Kearney J, Giovannucci E, Rimm E B, Ascherio A, Stampfer M J, Colditz G A, Wing A, Kampman E, Willett W C
Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.
Am J Epidemiol. 1996 May 1;143(9):907-17. doi: 10.1093/oxfordjournals.aje.a008834.
To examine the associations between intakes of calcium, Vitamin D, and dairy foods and the risk of colon cancer, the authors analyzed data from a prospective study of 47,935 US male professionals, 40-75 years of age and free of cancer in 1986. Within this cohort, 203 new cases of colon cancer were documented between 1986 and 1992. After adjusting for age and total energy intake, the authors found that the intake of calcium from foods and supplements was inversely associated with colon cancer risk (relative risk (RR) = 0.58, 95% confidence interval (CI) 0.39-087 between high and low intakes of calcium). However, after adjusting for confounding variables, they found that the trend was no longer statistically significant (p = 0.22), and the relative risk for the highest quintile group of intake was attenuated: 0.75 (95% CI 0.48-1.15). Similar results were observed for total vitamin D intake; the age- and energy-adjusted relative risk was 0.54% (95% CI 0/34-0/85) for the highest versus lowest quintile group, and this was attenuated in the multivariate model (RR = 0.66, 95% CI 0.42-1.05). The inverse association was weaker for dietary vitamin D (RR highest vs. lowest quintile = 0.88. 95% CI 0.54-1.42) and strongest for vitamin D arising from vitamin supplements (RR = 0.48, 95% CI 0.22-1.02). Thus, it is possible that other components of multivitamin use rather than vitamin D accounted for the reduction in risk. Consumption of milk and fermented dairy products was not significantly associated with the risk of colon cancer; individuals consuming two or more glasses of "whole" or skim milk per day had a relative risk of 1.09 (95% CI 0.69-1.72), compared with those who consumed "whole or skim milk less than once a month. These prospective data do not support the hypothesis that calcium intake is strongly protective against colon cancer risk, although a modest association cannot be excluded.
为了研究钙、维生素D和乳制品摄入量与结肠癌风险之间的关联,作者分析了一项针对47935名美国男性专业人员的前瞻性研究数据,这些男性年龄在40至75岁之间,于1986年时未患癌症。在这个队列中,1986年至1992年间记录了203例新的结肠癌病例。在调整年龄和总能量摄入量后,作者发现食物和补充剂中的钙摄入量与结肠癌风险呈负相关(高钙摄入量与低钙摄入量之间的相对风险(RR)=0.58,95%置信区间(CI)为0.39 - 0.87)。然而,在调整混杂变量后,他们发现这种趋势不再具有统计学意义(p = 0.22),并且摄入量最高五分位数组的相对风险有所减弱:0.75(95% CI 0.48 - 1.15)。总维生素D摄入量也观察到类似结果;最高五分位数组与最低五分位数组相比,年龄和能量调整后的相对风险为0.54%(95% CI 0.34 - 0.85),并且在多变量模型中这种关联有所减弱(RR = 0.66,95% CI 0.42 - 1.05)。饮食中维生素D的负相关较弱(最高五分位数组与最低五分位数组的RR = 0.88,95% CI 0.54 - 1.42),而维生素补充剂中的维生素D负相关最强(RR = 0.48,95% CI 0.22 - 1.02)。因此,可能是多种维生素使用中的其他成分而非维生素D导致了风险降低。牛奶和发酵乳制品的消费与结肠癌风险没有显著关联;每天饮用两杯或更多杯“全脂”或脱脂牛奶的个体相对风险为1.09(95% CI 0.69 - 1.72),而每月饮用“全脂或脱脂牛奶”少于一次的个体相比。这些前瞻性数据不支持钙摄入量对结肠癌风险有强烈保护作用的假设,尽管不能排除适度关联的可能性。