Yu Dao-Wu, Li Qu-Jin, Cheng Long, Yang Peng-Fei, Sun Wei-Ping, Peng Yang, Hu Jie-Jun, Wu Jing-Jing, Gong Jian-Ping, Zhong Guo-Chao
Am J Epidemiol. 2021 Oct 1;190(10):2029-2041. doi: 10.1093/aje/kwab131.
No epidemiologic studies have been conducted to assess the association of intake of dietary vitamin K with the risk of pancreatic cancer. We used prospective data from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial between 1993 and 2009 to fill this gap. A total of 101,695 subjects were identified. Dietary intakes of phylloquinone (vitamin K1), menaquinones (vitamin K2), and dihydrophylloquinone (dihydrovitamin K1) were assessed using a food frequency questionnaire. Cox regression was applied to calculate hazard ratios and 95% confidence intervals. During a mean follow-up of 8.86 years (900,744.57 person-years), 361 cases of pancreatic cancer were documented. In the fully adjusted model, dietary intakes of phylloquinone (for quartile 4 vs. quartile 1, hazard ratio (HR) = 0.57, 95% confidence interval (CI): 0.39, 0.83; P for trend = 0.002) and dihydrophylloquinone (for quartile 4 vs. quartile 1, HR = 0.59; 95% CI: 0.41, 0.85; P for trend = 0.006), but not menaquinones (for quartile 4 vs. quartile 1, HR = 0.93; 95% CI: 0.65, 1.33; P for trend = 0.816), were found to be inversely associated with the risk of pancreatic cancer in a nonlinear dose-response manner (all P values for nonlinearity < 0.05), and this was not modified by predefined stratification factors and remained in sensitivity analyses. In conclusion, dietary intakes of phylloquinone and dihydrophylloquinone, but not menaquinones, confer a lower risk of pancreatic cancer. Future studies should confirm our findings.
尚未开展流行病学研究来评估膳食维生素K摄入量与胰腺癌风险之间的关联。我们利用1993年至2009年间前列腺、肺、结肠直肠癌和卵巢癌筛查试验的前瞻性数据来填补这一空白。共确定了101,695名受试者。使用食物频率问卷评估叶绿醌（维生素K1）、甲萘醌（维生素K2）和二氢叶绿醌（二氢维生素K1）的膳食摄入量。应用Cox回归计算风险比和95%置信区间。在平均8.86年（900,744.57人年）的随访期间，记录了361例胰腺癌病例。在完全调整模型中，叶绿醌（四分位数4与四分位数1相比，风险比（HR）=0.57，95%置信区间（CI）：0.39，0.83；趋势P=0.002）和二氢叶绿醌（四分位数4与四分位数1相比，HR=0.59；95%CI：0.41，0.85；趋势P=0.006），而非甲萘醌（四分位数4与四分位数1相比，HR=0.93；95%CI：0.65，1.33；趋势P=0.816），被发现以非线性剂量反应方式与胰腺癌风险呈负相关（所有非线性P值<0.05），并且这并未因预定义的分层因素而改变，在敏感性分析中仍然存在。总之，叶绿醌和二氢叶绿醌的膳食摄入量可降低胰腺癌风险，而非甲萘醌。未来的研究应证实我们的发现。
