Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Japan.
Cancer Medicine, Cooperative Graduate Program, The Jikei University Graduate School of Medicine, Minato-ku, Japan.
Cancer Sci. 2020 Oct;111(10):3862-3872. doi: 10.1111/cas.14596. Epub 2020 Aug 26.
Although intake of highly sugary foods is considered to be a potential risk factor for colorectal cancer through hyperinsulinemia, the association of sugar intake and colorectal adenoma, a precursor lesion to most colorectal cancer, is poorly understood, particularly in Asian populations. We undertook a cross-sectional study in a Japanese population to investigate the association between dietary sugar intake and the prevalence of colorectal adenoma. Study subjects were selected from participants who underwent magnifying colonoscopy with dye spraying as part of a cancer screening program and who responded to a self-administered questionnaire before the colonoscopy. A total of 738 cases with colorectal adenoma and 697 controls were enrolled. Dietary intakes of glucose, fructose, galactose, sucrose, maltose, lactose, and total sugars (sum of these six mono- or disaccharides) were calculated from a food frequency questionnaire, and divided into quartiles based on the distribution among controls. Odds ratios and 95% confidence intervals of colorectal adenoma were estimated using unconditional logistic regression models, with adjustment for potential confounding factors. Total sugar intake was not significantly associated with the prevalence of colorectal adenoma (odds ratio for the highest intake group compared to reference group = 1.18; 95% confidence interval, 0.81-1.73; P for trend = .34). Furthermore, no statistically significant positive associations were observed for any of the six mono- or disaccharides. Findings were similar on additional analyses by site, size, and number of adenomas. Our findings do not support an association between high sugar intake and increased odds ratios of colorectal adenoma.
虽然高糖食物的摄入通过高胰岛素血症被认为是结直肠癌的潜在风险因素，但糖的摄入与结直肠腺瘤（大多数结直肠癌的前期病变）之间的关系尚未得到很好的理解，尤其是在亚洲人群中。我们在日本人群中进行了一项横断面研究，以调查饮食中糖的摄入与结直肠腺瘤患病率之间的关系。研究对象选自参加癌症筛查计划并接受了染料喷洒放大结肠镜检查的参与者，并且在结肠镜检查前回答了一份自我管理的问卷。共纳入了 738 例结直肠腺瘤病例和 697 例对照。通过食物频率问卷计算葡萄糖、果糖、半乳糖、蔗糖、麦芽糖、乳糖和总糖（这六种单糖或二糖的总和）的摄入量，并根据对照人群的分布将其分为四等份。使用非条件逻辑回归模型，调整潜在混杂因素后，估计结直肠腺瘤的比值比和 95%置信区间。总糖摄入量与结直肠腺瘤的患病率无显著相关性（最高摄入量组与参考组相比的比值比=1.18；95%置信区间，0.81-1.73；P 趋势=0.34）。此外，对于这六种单糖或二糖中的任何一种，都没有观察到统计学上显著的正相关关系。在对部位、大小和腺瘤数量进行的额外分析中，结果也相似。我们的研究结果不支持高糖摄入与结直肠腺瘤比值比增加之间存在关联。
