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青少年时期乳制品和钙的摄入与 NIH-AARP 饮食与健康研究中前列腺癌风险和死亡率的关系。

Adolescent dairy product and calcium intake in relation to later prostate cancer risk and mortality in the NIH-AARP Diet and Health Study.

机构信息

Department of Occupational and Environmental Health, College of Public Health, The University of Iowa, Iowa City, IA, USA.

Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.

出版信息

Cancer Causes Control. 2020 Oct;31(10):891-904. doi: 10.1007/s10552-020-01330-z. Epub 2020 Aug 2.

Abstract

PURPOSE

Although a growing body of evidence supports an early-life contribution to prostate cancer (PCa) development, few studies have investigated early-life diet, and only three have examined early-life dairy product intake, a promising candidate risk factor because of its known/suspected influence on insulin-like growth factor levels and height.

METHODS

We used recalled dietary data from 162,816 participants in the NIH-AARP Diet and Health Study to investigate associations for milk, cheese, ice cream, total dairy, and calcium intake at ages 12-13 years with incident total (n = 17,729), advanced (n = 2,348), and fatal PCa (n = 827) over 14 years of follow-up. We calculated relative risks (RRs) and 95% confidence intervals (CIs) by Cox proportional hazards regression.

RESULTS

We observed suggestive positive trends for milk, dairy, and calcium intake with total and/or advanced PCa (p-trends = 0.016-0.148). These trends attenuated after adjustment for additional components of adolescent diet, particularly red meat and vegetables/potatoes. In contrast, suggestive inverse trends were observed for cheese and ice cream intake with total and/or advanced PCa (p-trends = 0.043-0.153), and for milk, dairy, and calcium intake with fatal PCa (p-trend = 0.045-0.117).

CONCLUSION

Although these findings provide some support for a role of adolescent diet in increasing PCa risk, particularly for correlates of milk intake or overall dietary patterns, our protective findings for cheese and ice cream intake with PCa risk and mortality, and for all dairy products with PCa mortality, suggest alternative explanations, such as the influence of early-life socioeconomic status, and increased PCa screening, earlier detection, and better PCa care.

摘要

目的

尽管越来越多的证据表明前列腺癌(PCa)的发生与生命早期有关,但很少有研究调查生命早期的饮食,只有三项研究调查了生命早期乳制品的摄入情况,因为其对胰岛素样生长因子水平和身高的已知/可疑影响,所以乳制品是一个很有前途的候选风险因素。

方法

我们使用来自 NIH-AARP 饮食与健康研究的 162816 名参与者的回顾性饮食数据,调查了 12-13 岁时的牛奶、奶酪、冰淇淋、总乳制品和钙摄入量与 14 年随访期间发生的总(n=17729)、晚期(n=2348)和致命 PCa(n=827)之间的关联。我们通过 Cox 比例风险回归计算相对风险(RR)和 95%置信区间(CI)。

结果

我们观察到牛奶、乳制品和钙摄入量与总 PCa 和/或晚期 PCa 呈阳性趋势(p 趋势=0.016-0.148)。这些趋势在调整青少年饮食的其他成分,特别是红肉和蔬菜/土豆后减弱。相比之下,奶酪和冰淇淋的摄入量与总 PCa 和/或晚期 PCa 呈负相关趋势(p 趋势=0.043-0.153),牛奶、乳制品和钙摄入量与致命 PCa 呈负相关趋势(p 趋势=0.045-0.117)。

结论

尽管这些发现为青少年饮食在增加 PCa 风险中的作用提供了一些支持,特别是与牛奶摄入量或整体饮食模式相关的因素,但我们对奶酪和冰淇淋摄入与 PCa 风险和死亡率以及所有乳制品与 PCa 死亡率的保护作用的发现表明了其他解释,例如生命早期社会经济地位的影响,以及增加的 PCa 筛查、更早的检测和更好的 PCa 治疗。

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