乳制品和钙摄入量与 Adventist Health Study-2 队列中结直肠癌的独立关联。
Independent associations of dairy and calcium intakes with colorectal cancers in the Adventist Health Study-2 cohort.
机构信息
Adventist Health Study,Loma Linda University,24951 North Circle Drive,NH 2031,Loma Linda,CA 92350,USA.
出版信息
Public Health Nutr. 2017 Oct;20(14):2577-2586. doi: 10.1017/S1368980017001422. Epub 2017 Jul 24.
OBJECTIVE
Results associating dairy and Ca intakes with colorectal cancer (CRC) risk have been mixed. Most previous analyses have suffered from confounding between dairy and Ca intakes. We examined independent associations between these variables, also dairy foods, and CRC incidence in a population with a large range of dairy intakes.
DESIGN
Adventist Health Study-2 is a cohort study where subjects were enrolled 2002-2007. Proportional hazard regression analyses were performed to estimate hazard ratios (HR). Regression calibration was used to correct for dietary measurement error.
SETTING
The population lived in all states of the USA.
SUBJECTS
There were 77712 analytic subjects, all of whom were Seventh-day Adventists. Much of their dietary Ca came from non-dairy sources.
SUBJECTS
During a mean follow-up of 7·8 years, 380 incident colon cancer and 111 incident rectal cancer cases were observed.
RESULTS
Comparing extreme quintiles of intake in measurement error-corrected analyses, dairy intake (HR=0·31; 95 % CI 0·09, 0·88), independent of total Ca, was inversely related with risk of rectal cancer but gave little indication of association with colon cancer. However, total Ca intake (independent of dairy) was associated with risk of colon cancer (HR=0·55; 95 % CI 0·28, 0·98) and there was little indication of association with rectal cancer. Traditional regression analyses and associations with macronutrients from dairy generally supported these results. Milk intake was also negatively associated with CRC (HR=0·63; 95 % CI 0·43, 0·89).
CONCLUSIONS
Dairy intake may decrease the risk of rectal cancer, and Ca may reduce risk of colon cancer and CRC.
目的
乳制品和钙摄入量与结直肠癌（CRC）风险之间的关联结果存在差异。大多数先前的分析受到乳制品和钙摄入量之间混杂因素的影响。我们在一个乳制品摄入量范围较大的人群中，研究了这些变量以及乳制品与 CRC 发病率之间的独立关联。
设计
Adventist Health Study-2 是一项队列研究，于 2002 年至 2007 年招募参与者。使用比例风险回归分析来估计风险比（HR）。回归校准用于校正饮食测量误差。
地点
该人群居住在美国的所有州。
研究对象
共有 77712 名分析对象，均为基督复临安息日会信徒。他们的大部分膳食钙来自非乳制品来源。
研究对象
在平均 7.8 年的随访期间，观察到 380 例结肠癌和 111 例直肠癌病例。
结果
在经过测量误差校正的分析中，比较摄入量的极端五分位数，乳制品摄入量（HR=0.31；95%CI 0.09，0.88），与总钙独立，与直肠癌风险呈负相关，但与结肠癌几乎没有关联。然而，总钙摄入量（与乳制品无关）与结肠癌风险相关（HR=0.55；95%CI 0.28，0.98），与直肠癌几乎没有关联。传统回归分析和与乳制品中的宏量营养素的关联一般支持这些结果。牛奶摄入量也与 CRC 呈负相关（HR=0.63；95%CI 0.43，0.89）。
结论
乳制品摄入可能降低直肠癌的风险，而钙可能降低结肠癌和 CRC 的风险。
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