Han Peijin, Bidulescu Aurelian, Barber John R, Zeisel Steven H, Joshu Corinne E, Prizment Anna E, Vitolins Mara Z, Platz Elizabeth A
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Department of Epidemiology and Biostatistics, Indiana University Bloomington School of Public Health, Bloomington, IN, USA.
Cancer Causes Control. 2019 Apr;30(4):343-354. doi: 10.1007/s10552-019-01148-4. Epub 2019 Mar 1.
Two prior cohort studies suggested that choline, but not betaine intake, is associated with an increased risk of advanced prostate cancer (PCa). Given that evidence remains limited, we evaluated whether intakes of choline and derivative betaine are associated with total and lethal PCa risk and PCa death in men with PCa.
We included 6,528 men (24.4% African American) without a cancer diagnosis at baseline (1987-1989) followed through 2012. Dietary intake was assessed using a food frequency questionnaire coupled with a nutrient database. We used Cox proportional hazards regression to estimate hazards ratios (HRs) and 95% confidence intervals (CIs) of total and lethal PCa risk overall and by race.
Choline intake was not associated with total (n = 811) or lethal (n = 95) PCa risk overall or by race. Betaine intake was inversely associated with lethal (tertile 3 vs 1, HR 0.59, 95% CI 0.35-1.00, p trend = 0.04), but not total PCa risk; patterns for lethal PCa were similar by race. Neither nutrient was associated with PCa death in men with PCa.
Choline intake was not associated with total or lethal PCa or with PCa death in men with PCa. Betaine intake was inversely associated with lethal, but not total PCa risk or with PCa death in men with PCa. Our results do not support the hypothesis that higher choline intake increases lethal PCa risk, but do suggest that higher betaine intake may be associated with lower lethal PCa risk. Further investigation with a larger number of lethal cases is needed.
两项先前的队列研究表明，胆碱摄入量与晚期前列腺癌（PCa）风险增加有关，但甜菜碱摄入量与该风险无关。鉴于相关证据仍然有限，我们评估了胆碱及其衍生物甜菜碱的摄入量与PCa男性患者的总体和致命PCa风险以及PCa死亡之间的关系。
我们纳入了6528名男性（24.4%为非裔美国人），这些男性在基线时（1987 - 1989年）未被诊断出患有癌症，随访至2012年。使用食物频率问卷结合营养数据库评估饮食摄入量。我们使用Cox比例风险回归来估计总体和按种族划分的总体及致命PCa风险的风险比（HR）和95%置信区间（CI）。
胆碱摄入量与总体或按种族划分的总体（n = 811）或致命（n = 95）PCa风险均无关。甜菜碱摄入量与致命PCa风险呈负相关（三分位数3与1相比，HR 0.59，95% CI 0.35 - 1.00，p趋势 = 0.04），但与总体PCa风险无关；按种族划分的致命PCa模式相似。两种营养素与PCa男性患者的PCa死亡均无关。
胆碱摄入量与PCa男性患者的总体或致命PCa以及PCa死亡均无关。甜菜碱摄入量与致命PCa风险呈负相关，但与PCa男性患者的总体PCa风险或PCa死亡无关。我们的结果不支持较高胆碱摄入量会增加致命PCa风险的假设，但确实表明较高的甜菜碱摄入量可能与较低的致命PCa风险有关。需要对更多致命病例进行进一步研究。
