Dietary vitamin A intake and incidence of gastric cancer in a general Japanese population: the Hisayama Study
Dietary vitamin A intake and incidence of gastric cancer in a general Japanese population: the Hisayama Study
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DOI：
10.1007/s10120-011-0092-7
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发表时间：
2012-04-01
期刊：
影响因子：
7.4
通讯作者：
Kiyohara, Yutaka
中科院分区：
文献类型：
--
作者：
Miyazaki, Masashi;Doi, Yasufumi;Kiyohara, Yutaka
关于膳食维生素A摄入量与胃癌风险之间关系的前瞻性研究结果往往相互矛盾。本研究的目的是在日本普通人群中调查这一问题，对2,467名40岁或以上的日本社区居民进行了为期14年的前瞻性随访。膳食维生素A摄入量采用半定量食物频率法进行评估。在随访期间，93名受试者发生胃癌。年龄和性别校正的胃癌发病率随着膳食维生素A摄入水平的增加而逐渐上升：按膳食维生素A摄入水平< 639、639-837、838- 1，061和> 1，061 μ g视黄醇当量（RE）/天定义的四分位数组分别为2.2、3.0、3.8和4.5/1，000人年，趋势P < 0.01。经多因素校正后，第四个四分位数胃癌的危险性仍显著高于第一个四分位数[第二个四分位数的危险比（HR）= 1.47，95% CI = 0.70-3.09，P = 0.30;第三个四分位数的HR = 1.85，95% CI = 0.82-4.18，P = 0.14;第四个四分位数的HR = 2.96，95% CI = 1.12-7.80，P = 0.03]。无论胃癌的位置或组织学类型如何，维生素A摄入量的效果都相当。胃癌的风险比仅在高维生素A摄入量（> 1,061 μ g RE/d）和幽门螺杆菌感染的受试者中显著增加。我们的研究结果表明，在日本普通人群中，膳食维生素A摄入量与胃癌风险明显相关。
The results of prospective studies examining the association between dietary vitamin A intake and the risk of gastric cancer have often been conflicting. The objective of this study was to investigate this issue in a general Japanese population.A total of 2,467 community-dwelling Japanese subjects aged 40 years or older were followed up prospectively for 14 years. Dietary vitamin A intake was estimated using a semiquantitative food frequency method.During the follow-up period, gastric cancer developed in 93 subjects. The age- and sex-adjusted incidence of gastric cancer rose progressively with increasing levels of dietary vitamin A intake: at 2.2, 3.0, 3.8, and 4.5 per 1,000 person-years for quartile groups defined by dietary vitamin A intake levels of < 639, 639-837, 838-1,061, and > 1,061 mu g retinol equivalents (RE)/day, respectively (P for trend < 0.01). The risk of gastric cancer was significantly higher in the fourth quartile than in the first one even after multivariate adjustment [hazard ratio (HR) = 1.47, 95% confidence interval (CI) = 0.70-3.09, P = 0.30 for the second quartile; HR = 1.85, 95% CI = 0.82-4.18, P = 0.14 for the third quartile; HR = 2.96, 95% CI = 1.12-7.80, P = 0.03 for the fourth quartile]. Comparable effects of vitamin A intake were observed irrespective of the location or histological type of gastric cancer. The HR for gastric cancer increased significantly only in subjects with a combination of high vitamin A intake (> 1,061 mu g RE/day) and Helicobacter pylori infection.Our findings suggest that dietary vitamin A intake is clearly associated with the risk of gastric cancer in the general Japanese population.