Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
Cancer Epidemiol Biomarkers Prev. 2019 Feb;28(2):392-399. doi: 10.1158/1055-9965.EPI-18-0412. Epub 2018 Nov 21.
Despite considerable biological plausibility, other than for calcium, there are few reported epidemiologic studies on mineral intake-colorectal cancer associations, none of which investigated multiple minerals in aggregate.
Accordingly, we incorporated 11 minerals into a mineral score and investigated its association with incident colorectal cancer in the Iowa Women's Health Study, a prospective cohort study of 55- to 69-year-old women who completed a food frequency questionnaire in 1986. In the analytic cohort ( = 35, 221), 1,731 incident colorectal cancer cases were identified via the State Health Registry of Iowa. Participants' calcium, magnesium, manganese, zinc, selenium, potassium, and iodine intakes were ranked 1 to 5, with higher ranks indicating higher, potentially anticarcinogenic, intakes, whereas for iron, copper, phosphorus, and sodium intakes, the rankings were reversed to account for their possible procarcinogenic properties. The rankings were summed to create each woman's mineral score. The mineral score-incident colorectal cancer association was estimated using multivariable Cox proportional hazards regression.
There was decreasing risk with an increasing score ( = 0.001). The hazard ratios and 95% confidence intervals (CI) for those in mineral score quintiles 2 to 5 relative to those in the lowest were 0.91 (CI, 0.88-1.08), 0.85 (CI, 0.75-0.95), 0.86 (CI, 0.75-0.97), and 0.75 (CI, 0.71-0.95), respectively.
Our findings suggest that a predominance of putative anti- relative to pro-colorectal carcinogenic mineral intakes may be inversely associated with colorectal cancer risk.
These results support further investigation of colorectal cancer etiology using composite mineral intake scores.
除了钙以外,很少有研究报道矿物质摄入与结直肠癌之间的关联,而且这些研究都没有综合调查多种矿物质。
因此,我们将 11 种矿物质纳入矿物质评分中,并在爱荷华州妇女健康研究中进行了调查,这是一项针对 55 至 69 岁女性的前瞻性队列研究,她们于 1986 年完成了一份食物频率问卷。在分析队列(n=35221)中,通过爱荷华州健康登记处确定了 1731 例结直肠癌病例。参与者的钙、镁、锰、锌、硒、钾和碘摄入量被排名 1 至 5,排名越高表示摄入量越高,可能具有抗癌作用,而铁、铜、磷和钠的摄入量则相反,排名越高表示可能具有致癌作用。根据每个女性的矿物质评分,对排名进行了相加。使用多变量 Cox 比例风险回归估计矿物质评分与结直肠癌发病之间的关系。
评分越高,风险越低(P=0.001)。相对于评分最低的组,评分在五分位数 2 至 5 的女性的风险比和 95%置信区间(CI)分别为 0.91(CI,0.88-1.08)、0.85(CI,0.75-0.95)、0.86(CI,0.75-0.97)和 0.75(CI,0.71-0.95)。
我们的研究结果表明,假设的抗结直肠癌致癌矿物质摄入相对于促结直肠癌致癌矿物质摄入占优势,可能与结直肠癌风险呈负相关。
这些结果支持使用复合矿物质摄入评分进一步研究结直肠癌的病因。