Mellemgaard A, McLaughlin J K, Overvad K, Olsen J H
Danish Cancer Society, Division of Cancer Epidemiology, Copenhagen, Denmark.
Eur J Cancer. 1996 Apr;32A(4):673-82. doi: 10.1016/0959-8049(95)00633-8.
The role of diet in the aetiology of renal cell carcinoma was investigated in a population-based case-control study in Denmark. Cases were 20-79 years old, with a histologically verified diagnosis of renal cell carcinoma. Controls were sampled from the general population and were frequency-matched on age and sex. A total of 351 cases (73% of the eligible) and 340 controls (68% of the eligible) were included in the study. Dietary information was obtained in a self-administered food frequency questionnaire and the information was confirmed in a subsequent interview performed by trained interviewers who also elicited information on other suspected risk factors such as smoking, occupation, medical history, education and reproductive history. Logistic regression models were used to calculate the odds ratios, and, both frequency of consumption of various food stuffs and computed nutrients were examined. A positive association was observed between risk of renal cell carcinoma and total energy intake (odds ratio, OR, for highest quartile compared to lowest: 1.7 (95% confidence interval, CI, 1.0-3.0) for men, and 3.5 (95% CI 1.6-6.5) for women), fat intake (OR for highest quartile compared to lowest: 1.9 (95% CI 1.1-3.5) for men, and 3.3 (95% CI 1.6-6.9) for women). For women, an effect was also seen for intake of carbohydrates (OR for highest quartile compared to lowest: 3.2 (95% CI 1.5-6.8), while no protective effect was seen for vegetables or fruit. Dairy products may be associated with risk of renal cell cancer (OR for women using thickly spread butter compared to thinly spread: 11.4 (95% CI 2.8-45), OR for women who drank more than one glass of milk with 3.5% fat content compared to never drink milk: 3.7 (95% CI 1.2-11). As expected, total energy intake, intake of fat, protein and carbohydrates were closely correlated making it difficult to identify one of the energy sources as more closely associated with risk of renal cell cancer than the other. Several energy sources have been identified as possible risk factors for renal cell carcinoma. It is possible that a high energy intake as such rather than the individual sources are responsible for the increased risk. Furthermore, dairy fats may be associated with renal cell carcinoma risk. The observed associations appeared stronger in women, and did not explain the association with obesity and low socio-economic status previously found in Denmark.
在丹麦一项基于人群的病例对照研究中,调查了饮食在肾细胞癌病因学中的作用。病例年龄在20至79岁之间,经组织学确诊为肾细胞癌。对照从普通人群中抽取,并在年龄和性别上进行频数匹配。共有351例病例(占符合条件者的73%)和340名对照(占符合条件者的68%)纳入研究。通过一份自行填写的食物频率问卷获取饮食信息,并由经过培训的访谈员在后续访谈中对该信息进行确认,访谈员还收集了其他可疑风险因素的信息,如吸烟、职业、病史、教育程度和生殖史。使用逻辑回归模型计算比值比,并对各种食物的消费频率和计算得出的营养素进行了检查。观察到肾细胞癌风险与总能量摄入之间存在正相关(男性中,最高四分位数与最低四分位数相比的比值比,OR,为1.7(95%置信区间,CI,1.0 - 3.0);女性为3.5(95%CI 1.6 - 6.5)),脂肪摄入(男性中,最高四分位数与最低四分位数相比的OR为1.9(95%CI 1.1 - 3.5);女性为3.3(95%CI 1.6 - 6.9))。对于女性,碳水化合物摄入也有影响(最高四分位数与最低四分位数相比的OR为3.2(95%CI 1.5 - 6.8)),而蔬菜或水果未显示出保护作用。乳制品可能与肾细胞癌风险相关(与使用薄涂黄油的女性相比,使用厚涂黄油的女性的OR为11.4(95%CI 2.8 - 45);与从不喝牛奶的女性相比,每天喝一杯以上含3.5%脂肪牛奶的女性的OR为3.7(95%CI 1.2 - 11))。正如预期的那样,总能量摄入、脂肪、蛋白质和碳水化合物的摄入密切相关,因此难以确定其中一种能量来源比另一种与肾细胞癌风险的关联更紧密。已确定几种能量来源可能是肾细胞癌的风险因素。有可能是高能量摄入本身而非个别能量来源导致了风险增加。此外,乳制品脂肪可能与肾细胞癌风险相关。观察到的关联在女性中似乎更强,且无法解释丹麦先前发现的与肥胖和低社会经济地位的关联。