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钙和镁的摄入与食管腺癌发病风险的相关性:NIH-AARP 饮食与健康研究前瞻性队列分析。

Associations between calcium and magnesium intake and the risk of incident oesophageal cancer: an analysis of the NIH-AARP Diet and Health Study prospective cohort.

机构信息

Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, TN, USA.

Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN, USA.

出版信息

Br J Cancer. 2020 Jun;122(12):1857-1864. doi: 10.1038/s41416-020-0818-6. Epub 2020 Apr 3.

Abstract

BACKGROUND

Risk reduction through dietary modifications is an adjunct strategy for prevention of oesophageal cancer, a leading cause of cancer-related mortality and morbidity worldwide. We aimed to estimate the association between calcium and magnesium intakes and incident oesophageal cancer (OC).

METHODS

We conducted a retrospective analysis of the NIH-AARP Diet and Health Study prospective cohort. We used multivariable Cox proportional hazard modeling to estimate the association between total intakes and incident OC overall and by histology (oesophageal squamous cell carcinoma (OSCC) and adenocarcinoma (OAC)). Sensitivity and stratified analyses were performed.

RESULTS

Among 536,359 included respondents, 1414 incident OCs occurred over 6.5 million person-years follow-up time. Increasing dietary calcium intake was associated with an adjusted 32-41% lower risk of OSCC compared to the lowest quartile (p-trend 0.01). There was a positive association between increasing magnesium intake and OAC risk, but only among participants with low calcium:magnesium intake ratios (p-trend 0.04). There was a significant interaction with smoking status.

CONCLUSIONS

Based on a retrospective analysis of the NIH-AARP Diet and Health Study prospective cohort, dietary intakes of calcium and magnesium were significantly associated with risk of OSCC and, among certain participants, OAC, respectively. If validated, these findings could inform dietary modifications among at-risk individuals. Mechanistic investigations would provide additional insight.

摘要

背景

通过饮食调整来降低风险是预防食管癌的一种辅助策略,食管癌是全球导致癌症相关死亡和发病的主要原因之一。我们旨在评估钙和镁的摄入量与食管癌(OC)发病风险之间的关联。

方法

我们对 NIH-AARP 饮食与健康研究前瞻性队列进行了回顾性分析。我们使用多变量 Cox 比例风险模型来估计总摄入量与 OC 总体以及组织学(食管鳞状细胞癌(OSCC)和腺癌(OAC))之间的关联。进行了敏感性和分层分析。

结果

在纳入的 536359 名受访者中,有 1414 例 OC 在 650 多万人年的随访时间内发生。与最低四分位数相比,饮食中钙摄入量增加与 OSCC 风险降低 32-41%相关(趋势检验 p<0.01)。镁摄入量增加与 OAC 风险呈正相关,但仅在钙/镁摄入量比值较低的参与者中(趋势检验 p<0.04)。这与吸烟状况存在显著交互作用。

结论

基于 NIH-AARP 饮食与健康研究前瞻性队列的回顾性分析,钙和镁的饮食摄入量与 OSCC 风险显著相关,而在某些参与者中,与 OAC 风险相关。如果得到验证,这些发现可以为高危人群的饮食调整提供信息。机制研究将提供更多的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b59e/7283350/c66897ae4935/41416_2020_818_Fig1_HTML.jpg

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