EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.
Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.
Cancer Causes Control. 2022 May;33(5):779-791. doi: 10.1007/s10552-022-01565-y. Epub 2022 Mar 19.
PURPOSE: Previous studies show that consuming foods preserved by salting increases the risk of gastric cancer, while results on the association between total salt or added salt and gastric cancer are less consistent and vary with the exposure considered. This study aimed to quantify the association between dietary salt exposure and gastric cancer, using an individual participant data meta-analysis of studies participating in the Stomach cancer Pooling (StoP) Project. METHODS: Data from 25 studies (10,283 cases and 24,643 controls) from the StoP Project with information on salt taste preference (tasteless, normal, salty), use of table salt (never, sometimes, always), total sodium intake (tertiles of grams/day), and high-salt and salt-preserved foods intake (tertiles of grams/day) were used. A two-stage approach based on random-effects models was used to pool study-specific adjusted (sex, age, and gastric cancer risk factors) odds ratios (aORs), and the corresponding 95% confidence intervals (95% CI). RESULTS: Gastric cancer risk was higher for salty taste preference (aOR 1.59, 95% CI 1.25-2.03), always using table salt (aOR 1.33, 95% CI 1.16-1.54), and for the highest tertile of high-salt and salt-preserved foods intake (aOR 1.24, 95% CI 1.01-1.51) vs. the lowest tertile. No significant association was observed for the highest vs. the lowest tertile of total sodium intake (aOR 1.08, 95% CI 0.82-1.43). The results obtained were consistent across anatomic sites, strata of Helicobacter pylori infection, and sociodemographic, lifestyle and study characteristics. CONCLUSION: Salty taste preference, always using table salt, and a greater high-salt and salt-preserved foods intake increased the risk of gastric cancer, though the association was less robust with total sodium intake.
目的:先前的研究表明,食用腌制食品会增加患胃癌的风险,而关于总盐或添加盐与胃癌之间的关系的结果则不太一致,且因所考虑的暴露因素而异。本研究旨在使用参与胃癌汇集(StoP)项目的研究的个体参与者数据荟萃分析来量化饮食盐暴露与胃癌之间的关联。
方法:使用来自 StoP 项目的 25 项研究的数据(10283 例病例和 24643 例对照),这些研究提供了关于盐味偏好(无味、正常、咸)、使用食盐(从不、有时、总是)、总钠摄入量(克/天的三分位数)和高盐及盐腌食品摄入量(克/天的三分位数)的信息。采用基于随机效应模型的两阶段方法来汇总研究特定的调整后(性别、年龄和胃癌危险因素)比值比(aOR),以及相应的 95%置信区间(95%CI)。
结果:与低盐和非腌制食品摄入量最低三分位数相比,更喜欢咸味(aOR 1.59,95%CI 1.25-2.03)、总是使用食盐(aOR 1.33,95%CI 1.16-1.54)和高盐及盐腌食品摄入量最高三分位数与胃癌风险较高相关。而对于总钠摄入量最高与最低三分位数之间,未观察到显著关联(aOR 1.08,95%CI 0.82-1.43)。这些结果在解剖部位、幽门螺杆菌感染分层以及社会人口统计学、生活方式和研究特征方面是一致的。
结论:咸味偏好、总是使用食盐以及高盐及盐腌食品摄入量的增加都会增加胃癌的风险,尽管与总钠摄入量的关联不太稳健。
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