Chen Chien Hua, Tsai Min Kuang, Lee June Han, Lin Ro-Ting, Hsu Chung Y, Wen Christopher, Wu Xifeng, Chu Ta-Wei, Wen Chi Pang
Digestive Disease Center, Changbing Show-Chwan Memorial Hospital, Lukang, Taiwan.
Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
Front Oncol. 2022 Apr 7;12:835901. doi: 10.3389/fonc.2022.835901. eCollection 2022.
Although the link between sugar-sweetened beverages (SSB) and pancreatic cancer has been suggested for its insulin-stimulating connection, most epidemiological studies showed inconclusive relationship. Whether the result was limited by sample size is explored. This prospective study followed 491,929 adults, consisting of 235,427 men and 256,502 women (mean age: 39.9, standard deviation: 13.2), from a health surveillance program and there were 523 pancreatic cancer deaths between 1994 and 2017. The individual identification numbers of the cohort were matched with the National Death file for mortality, and Cox models were used to assess the risk. The amount of SSB intake was recorded based on the average consumption in the month before interview by a structured questionnaire. We classified the amount of SSB intake into 4 categories: 0-<0.5 serving/day, ≥0.5-<1 serving per day, ≥1-<2 servings per day, and ≥2 servings per day. One serving was defined as equivalent to 12 oz and contained 35 g added sugar. We used the age and the variables at cohort enrolment as the reported risks of pancreatic cancers. The cohort was divided into 3 age groups, 20-39, 40-59, and ≥60. We found young people (age <40) had higher prevalence and frequency of sugar-sweetened beverages than the elderly. Those consuming 2 servings/day had a 50% increase in pancreatic cancer mortality (HR = 1.55, 95% CI: 1.08-2.24) for the total cohort, but a 3-fold increase (HR: 3.09, 95% CI: 1.44-6.62) for the young. The risk started at 1 serving every other day, with a dose-response relationship. The association of SSB intake of ≥2 servings/day with pancreatic cancer mortality among the total cohort remained significant after excluding those who smoke or have diabetes (HR: 2.12, 97% CI: 1.26-3.57), are obese (HR: 1.57, 95% CI: 1.08-2.30), have hypertension (HR: 1.90, 95% CI: 1.20-3.00), or excluding who died within 3 years after enrollment (HR: 1.67, 95% CI: 1.15-2.45). Risks remained in the sensitivity analyses, implying its independent nature. We concluded that frequent drinking of SSB increased pancreatic cancer in adults, with highest risk among young people.
尽管含糖饮料（SSB）与胰腺癌之间的联系因其刺激胰岛素的作用而被提出，但大多数流行病学研究显示两者关系尚无定论。本研究探讨了研究结果是否受样本量限制。这项前瞻性研究对来自健康监测项目的491,929名成年人进行了随访，其中包括235,427名男性和256,502名女性（平均年龄：39.9岁，标准差：13.2岁），在1994年至2017年间有523例胰腺癌死亡病例。队列中的个人识别号码与国家死亡档案进行匹配以获取死亡率信息，并使用Cox模型评估风险。通过结构化问卷根据访谈前一个月的平均消费量记录SSB摄入量。我们将SSB摄入量分为4类：0 - <0.5份/天、≥0.5 - <1份/天、≥1 - <2份/天和≥2份/天。1份定义为相当于12盎司且含有35克添加糖。我们将年龄和队列入组时的变量作为报告的胰腺癌风险因素。队列分为3个年龄组，20 - 39岁、40 - 59岁和≥60岁。我们发现年轻人（年龄<40岁）饮用含糖饮料的患病率和频率高于老年人。对于整个队列，每天饮用2份的人群胰腺癌死亡率增加50%（风险比[HR] = 1.55，95%置信区间[CI]：1.08 - 2.24），但对于年轻人则增加了3倍（HR：3.09，95% CI：1.44 - 6.62）。风险从每隔一天饮用1份开始，呈剂量反应关系。在排除吸烟或患有糖尿病者（HR：2.12，97% CI：1.26 - 3.57）、肥胖者（HR：1.57，95% CI：1.08 - 2.30）、患有高血压者（HR：1.90，95% CI：1.20 - 3.00）或排除入组后3年内死亡者（HR：1.67，95% CI：1.15 - 2.45）后，整个队列中每天饮用≥2份SSB与胰腺癌死亡率之间的关联仍然显著。敏感性分析中风险依然存在，这表明其具有独立性。我们得出结论，经常饮用SSB会增加成年人患胰腺癌的风险，其中年轻人风险最高。
