Slattery M L, Potter J D, Duncan D M, Berry T D
University of Utah Medical School, Salt Lake City, USA.
Int J Cancer. 1997 Nov 27;73(5):670-7. doi: 10.1002/(sici)1097-0215(19971127)73:5<670::aid-ijc10>3.0.co;2-a.
There are many biological mechanisms whereby dietary fat and specific dietary fatty acids may alter risk of colon cancer in addition to their contribution to total energy intake. To evaluate these potential associations, we used detailed dietary intake data collected in a population-based study of 1,993 incident colon cancer cases and 2,410 controls conducted in 3 areas of the United States. The most commonly consumed fatty acid in the study population was oleic acid. One-third of dietary fats consumed came from additions to other foods at the table or from the preparation of other foods. After adjusting for total energy intake, physical activity and body size, neither total dietary fat nor specific fatty acids was associated with risk of colon cancer. However, among older women, fats from food preparation were associated with increased risk of colon cancer (OR 1.84, 95% CI 1.20-2.80), while fats from foods themselves or from additions to other foods were not. While dietary fats were not associated with colon cancer risk in the total population, subgroups of the population appeared to be at slightly greater risk if they consumed a high-fat diet. Women who consumed a diet high in mono-unsaturated fatty acids (MFAs) and poly-unsaturated fatty acids (PFAs) and who had a family history of colorectal cancer were at greater risk of colon cancer than those with similar intakes but without a family history of colorectal cancer. Similar associations with family history were noted among men diagnosed at younger ages for MFA, linolenic acid and 20-carbon PFA.
除了对总能量摄入有影响外，膳食脂肪和特定膳食脂肪酸还可通过多种生物学机制改变结肠癌风险。为评估这些潜在关联，我们使用了在美国3个地区开展的一项基于人群的研究中收集的详细膳食摄入数据，该研究涉及1993例结肠癌新发病例和2410名对照。研究人群中最常摄入的脂肪酸是油酸。所摄入的膳食脂肪中有三分之一来自就餐时添加到其他食物中的脂肪或其他食物的烹饪用脂。在对总能量摄入、身体活动和体型进行调整后，膳食总脂肪和特定脂肪酸均与结肠癌风险无关。然而，在老年女性中，烹饪用脂与结肠癌风险增加相关（比值比1.84，95%可信区间1.20 - 2.80），而食物本身的脂肪或添加到其他食物中的脂肪则无此关联。虽然膳食脂肪在总体人群中与结肠癌风险无关，但如果人群亚组摄入高脂肪饮食，其风险似乎会略高。摄入富含单不饱和脂肪酸（MFA）和多不饱和脂肪酸（PFA）饮食且有结直肠癌家族史的女性，比摄入类似饮食但无结直肠癌家族史的女性患结肠癌的风险更高。在较年轻年龄被诊断患癌的男性中，对于MFA、亚麻酸和20碳PFA，也发现了与家族史类似的关联。
