Garland M, Willett W C, Manson J E, Hunter D J
Dept. of Epidemiology, Harvard School of Public Health, Boston, MA 02115.
J Am Coll Nutr. 1993 Aug;12(4):400-11. doi: 10.1080/07315724.1993.10718329.
We reviewed epidemiologic evidence on the relationship between four antioxidant micronutrients (vitamin A, vitamin C, vitamin E, and selenium) and breast cancer risk. Available data support a modest protective effect of vitamin A, although more studies are needed to examine further this association and to assess the relative contributions of preformed vitamin A (retinol) and carotenoids. In addition, the possibility that some other component of vitamin A-rich foods may account for this observed association should be explored. Data on the relationship between vitamins C and E and breast cancer risk are limited and inconsistent, and further information is necessary. A substantial body of evidence indicates a lack of any appreciable effect of selenium intake on breast cancer risk, at least within the range of human diets. Future observational studies should ideally be prospective in design, as prospective studies are less prone to selection and recall bias than are case-control studies, and should address methodologic issues such as confounding by other micronutrients and appropriate storage conditions of blood specimens. Although hypotheses relating micronutrient intake to risk of breast cancer should be tested in randomized trials, ethical and logistical constraints make these studies difficult to perform.
我们回顾了关于四种抗氧化微量营养素（维生素A、维生素C、维生素E和硒）与乳腺癌风险之间关系的流行病学证据。现有数据支持维生素A具有一定程度的保护作用，不过仍需要更多研究来进一步探究这种关联，并评估预制维生素A（视黄醇）和类胡萝卜素的相对贡献。此外，还应探索富含维生素A的食物中的其他某些成分可能导致这一观察到的关联的可能性。关于维生素C和E与乳腺癌风险之间关系的数据有限且不一致，因此需要更多信息。大量证据表明，至少在人类饮食范围内，硒摄入量对乳腺癌风险没有任何明显影响。未来的观察性研究在设计上理想情况下应是前瞻性的，因为前瞻性研究比病例对照研究更不易出现选择偏倚和回忆偏倚，并且应解决诸如其他微量营养素造成的混杂以及血液样本的适当储存条件等方法学问题。尽管关于微量营养素摄入量与乳腺癌风险的假说应在随机试验中进行检验，但伦理和后勤方面的限制使得这些研究难以开展。
