Ferraroni M, La Vecchia C, D'Avanzo B, Negri E, Franceschi S, Decarli A
Istituto di Statistica Medica e Biometria, Università di Milano, Italy.
Br J Cancer. 1994 Dec;70(6):1150-5. doi: 10.1038/bjc.1994.463.
The relationship between estimated intake of selected micronutrients and the risk of colorectal cancer was analysed using data from a case-control study conducted in northern Italy. The study was based on 828 patients with colon cancer, 498 with rectal cancer and 2,024 controls in hospital for acute, non-neoplastic, non-digestive tract diseases. Relative risks (RRs) of intake quintiles were computed after allowance for age, sex and other major potential confounding factors, including an estimate of total energy intake. No apparent trend in risk across intake quintiles was evident for retinol, vitamin D, methionine and calcium. For beta-carotene, ascorbic acid, vitamin E and folate there was a trend of a protective effect with increasing consumption: the RR for the highest versus the lowest quintile was 0.32 for beta-carotene, 0.40 for ascorbic acid, 0.60 for vitamin E and 0.52 for folate. These inverse associations were similar for colon and rectal cancer, and consistent across strata of sex and age. When simultaneous allowance was made for all these micronutrients, besides other covariates, the only persistent protective effects were for beta-carotene (RR = 0.38 for the highest quintile) and ascorbic acid (RR = 0.52). Whether this reflects a specific, or stronger, effect of these micronutrients, rather than problems of collinearity between micronutrients or other limitations of the data, remains open to discussion. Still, this study suggests that specific micronutrients may exert an independent protective effect against colorectal carcinogenesis.
利用意大利北部一项病例对照研究的数据,分析了特定微量营养素的估计摄入量与结直肠癌风险之间的关系。该研究基于828例结肠癌患者、498例直肠癌患者以及2024例因急性、非肿瘤性、非消化道疾病住院的对照者。在考虑年龄、性别和其他主要潜在混杂因素(包括总能量摄入估计值)后,计算了摄入量五分位数的相对风险(RR)。视黄醇、维生素D、蛋氨酸和钙的摄入量五分位数之间未发现明显的风险趋势。对于β-胡萝卜素、抗坏血酸、维生素E和叶酸,随着摄入量增加有保护作用的趋势:β-胡萝卜素最高五分位数与最低五分位数的RR为0.32,抗坏血酸为0.40,维生素E为0.60,叶酸为0.52。这些负相关在结肠癌和直肠癌中相似,且在性别和年龄分层中一致。当同时考虑所有这些微量营养素以及其他协变量时,唯一持续存在的保护作用是针对β-胡萝卜素(最高五分位数的RR = 0.38)和抗坏血酸(RR = 0.52)。这是否反映了这些微量营养素的特定或更强作用,而非微量营养素之间的共线性问题或数据的其他局限性,仍有待讨论。不过,这项研究表明特定微量营养素可能对结直肠癌发生具有独立的保护作用。