Calcium intake and colorectal adenoma in a US colorectal cancer early detection program1-3
Calcium intake and colorectal adenoma in a US colorectal cancer early detection program1-3
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DOI：
10.1093/ajcn/80.5.1358
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发表时间：
2004-11-01
影响因子：
7.1
通讯作者：
Hayes, RB
中科院分区：
文献类型：
--
作者：
Peters, U;Chatterjee, N;Hayes, RB
背景资料：钙可以通过结合次级胆汁和脂肪酸来降低结直肠肿瘤的风险，从而导致肠道中的抗增殖作用，或者直接作用于结肠上皮，从而影响分化和凋亡。目的：我们调查了钙摄入量和结肠腺瘤的风险，以评估钙摄入量与结直肠肿瘤发展早期阶段的相关性。设计：我们比较了3696例经组织学证实的远端结肠腺瘤患者的补充钙和膳食钙摄入量（即降结肠、乙状结肠或直肠）与34 817例乙状结肠镜检查阴性对照参与者的前列腺、肺、结直肠、卵巢癌筛查试验钙摄入量在研究开始时通过137项食物频率问卷和关于钙补充剂使用量和持续时间的其他问题进行评估。在对已知的风险因素进行调整后，总钙摄入量最高五分之一的参与者，（>1767 mg/d）比最低五分位数的参与者（1200 mg/d）比不使用补充剂的参与者（优势比：0.73; 95%CI：0.56，0.91;趋势P = 0.005）。总钙和补充钙的保护协会是最强的结肠腺瘤（降结肠和乙状结肠）。结论：高钙摄入量，特别是从补充剂，与远端结直肠腺瘤的风险降低。
Background: Calcium can reduce the risk of colorectal tumors by binding secondary bile and fatty acids, which leads to antiproliferative effects in the bowel, or by acting directly on the colonic epithelium, which affects differentiation and apoptosis.Objective: We investigated calcium intake and risk of colon adenoma to evaluate the association of calcium intake with early stages of colorectal tumor development.Design: We compared the supplemental and dietary calcium intakes of 3696 participants with histologically verified adenoma of the distal colon (ie, descending colon, sigmoid colon, or rectum) with the calcium intakes of 34 817 sigmoidoscopy-negative control participants in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Calcium intake was assessed at study entry with a 137-item food-frequency questionnaire and additional questions on the amount and duration of calcium supplement use.Results: After adjustment for known risk factors, adenoma risk was lower by 12% for participants in the highest quintile of total calcium intake (>1767 mg/d) than for participants in the lowest quintile (1200 mg/d than for nonusers of supplements (odds ratio: 0.73; 95% CI: 0.56, 0.91; P for trend = 0.005). The protective associations of total and supplemental calcium were strongest for colon adenoma (descending and sigmoid colon).Conclusion: High calcium intake, particularly from supplements, is associated with a reduced risk of distal colorectal adenoma.