Zhong Guo-Chao, Pu Jian-Yuan, Wu Yi-Lin, Yi Zhu-Jun, Wan Lun, Wang Kang, Hao Fa-Bao, Zhao Yong, Gong Jian-Ping
Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Hepatobiliary Surgery, The People's Hospital of Dazu district, Chongqing, China.
Cancer Epidemiol Biomarkers Prev. 2020 May;29(5):1019-1028. doi: 10.1158/1055-9965.EPI-19-1511. Epub 2020 Feb 12.
Total antioxidant capacity (TAC) reflects an individual's overall antioxidant intake. We sought to clarify whether higher TAC is associated with lower risks of pancreatic cancer incidence and mortality in the U.S. general population.
A total of 96,018 American adults were identified from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. A ferric-reducing ability of plasma score was used to reflect an individual's TAC intake from diet and/or supplements. Cox regression was used to calculate hazard ratios (HR) for pancreatic cancer incidence, and competing risk regression was used to calculate subdistribution HRs for pancreatic cancer mortality. Restricted cubic spline regression was used to test nonlinearity.
A total of 393 pancreatic cancer cases and 353 pancreatic cancer-related deaths were documented. Total (diet + supplements) TAC was found to be inversely associated with pancreatic cancer incidence (HR = 0.53; 95% confidence interval, 0.39-0.72; = 0.0002) and mortality (subdistribution HR = 0.52; 95% confidence interval 0.38-0.72; = 0.0003) in a nonlinear dose-response manner (all < 0.01). Similar results were observed for dietary TAC. No association of supplemental TAC with pancreatic cancer incidence and mortality was found.
In the U.S. general population, dietary but not supplemental TAC level is inversely associated with risks of pancreatic cancer incidence and mortality in a nonlinear dose-response pattern.
This is the first prospective study indicating that a diet rich in antioxidants may be beneficial in decreasing pancreatic cancer incidence and mortality.
总抗氧化能力（TAC）反映了个体的总体抗氧化剂摄入量。我们试图阐明在美国普通人群中，较高的TAC是否与较低的胰腺癌发病率和死亡率风险相关。
从前列腺、肺、结肠和卵巢癌筛查试验中识别出总共96,018名美国成年人。血浆铁还原能力评分用于反映个体从饮食和/或补充剂中摄入的TAC。Cox回归用于计算胰腺癌发病率的风险比（HR），竞争风险回归用于计算胰腺癌死亡率的亚分布HR。使用受限立方样条回归来检验非线性。
共记录了393例胰腺癌病例和353例与胰腺癌相关的死亡。发现总（饮食 + 补充剂）TAC与胰腺癌发病率呈负相关（HR = 0.53；95%置信区间，0.39 - 0.72；P = 0.0002），并以非线性剂量反应方式与死亡率呈负相关（亚分布HR = 0.52；95%置信区间0.38 - 0.72；P = 0.0003）（所有P < 0.01）。饮食TAC也观察到类似结果。未发现补充TAC与胰腺癌发病率和死亡率之间存在关联。
在美国普通人群中，饮食中的TAC水平而非补充剂中的TAC水平以非线性剂量反应模式与胰腺癌发病率和死亡率风险呈负相关。
这是第一项前瞻性研究，表明富含抗氧化剂的饮食可能有助于降低胰腺癌的发病率和死亡率。
