for proximal colon cancer (0.94, 0.72-1.22, p-common effects  = 0.14). Additionally, when comparing different latencies, the overall pattern suggested that the inverse association appeared to be stronger with increasing latency and was strongest for intakes 12-16 years before diagnosis. Comparing total calcium intakes of ≥1,400 vs. <600 mg/d for intake 12-16 y before diagnosis, the pooled RR (95% CIs) of CRC was 0.76 (0.64-0.91). Higher calcium intake was associated with a lower risk of developing colon cancer, especially for distal colon cancer. Overall inverse association was linear and did not differ by intake source. Additionally, calcium intake approximately 10 years before diagnosis appeared to be associated with a lower risk of CRC.

摘要

钙摄入量与结直肠癌(CRC)风险之间的关系尚无定论。我们开展这项研究,旨在评估钙摄入量与CRC风险之间的关联是否因解剖部位而异,确定这种关联的剂量反应关系,并评估钙在致癌过程中可能发挥作用的时间点。我们在护士健康研究中每4年评估一次钙摄入量,并对88509名女性(1980 - 2012年)进行随访,在健康专业人员随访研究中对47740名男性(1986 - 2012年)进行随访。我们记录了3078例结直肠癌新发病例。总钙摄入量(≥1400 vs. <600毫克/天)与结肠癌风险在统计学上显著降低相关(多变量相对风险:0.78,95%置信区间:0.65 - 0.95)。从不同钙源(所有食物或仅乳制品)观察到类似结果。这种负相关是线性的,对于远端结肠癌(0.65,0.43 - 0.99)而言,提示性地比近端结肠癌(0.94,0.72 - 1.22,共同效应p = 0.14)更强。此外,在比较不同潜伏期时,总体模式表明,随着潜伏期增加,负相关似乎更强,在诊断前12 - 16年的摄入量时最强。比较诊断前12 - 16年总钙摄入量≥1400与<600毫克/天的情况,CRC的合并相对风险(95%置信区间)为0.76(0.64 - 0.91)。较高的钙摄入量与患结肠癌的风险较低相关,尤其是对于远端结肠癌。总体负相关是线性的,且不因摄入来源而异。此外,诊断前约10年的钙摄入量似乎与较低的CRC风险相关。

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