Kirkpatrick C S, White E, Lee J A
Department of Epidemiology, University of Washington, Seattle.
Am J Epidemiol. 1994 May 1;139(9):869-80. doi: 10.1093/oxfordjournals.aje.a117093.
Intakes of vitamin A, dietary antioxidants, and other dietary components were examined for their relation to the risk of malignant melanoma among 234 cases and 248 controls in three counties of western Washington State. Cases were drawn from persons diagnosed with melanoma between 1984 and 1987 and identified through a Seattle-Puget Sound cancer registry. Population controls were identified through random digit dialing and were randomly selected, stratified by age, sex, and county. Subjects completed a telephone interview and a mailed food frequency questionnaire asking for information on diet, demographic factors, and factors known to be associated with melanoma. Subjects were asked to estimate their food intake 7 years prior to diagnosis for cases and during a comparable time period for controls. Among data on 16 nutrients calculated from reported food intake, one significant finding emerged: Vitamin E obtained from food was inversely related to risk of melanoma (for highest quartile vs. lowest quartile, age-, education-, and energy intake-adjusted odds ratio (OR) = 0.34, 95% confidence interval (CI) 0.16-0.72; p for trend = 0.01). When intake of nutrients from food plus vitamin and mineral supplements was considered, zinc from food and supplements was associated with a decreased risk of melanoma (for highest quartile vs. lowest quartile, adjusted OR = 0.46, 95% CI 0.24-0.91; p for trend = 0.01). There was no evidence that vitamin A, preformed retinol, or carotenoids were associated with a decreased risk of melanoma or that alcohol or polyunsaturated fats were associated with an increased risk. Body mass index (weight (kg)/height (m)2) was significantly related to melanoma risk; cases were more obese than controls (for highest quartile vs. lowest quartile, age-, sex-, and education-adjusted OR = 1.90, 95% CI 1.10-3.27; p for trend = 0.02). These results provide limited support for the hypothesis that antioxidants such as vitamin E or cofactors in protection from oxidative damage such as zinc may be protective for melanoma, and they suggest that obesity should be measured in future studies of melanoma.
在华盛顿州西部三个县的234例病例和248例对照中，研究了维生素A、膳食抗氧化剂及其他膳食成分的摄入量与恶性黑色素瘤风险之间的关系。病例来自1984年至1987年间被诊断为黑色素瘤的患者，并通过西雅图-普吉特海湾癌症登记处确定。通过随机数字拨号确定人群对照，并按年龄、性别和县区进行随机分层。受试者完成了电话访谈和邮寄的食物频率问卷，询问有关饮食、人口统计学因素以及已知与黑色素瘤相关因素的信息。要求病例组受试者估计其在诊断前7年的食物摄入量，对照组受试者估计在可比时间段内的食物摄入量。在根据报告的食物摄入量计算出的16种营养素数据中，有一个显著发现：从食物中获取的维生素E与黑色素瘤风险呈负相关（最高四分位数与最低四分位数相比，年龄、教育程度和能量摄入量调整后的比值比（OR）=0.34，95%置信区间（CI）0.16 - 0.72；趋势检验p值 = 0.01）。当考虑食物加维生素和矿物质补充剂中的营养素摄入量时，食物和补充剂中的锌与黑色素瘤风险降低有关（最高四分位数与最低四分位数相比，调整后的OR = 0.46，95%CI 0.24 - 0.91；趋势检验p值 = 0.01）。没有证据表明维生素A、视黄醇或类胡萝卜素与黑色素瘤风险降低有关，也没有证据表明酒精或多不饱和脂肪与风险增加有关。体重指数（体重（kg）/身高（m）²）与黑色素瘤风险显著相关；病例组比对照组更肥胖（最高四分位数与最低四分位数相比，年龄、性别和教育程度调整后的OR = 1.90，95%CI 1.10 - 3.27；趋势检验p值 = 0.02）。这些结果为以下假设提供了有限的支持，即维生素E等抗氧化剂或锌等预防氧化损伤的辅助因子可能对黑色素瘤有保护作用，并且表明在未来黑色素瘤研究中应测量肥胖情况。
