Energy balance and colon cancer--beyond physical activity.
Energy balance and colon cancer--beyond physical activity.
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发表时间：
1997
期刊：
影响因子：
11.2
通讯作者：
M. Slattery;J. Potter;B. Caan;S. Edwards;A. Coates;K. Ma;T. Berry
中科院分区：
文献类型：
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作者：
M. Slattery;J. Potter;B. Caan;S. Edwards;A. Coates;K. Ma;T. Berry
低水平的体力活动、高水平的能量摄入和身体质量都与结肠癌有直接关系。这项研究的目的是确定缺乏运动与能量平衡的其他组成部分(能量摄入和身体质量)在确定结肠癌风险方面是如何相互作用的。数据来自犹他州8个县、北加州凯撒永久医疗保健计划和明尼苏达州双子城大都市区确定的2073例初发结肠癌病例和2466名年龄和性别匹配的对照组。近期和终生的体力活动通过在家里、休闲和工作中进行的活动强度来评估；能量摄入量通过广泛的饮食历史问卷来估计；身体质量指数(BMI)根据访谈时测量的身高和报告的参考年份的体重来计算。对于男性和女性来说，缺乏终生剧烈的休闲活动与患结肠癌的风险增加相关[优势比(OR)，男性为1.63和95%可信区间(CI)，男性为1.26-2.12，女性为1.59和95%CI，1.21-2.10，比较最低和最高活动水平]。在确诊时，不同肿瘤部位或不同年龄与体力活动相关的风险没有差异。高能量摄入也与男性和女性患结肠癌的风险增加有关(男性和女性的OR分别为1.74和95%CI，1.14~2.67，1.70和95%CI，1.07~2.70)。男性较大的BMI与风险增加(OR，1.94和95%CI，1.49-2.54)比女性(OR，1.45和95%CI，1.08-1.94)更相关。患结肠癌的风险最大的是那些能量平衡最不利的人，他们身体不活跃，能量摄入量高，BMI大(OR，3.35和95%CI，2.09-5.35)。然而，当体力活动较多时，高能量摄入和较大的BMI导致结肠癌风险无显著增加(OR，1.28和95%CI，0.81-2.03)。这种模式在两性之间是一致的，但有一些证据表明，由于不利于能量平衡，男性可能比女性，特别是老年女性，面临更高的风险。这些结果支持了之前的发现，即缺乏运动、高能量摄入量和较大的身体质量与患结肠癌的风险增加有关。然而，作为一个整体，能量平衡似乎与结肠癌的风险有关。这些发现表明全身代谢对癌症的发生有影响，并对预防有重要意义。
Low levels of physical activity and high levels of energy intake and body mass have all been directly associated with colon cancer. The purpose of this study was to determine how physical inactivity interacts with other components of energy balance (energy intake and body mass) in determining colon cancer risk. Data were obtained from 2073 first primary cases of colon cancer and 2466 age- and sex-matched controls identified from 8 counties in Utah, the Northern California Kaiser Permanente Medical Care Program, and the Twin Cities metropolitan area in Minnesota. Recent and lifetime physical activity was assessed by intensity of activities performed at home, leisure, and at work; energy intake was estimated from an extensive diet history questionnaire; and body mass index (BMI) was calculated from measured height at the time of interview and reported weight for the referent year. For both men and women, lack of lifetime vigorous leisure-time activity was associated with increased risk of colon cancer [odds ratio (OR), 1.63 and 95% confidence interval (CI), 1.26-2.12 for men and OR, 1.59 and 95% CI, 1.21-2.10 for women, comparing the lowest to highest level of activity]. There were no differences in risk associated with physical activity by tumor site within the colon or by age at diagnosis. High levels of energy intake were also associated with increased risk of colon cancer in men and women (OR, 1.74 and 95% CI, 1.14-2.67 for men and OR, 1.70 and 95% CI, 1.07-2.70 for women). A large BMI was more associated with increased risk in men (OR, 1.94 and 95% CI, 1.49-2.54) than in women (OR, 1.45 and 95% CI, 1.08-1.94). Those at greatest risk of colon cancer were those who had the most unfavorable energy balance in that they were physically inactive, had high energy intakes, and had a large BMI (OR, 3.35 and 95% CI, 2.09-5.35). However, when physical activity was high, having a high energy intake and large BMI resulted in a nonsignificant increased colon cancer risk (OR, 1.28 and 95% CI, 0.81-2.03). This pattern was consistent between the sexes, but there was some evidence that men may be at higher risk than women, especially older women, as a result of unfavorable energy balance. These results support previous findings that physical inactivity, high energy intake, and large body mass are associated with increased risk of developing colon cancer. However, energy balance as a whole seems to be associated with risk of colon cancer. These findings suggest systemic metabolic influences on carcinogenesis and have important implications for prevention.