Um Caroline Y, Fedirko Veronika, Flanders W Dana, Judd Suzanne E, Bostick Roberd M
a Nutrition and Health Sciences Graduate Program, Emory University , Atlanta , Georgia , USA.
b Department of Epidemiology , Emory University , Atlanta , Georgia , USA.
Nutr Cancer. 2017 Apr;69(3):416-427. doi: 10.1080/01635581.2017.1274408. Epub 2017 Jan 27.
Calcium intake has been consistently, modestly inversely associated with colorectal neoplasms, and supplemental calcium reduced adenoma recurrence in clinical trials. Milk products are the major source of dietary calcium in the United States, but their associations with colorectal neoplasms are unclear. Data pooled from three colonoscopy-based case-control studies of incident, sporadic colorectal adenoma (n = 807 cases, 2,185 controls) were analyzed using multivariable unconditional logistic regression. Residuals from linear regression models of milk with dietary calcium were estimated as the noncalcium, insulin-like growth factor 1-containing component of milk. For total, dietary, and supplemental calcium intakes, the adjusted odds ratios (ORs) comparing the highest to the lowest intake quintiles were 0.94 (95% confidence interval [CI] 0.69-1.30), 0.86 (CI 0.62-1.20), and 0.99 (CI 0.77-1.27), respectively. The corresponding ORs for consumption of total milk products, total milk, nonfat milk, total milk product residuals, and nonfat milk residuals were, respectively, 0.99, 0.90, 0.92, 0.94, and 0.95; all CIs included 1.0. For those who consumed any whole milk relative to those who consumed none, the OR was 1.15 (CI 0.89-1.49). These results are consistent with previous findings of modest inverse associations of calcium intakes with colorectal adenoma, but suggest that milk products may not be associated with adenoma.
钙摄入量一直与结直肠肿瘤呈适度的负相关,并且在临床试验中补充钙可降低腺瘤复发率。乳制品是美国膳食钙的主要来源,但其与结直肠肿瘤的关系尚不清楚。我们使用多变量无条件逻辑回归分析了三项基于结肠镜检查的偶发性、散发性结直肠腺瘤病例对照研究(807例病例,2185例对照)汇总的数据。牛奶中膳食钙的线性回归模型残差被估计为牛奶中不含钙的、含胰岛素样生长因子1的成分。对于总钙摄入量、膳食钙摄入量和补充钙摄入量,将最高摄入量五分位数与最低摄入量五分位数进行比较的调整优势比(OR)分别为0.94(95%置信区间[CI] 0.69 - 1.30)、0.86(CI 0.62 - 1.20)和0.99(CI 0.77 - 1.27)。总乳制品、全脂牛奶、脱脂牛奶、总乳制品残差和脱脂牛奶残差消费的相应OR分别为0.99、0.90、0.92、0.94和0.95;所有置信区间均包含1.0。与未饮用全脂牛奶的人相比,饮用任何全脂牛奶的人的OR为1.15(CI 0.89 - 1.49)。这些结果与先前关于钙摄入量与结直肠腺瘤呈适度负相关的研究结果一致,但表明乳制品可能与腺瘤无关。