Wang Zhe, Wang Wenhao, Yang Aimin, Zhao Weihong, Yang Jing, Wang Zhilian, Wang Wei, Su Xiaoqiang, Wang Jintao, Song Jinghui, Li Li, Lv Weiguo, Li Dongyan, Liu Huiqiang, Wang Chen, Hao Min
Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR.
J Cancer. 2021 Jan 1;12(1):111-123. doi: 10.7150/jca.39806. eCollection 2021.
Population-based studies investigating the association between dietary mineral intake and risk of cervical intraepithelial neoplasia (CIN) or cervical cancer in Chinese women are few. We performed a cross-sectional analysis of screening data obtained from 2,304 women in 2014 within an ongoing cohort study comprising 40,000 women in China. Dietary intake was assessed using a semiquantitative food frequency questionnaire. Nutrition intake was calculated using a 26-item list of food sources drawn from a validated, comprehensive database. All participants were surveyed through in-person interviews, physical examinations, and laboratory tests. The Pearson chi-square test was used for categorical variables. Multivariable logistic regression models were used to evaluate the relationship between dietary mineral intake and CIN+ risk. The food frequency questionnaire exhibited acceptable reproducibility and reasonable validity in assessing nutrient intakes among these women. After adjusting for multiple potential confounders, low dietary calcium intake was associated with CIN2+ risk (first versus fourth quartile: odds ratio [OR]=1.52, 95% confidence interval [CI]: 1.01-2.32). Similar for magnesium (OR=1.80, 95% CI: 1.20-2.68), phosphorus (OR=1.69, 95% CI: 1.12-2.55), zinc (OR=1.55, 95% CI: 1.03-2.34), and potassium (OR=1.92, 95% CI: 1.28-2.88). Low dietary intakes of calcium and potassium were significantly associated with CIN1 risk. Increased CIN2+ risk correlated with rates of no oral contraceptives and lower levels of dietary Potassium. These results thus proposed that low dietary mineral intake was an independent risk factor, potential synergy may exist between low dietary mineral levels and oral contraceptives contribute to the development of higher-grade CIN and cervical cancer.
针对中国女性饮食矿物质摄入量与宫颈上皮内瘤变(CIN)或宫颈癌风险之间关联的基于人群的研究较少。我们在一项正在进行的包含40000名中国女性的队列研究中,对2014年从2304名女性获得的筛查数据进行了横断面分析。使用半定量食物频率问卷评估饮食摄入量。营养摄入量通过从经过验证的综合数据库中提取的26种食物来源清单进行计算。所有参与者均通过面对面访谈、体格检查和实验室检测进行调查。对分类变量使用Pearson卡方检验。多变量逻辑回归模型用于评估饮食矿物质摄入量与CIN+风险之间的关系。食物频率问卷在评估这些女性的营养素摄入量方面表现出可接受的重复性和合理的有效性。在调整多个潜在混杂因素后,低饮食钙摄入量与CIN2+风险相关(第一四分位数与第四四分位数:比值比[OR]=1.52,95%置信区间[CI]:1.01 - 2.32)。镁(OR=1.80,95% CI:1.20 - 2.68)、磷(OR=1.69,95% CI:1.12 - 2.55)、锌(OR=1.55,95% CI:1.03 - 2.34)和钾(OR=1.92,95% CI:1.28 - 2.88)情况类似。低饮食钙和钾摄入量与CIN1风险显著相关。CIN2+风险增加与未使用口服避孕药的比例以及较低的饮食钾水平相关。因此,这些结果表明低饮食矿物质摄入量是一个独立的风险因素,低饮食矿物质水平与口服避孕药之间可能存在潜在协同作用,促使更高级别CIN和宫颈癌的发生。