Nagengast F M, van der Werf S D, Lamers H L, Hectors M P, Buys W C, van Tongeren J M
Department of Internal Medicine, St. Radboud Hospital, Nijmegen, The Netherlands.
Dig Dis Sci. 1988 Jun;33(6):673-8. doi: 10.1007/BF01540429.
Bacterial transformation of bile acids is possibly involved in colorectal carcinogenesis. In several epidemiological studies, the secondary bile acid concentration in feces is related to the incidence of colonic cancer. However, data on fecal bile acids in case-control studies are conflicting. We investigated the influence of age, intestinal transit time, and dietary composition on fecal bile acid profiles in healthy subjects of three different age groups (mean ages 22, 48, and 67 years). Fecal bile acids were analyzed by gas-liquid chromatography. The concentration of the major secondary fecal bile acids increased with advancing age and was significantly higher in elderly subjects, compared to young adults. The concentration in middle-aged persons was intermediate. Analysis of dietary constituents showed that the fat intake in the three groups was comparable. The dietary fiber intake in elderly subjects was significantly lower than in the other two groups. The former group did excrete less dry fecal material compared to both other groups. Dietary fiber intake was negatively correlated with the total bile acid concentration. Probably, a decrease in dietary fiber intake results in higher fecal bile acid concentrations with advancing age. From the findings of this study, it is obvious that matching for age is important when case-control studies concerning the role of fecal bile acids in colorectal carcinogenesis are conducted.
胆汁酸的细菌转化可能与结直肠癌的发生有关。在一些流行病学研究中,粪便中次级胆汁酸的浓度与结肠癌的发病率相关。然而,病例对照研究中关于粪便胆汁酸的数据存在矛盾。我们调查了年龄、肠道转运时间和饮食组成对三个不同年龄组(平均年龄分别为22岁、48岁和67岁)健康受试者粪便胆汁酸谱的影响。通过气液色谱法分析粪便胆汁酸。主要次级粪便胆汁酸的浓度随着年龄的增长而增加,与年轻人相比,老年人中的浓度显著更高。中年人的浓度处于中间水平。对饮食成分的分析表明,三组的脂肪摄入量相当。老年受试者的膳食纤维摄入量显著低于其他两组。与其他两组相比,老年组排出的干粪便物质确实更少。膳食纤维摄入量与总胆汁酸浓度呈负相关。可能是膳食纤维摄入量的减少导致随着年龄增长粪便胆汁酸浓度升高。从这项研究的结果来看,在进行关于粪便胆汁酸在结直肠癌发生中作用的病例对照研究时,年龄匹配很重要。