Department of Medicine, Division of Epidemiology, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, TN, USA.
Spelman College, Atlanta, GA, USA.
Am J Clin Nutr. 2020 Jun 1;111(6):1244-1251. doi: 10.1093/ajcn/nqaa030.
Red and processed meat, recognized carcinogens, are risk factors for colorectal neoplasia, including polyps, the precursor for colorectal cancer. The mechanism is unclear. One possible explanation is the mutagenic activity of these foods, perhaps due to generation during cooking [e.g., heterocyclic amine (HCA) intake]. Few studies have evaluated meat intake and sessile serrated lesion (SSL) risk, a recently recognized precursor, and no study has evaluated meat cooking methods and meat-derived mutagens with SSL risk.
We evaluated intakes of meat, meat cooking methods, and inferred meat mutagens with SSL risk and in comparison to risk of other polyps.
Meat, well-done meat, and inferred meat mutagen intakes were evaluated. Polytomous logistic regression models were used to estimate ORs and 95% CIs among cases (556 hyperplastic polyp, 1753 adenoma, and 208 SSL) and controls (3804) in the large colonoscopy-based, case-control study, the Tennessee Colorectal Polyp Study.
The highest quartile intakes of red meat (OR: 2.38; 95% CI: 1.44, 3.93), processed meat (OR: 2.03; 95% CI: 1.30, 3.17), well-done red meat (OR: 2.19; 95% CI: 1.34, 3.60), and the HCA 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQX; OR: 2.48; 95% CI: 1.49, 4.16) were associated with increased risk of SSLs in comparison to the lowest quartile intake.
High intakes of red and processed meats are strongly and especially associated with SSL risk and part of the association may be due to HCA intake. Future studies should evaluate other mechanism(s) and the potential for primary prevention.
已确认的致癌物质,红色和加工肉类,是结直肠肿瘤的风险因素,包括息肉,结直肠癌的前体。其机制尚不清楚。一种可能的解释是这些食物的诱变活性,可能是由于烹饪过程中产生的[例如,杂环胺(HCA)摄入]。很少有研究评估肉类摄入量和无蒂锯齿状病变(SSL)风险,这是最近发现的前体,也没有研究评估肉类烹饪方法和与 SSL 风险相关的肉类衍生诱变剂。
我们评估了 SSL 风险与肉摄入量、肉烹饪方法和推断的肉诱变剂的关系,并与其他息肉的风险进行了比较。
评估了肉、熟透的肉和推断的肉诱变剂的摄入量。多分类逻辑回归模型用于估计大型结肠镜检查基础病例对照研究(田纳西州结直肠息肉研究)中病例(556 个增生性息肉、1753 个腺瘤和 208 个 SSL)和对照(3804 个)中 OR 和 95%CI。
红色肉类(OR:2.38;95%CI:1.44,3.93)、加工肉类(OR:2.03;95%CI:1.30,3.17)、熟透的红色肉类(OR:2.19;95%CI:1.34,3.60)和 HCA 2-氨基-3,8-二甲基咪唑[4,5-f]喹喔啉(MeIQX;OR:2.48;95%CI:1.49,4.16)的最高四分位摄入量与 SSL 风险增加相关,而最低四分位摄入量则较低。
高摄入量的红色和加工肉类与 SSL 风险密切相关,尤其是与 SSL 风险相关,部分关联可能归因于 HCA 的摄入。未来的研究应该评估其他机制和潜在的一级预防。