A PROSPECTIVE-STUDY OF THE INTAKE OF VITAMIN-C, VITAMIN-E, AND VITAMIN-A AND THE RISK OF BREAST-CANCER
A PROSPECTIVE-STUDY OF THE INTAKE OF VITAMIN-C, VITAMIN-E, AND VITAMIN-A AND THE RISK OF BREAST-CANCER
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DOI：
10.1056/nejm199307223290403
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发表时间：
1993-07-22
影响因子：
158.5
通讯作者：
WILLETT, WC
中科院分区：
文献类型：
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作者：
HUNTER, DJ;MANSON, JE;WILLETT, WC
背景虽然已经假设大量摄入抗氧化剂维生素C、E和A可以降低乳腺癌的风险，但很少有前瞻性数据可用。我们前瞻性研究了89,494名女性，她们在1980年时年龄在34岁到59岁之间，没有被诊断出癌症。他们从食物和补充剂中摄入的维生素C、E和A在基线和1984年使用经过验证的半定量食物频率量表进行评估。在8年的随访中，1439名妇女被诊断为乳腺癌。在对已知的危险因素进行多变量校正后，维生素C摄入量最高的五分之一组妇女与摄入量最低的五分之一组妇女的相对危险度为1.03（95%置信区间为0.87 ~ 1.21）;对于维生素E，在控制了维生素A的摄入量后，相对危险度为0.99（95%置信区间为0.83 ~ 1.19）。相反，在维生素A摄入量最高的五分之一组中，相对风险为0.84（95%置信区间为0.71至0.98;趋势P = 0.001）。在食物中维生素A摄入量最低的五分之一组妇女中，从补充剂中摄入维生素A与风险降低有关（P = 0.03）。维生素A摄入量与乳腺癌风险的显著负相关性也被发现在基于1984年问卷调查和4年随访的数据研究中。在我们的研究中，大量摄入维生素C或E并不能保护女性免受乳腺癌的侵害。维生素A摄入量低可能会增加患这种疾病的风险;维生素A补充剂的任何益处可能仅限于饮食中维生素A含量低的女性。
Background. Although it has been hypothesized that large intakes of the antioxidant vitamins C, E, and A reduce the risk of breast cancer, few prospective data are available.Methods. We prospectively studied 89,494 women who were 34 to 59 years old in 1980 and who did not have diagnosed cancer. Their intakes of vitamins C, E, and A from foods and supplements were assessed at base line and in 1984 with the use of a validated semiquantitative food-frequency questionnaire.Results. Breast cancer was diagnosed in 1439 women during eight years of follow-up. After multivariate adjustment for known risk factors, the relative risk among women in the highest quintile group for intake of vitamin C as compared with the risk among those in the lowest quintile group was 1.03 (95 percent confidence interval, 0.87 to 1.21); for vitamin E, after vitamin A intake had been controlled for, the relative risk was 0.99 (95 percent confidence interval, 0.83 to 1.19). In contrast, among women in the highest quintile group for intake of total vitamin A the relative risk was 0.84 (95 percent confidence interval, 0.71 to 0.98; P for trend = 0.001). Among women in the lowest quintile group for intake of vitamin A from food, consumption of vitamin A from supplements was associated with a reduced risk (P = 0.03). The significant inverse association of vitamin A intake with the risk of breast cancer was also found on study of data based on the 1984 questionnaire and four years of follow-up.Conclusions. Large intakes of vitamin C or E did not protect women in our study from breast cancer. A low intake of vitamin A may increase the risk of this disease; any benefit of vitamin A supplements may be limited to women with diets low in vitamin A.