番茄红素及其他类胡萝卜素的摄入与子宫肌瘤发病率：一项前瞻性超声研究
Intake of Lycopene and other Carotenoids and Incidence of Uterine Leiomyomata: A Prospective Ultrasound Study.
作者信息
Wise Lauren A, Wesselink Amelia K, Bethea Traci N, Brasky Theodore M, Wegienka Ganesa, Harmon Quaker, Block Torin, Baird Donna D
机构信息
(1)Department of Epidemiology, Boston University School of Public Health, Boston, MA.
(1)Department of Epidemiology, Boston University School of Public Health, Boston, MA.
出版信息
J Acad Nutr Diet. 2021 Jan;121(1):92-104. doi: 10.1016/j.jand.2020.08.013. Epub 2020 Oct 21.
BACKGROUND
Uterine leiomyomata (UL) are the leading indication for hysterectomy in the United States. Dietary supplementation with lycopene was associated with reduced size and incidence of oviduct leiomyoma in the Japanese quail. Two US prospective cohort studies of women reported little association between intake of lycopene, or other carotenoids, and UL incidence. However, these studies relied on self-reported physician-diagnosed UL, which is prone to misclassification.
OBJECTIVE
This study examines the association between dietary intake of carotenoids and UL incidence.
DESIGN
Data were derived from the Study of the Environment, Lifestyle, and Fibroids, a prospective cohort study. Women completed self-administered baseline questionnaires on demographic characteristics, reproductive history, and lifestyle, including a 110-item validated food frequency questionnaire, from which dietary intakes of carotenoids-including alpha carotene, beta carotene, cryptoxanthin, lutein-zeaxanthin, and lycopene-and vitamin A were estimated.
PARTICIPANTS/SETTING: One thousand two hundred thirty Black women aged 23 to 35 years who did not have a previous diagnosis of UL, cancer, or autoimmune disease were eligible for enrollment (2010-2012). Participants were residents of the Detroit, MI, metropolitan area.
MAIN OUTCOME MEASURES
Transvaginal ultrasound was used to assess UL at baseline and 20, 40, and 60 months of follow-up.
STATISTICAL ANALYSES PERFORMED
Cox regression was used to estimate hazard ratios and 95% CIs, adjusted for energy intake, age at menarche, education, body mass index, parity, age at first birth, years since last birth, current use of oral contraceptives or progestin-only injectables, alcohol intake, and cigarette smoking.
RESULTS
Among 1,230 women without prevalent UL at baseline, 301 incident UL cases during follow-up were identified. Intakes of lycopene, other carotenoids, and vitamin A were not appreciably associated with UL incidence. Hazard ratios comparing quartiles 2 (2,376 to 3,397 μg/day), 3 (3,398 to 4,817 μg/day), and 4 (≥4,818 μg/day) with quartile 1 (<2,376 μg/day) of lycopene intake were 1.03 (95% CI 0.72 to 1.47), 1.22 (95% CI 0.86 to 1.72), and 0.95 (95% CI 0.67 to 1.36), respectively.
CONCLUSIONS
Study findings do not support the hypothesis that greater carotenoid intake is associated with reduced UL incidence.
背景
子宫平滑肌瘤（UL）是美国子宫切除术的主要指征。在日本鹌鹑中，补充番茄红素与输卵管平滑肌瘤的大小减小和发病率降低有关。两项针对美国女性的前瞻性队列研究报告称，番茄红素或其他类胡萝卜素的摄入量与UL发病率之间几乎没有关联。然而，这些研究依赖于自我报告的医生诊断的UL，这容易出现错误分类。
目的
本研究探讨类胡萝卜素的饮食摄入量与UL发病率之间的关联。
设计
数据来自环境、生活方式和肌瘤研究，这是一项前瞻性队列研究。女性完成了关于人口统计学特征、生殖史和生活方式的自我管理基线问卷，包括一份经过验证的110项食物频率问卷，据此估计类胡萝卜素（包括α-胡萝卜素、β-胡萝卜素、隐黄质、叶黄素-玉米黄质和番茄红素）和维生素A的饮食摄入量。
参与者/地点：1230名年龄在23至35岁之间、此前未被诊断患有UL、癌症或自身免疫性疾病的黑人女性符合纳入条件（2010 - 2012年）。参与者是密歇根州底特律市大都会地区的居民。
主要观察指标
在基线以及随访的20、40和60个月时，使用经阴道超声评估UL。
进行的统计分析
采用Cox回归估计风险比和95%置信区间，并对能量摄入、初潮年龄、教育程度、体重指数、产次、初产年龄、上次生育后的年数、当前使用口服避孕药或仅使用孕激素注射剂、酒精摄入和吸烟进行了调整。
结果
在基线时无UL的1230名女性中，随访期间确定了301例UL发病病例。番茄红素、其他类胡萝卜素和维生素A的摄入量与UL发病率没有明显关联。将番茄红素摄入量的第2四分位数（2376至3397μg/天）、第3四分位数（3398至4817μg/天）和第4四分位数（≥4818μg/天）与第1四分位数（<2376μg/天）进行比较的风险比分别为1.03（95%置信区间0.72至1.47）、1.22（95%置信区间0.86至1.72）和0.95（95%置信区间0.67至1.36）。
结论
研究结果不支持类胡萝卜素摄入量增加与UL发病率降低相关的假设。
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