Liu Zhao-Min, Tse Lap Ah, Ho Suzanne C, Wu Suyang, Chen Bailing, Chan Dicken, Wong Samuel Yeung-Shan
Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.
Division of Occupational and Environmental Health, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China.
J Cancer Res Clin Oncol. 2017 Nov;143(11):2317-2326. doi: 10.1007/s00432-017-2477-4. Epub 2017 Jul 19.
Our study aims to investigate the association between dietary acrylamide exposure and cancer mortality among Chinese elderly.
A prospective cohort of 4000 elderly men and women aged 65 years and above (Mr. and Ms. OS Hong Kong study) was recruited from local communities from 2001 to 2003. Dietary exposure to acrylamide was evaluated at baseline based on a validated food frequency questionnaire and an acrylamide database from the 1st Hong Kong Total Diet Study. Data on mortality statistics through March 2014 were obtained from the Death Registry of the Department of Health of Hong Kong with a median follow-up of 11.1 years. Cox proportional hazards models were used to examine the association between the acrylamide exposure and cancer mortality. Sex hormones were assessed in men.
During a median follow-up of 11.1 years (39,271 person-years), we ascertained 330 cancer deaths. Vegetables (43.7%) and cereals (28.9%) products were the major contributors to dietary acrylamide. Compared with the lowest quartile of acrylamide intake (<9.9 µg/day), the multivariable hazard ratios for the highest quartile (>17.1 µg/day) were 1.9 (95% CI 1.3-2.8; P < 0.01), 1.9 (95% CI 1.0-3.6; P = 0.05), and 2.0 (95% CI 1.0-4.0; P = 0.06) for the cancer mortality from overall, digestive and respiratory system, respectively. The associations were attenuated to null after further adjustment for circulating free estradiol in men. No statistically significant interactions were observed between acrylamide exposure and sex, obesity and overall lifestyle pattern scores.
The longitudinal data provided evidence that dietary acrylamide, in amounts that Chinese elderly are typically exposed to, was associated with increased cancer mortality. Circulating free estradiol may mediate the association in men.
我们的研究旨在调查中国老年人饮食中丙烯酰胺暴露与癌症死亡率之间的关联。
2001年至2003年从当地社区招募了4000名65岁及以上的老年男性和女性(香港OS先生和女士研究)组成前瞻性队列。基于经过验证的食物频率问卷和香港首次总膳食研究中的丙烯酰胺数据库,在基线时评估饮食中丙烯酰胺的暴露情况。通过香港卫生署死亡登记处获得截至2014年3月的死亡率统计数据,中位随访时间为11.1年。使用Cox比例风险模型来检验丙烯酰胺暴露与癌症死亡率之间的关联。对男性进行了性激素评估。
在中位随访11.1年(39271人年)期间,我们确定了330例癌症死亡病例。蔬菜(43.7%)和谷物(28.9%)制品是饮食中丙烯酰胺的主要来源。与丙烯酰胺摄入量最低四分位数(<9.9μg/天)相比,最高四分位数(>17.1μg/天)的多变量风险比在总体、消化系统和呼吸系统癌症死亡率方面分别为1.9(95%CI 1.3 - 2.8;P < 0.01)、1.9(95%CI 1.0 - 3.6;P = 0.05)和2.0(95%CI 1.0 - 4.0;P = 0.06)。在对男性循环游离雌二醇进行进一步调整后,这些关联减弱至无统计学意义。在丙烯酰胺暴露与性别、肥胖和总体生活方式模式得分之间未观察到统计学上显著的相互作用。
纵向数据提供了证据,表明中国老年人通常接触量的饮食丙烯酰胺与癌症死亡率增加有关。循环游离雌二醇可能介导男性中的这种关联。