Hill H A, Austin H
Department of Epidemiology, Rollins School of Public Health of Emory University, Atlanta, Georgia 30322, USA.
Cancer Causes Control. 1996 Jan;7(1):19-32. doi: 10.1007/BF00115635.
Epidemiologic evidence on the relation between nutrition and endometrial cancer (EC) is reviewed. Obesity is an important determinant of EC, probably because of its effect on the hormonal milieu of both pre- and postmenopausal women. However, epidemiologic studies of body fat distribution and EC are inconsistent, as are the data pertaining to the relation between body fat distribution and sex hormones. Randomized and observational studies of diet and sex hormones indicate that low fat diets may be associated weakly with decreased estrogen levels, and thus a lowering of EC risk. Only ecologic and case-control studies of diet and EC have been reported. These findings as well as the methodologic limitations of these study designs are discussed. Both types of studies implicate fat as a potential risk factor, while the case-control studies suggest that carotene may lower risk of EC. Epidemiologic studies of alcohol and EC also are inconsistent, but generally indicate no association, or a weak protective effect. The role of diet in the etiology of EC is unresolved. The conduct of cohort and intervention studies, which can avoid many of the methodologic shortcomings of ecologic and case-control studies, would improve our understanding of diet and EC.
本文综述了营养与子宫内膜癌（EC）关系的流行病学证据。肥胖是EC的一个重要决定因素，这可能是因为它对绝经前和绝经后女性的激素环境都有影响。然而，关于体脂分布与EC的流行病学研究结果并不一致，体脂分布与性激素关系的数据也是如此。饮食与性激素的随机和观察性研究表明，低脂饮食可能与雌激素水平降低存在微弱关联，从而降低EC风险。目前仅报道了饮食与EC的生态学和病例对照研究。本文讨论了这些研究结果以及这些研究设计的方法学局限性。这两类研究均表明脂肪是一个潜在的风险因素，而病例对照研究表明胡萝卜素可能降低EC风险。关于酒精与EC的流行病学研究结果也不一致，但总体表明两者无关联或存在微弱的保护作用。饮食在EC病因中的作用尚无定论。开展队列研究和干预研究可以避免生态学和病例对照研究的许多方法学缺陷，这将有助于我们更好地理解饮食与EC的关系。
