CALCIUM, VITAMIN-D, DAIRY FOODS, AND THE OCCURRENCE COLORECTAL ADENOMAS AMONG MEN AND WOMEN IN 2 PROSPECTIVE STUDIES
CALCIUM, VITAMIN-D, DAIRY FOODS, AND THE OCCURRENCE COLORECTAL ADENOMAS AMONG MEN AND WOMEN IN 2 PROSPECTIVE STUDIES
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DOI：
10.1093/oxfordjournals.aje.a116931
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发表时间：
1994-01-01
影响因子：
5
通讯作者：
WILLETT, WC
中科院分区：
文献类型：
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作者：
KAMPMAN, E;GIOVANNUCCI, E;WILLETT, WC
大量摄入钙、维生素 D 或特定乳制品被认为可以降低结直肠癌的发病率。美国的两项大型队列研究研究了这些营养素和食物与结直肠腺瘤（癌症前兆）的发生之间的关系。病例是被诊断为左结肠或直肠腺瘤性息肉的患者（331 名男性，1986-1990 年；350 名女性，1980-1988 年），对照是内镜检查结果腺瘤阴性的人（9,159 名男性和 8,585 名女性）。调整年龄、总能量、结直肠癌家族史、体重指数、饮酒量、叶酸、饱和脂肪和纤维摄入量、内窥镜检查指征和既往内窥镜检查后，总钙摄入量与腺瘤风险无关（相对风险 (RR)、最高与最低五分位摄入量：男性，1.13，95% 置信区间 (Cl) 0.76-1.66；女性，1.17，95% Cl 0.81-1.69）。维生素 D 摄入总量与男性腺瘤风险无关（RR = 1.29，95% Cl 0.87-1.93）。在 1980-1988 年的分析中，观察到女性存在反向非显着相关性（RR = 0.68，95% Cl 0.41-1.13，趋势 p = 0.09），主要归因于多种维生素补充剂的摄入，但使用更详细的饮食评估对 4 年数据（1984-1988）进行的分析表明，与维生素 D 没有关联（RR = 1.04， 95% Cl 0.65-1.67）。牛奶消耗量和总发酵乳制品摄入量与腺瘤风险无关。总之，结直肠腺瘤的发生与钙摄入量和牛奶摄入量均无关，而来自补充剂而非饮食的维生素 D 仅与女性风险呈轻微但不显着的负相关。
A high intake of calcium, vitamin D, or specific dairy products is thought to reduce the incidence of colorectal cancer. The association of these nutrients and foods with the occurrence of colorectal adenomas, precursors of cancer, was studied in two large US cohort studies. Cases were patients with a diagnosis of adenomatous polyps of the left colon or rectum (331 men, 1986-1990; 350 women, 1980-1988), and controls were persons with endoscopic findings negative for adenoma (9,159 men and 8,585 women). After adjustment for age, total energy, family history of colorectal cancer, body mass index, alcohol consumption, folate, intake of saturated fat and fiber, indications for endoscopy, and previous endoscopy, total calcium intake was not associated with the risk for adenoma (relative risk (RR), highest vs, lowest quintile of intake: men, 1.13, 95% confidence interval (Cl) 0.76-1.66; women, 1.17, 95% Cl 0.81-1.69). Total vitamin D intake was unrelated to the risk for adenoma in men (RR = 1.29, 95% Cl 0.87-1.93). An inverse nonsignificant association was observed in women in the 1980-1988 analyses (RR = 0.68, 95% Cl 0.41-1.13, trend p = 0.09), mainly attributable to the intake of multivitamin supplements, but an analysis of 4-year data (1984-1988) using a more detailed dietary assessment showed no association with vitamin D (RR = 1.04, 95% Cl 0.65-1.67). Milk consumption and intake of total fermented dairy products were not related to adenoma risk. In conclusion, the occurrence of colorectal adenoma was neither related to calcium intake nor to milk consumption, whereas vitamin D from supplements but not diet was slightly, but not significantly, inversely associated with risk among women only.