Plasma Phospholipid Fatty Acids and Prostate Cancer Risk in the SELECT Trial
Plasma Phospholipid Fatty Acids and Prostate Cancer Risk in the SELECT Trial
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DOI：
10.1093/jnci/djt174
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发表时间：
2013-08-01
影响因子：
10.3
通讯作者：
Kristal, Alan R.
中科院分区：
文献类型：
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作者：
Brasky, Theodore M.;Darke, Amy K.;Kristal, Alan R.
饮食中？-3脂肪酸摄入量与前列腺癌风险的研究不一致；然而，最近的大型前瞻性研究发现，血液中长链？-3多不饱和脂肪酸([LC？-3 PUFA]20：5？3；22：5？3；22：6？3)浓度高的男性患前列腺癌的风险增加。这项病例队列研究考察了硒和维生素E癌症预防试验参与者中血浆磷脂脂肪酸与前列腺癌风险之间的关系。病例受试者为834名被诊断为前列腺癌的男性，其中156人为高级别癌症。亚队列由1393名男性组成，他们在基线和层级内随机选择，在年龄和种族上与病例对象的频率匹配。比例风险模型估计了脂肪酸与前列腺癌风险总体和分级之间的关联的风险比(HR)和95%可信区间(CI)。与LC？-3PUFA中最低四分位数的男性相比，低级别(HR 1.44，95%CI 1.08至1.93)、高级别(HR 1.71，95%CI 1.00至2.94)和总前列腺癌(HR 1.43，95%CI 1.09至1.88)的风险增加。单独的长链？-3脂肪酸的关联性相似。更高的亚油酸(？-6)与低级别(HR 0.75，95%CI 0.56至0.99)和完全前列腺癌(HR 0.77，95%CI 0.59至1.01)的风险降低相关；然而，没有剂量反应。这项研究证实了先前关于血中LC？-3PUFA浓度高的男性前列腺癌风险增加的报道。这些发现的一致性表明，这些脂肪酸与前列腺癌的发生有关。增加LC？-3PUFA摄入量的建议应考虑其潜在的风险。
Studies of dietary ?-3 fatty acid intake and prostate cancer risk are inconsistent; however, recent large prospective studies have found increased risk of prostate cancer among men with high blood concentrations of long-chain ?-3 polyunsaturated fatty acids ([LC?-3PUFA] 20:5?3; 22:5?3; 22:6?3]. This casecohort study examines associations between plasma phospholipid fatty acids and prostate cancer risk among participants in the Selenium and Vitamin E Cancer Prevention Trial.Case subjects were 834 men diagnosed with prostate cancer, of which 156 had high-grade cancer. The subcohort consisted of 1393 men selected randomly at baseline and from within strata frequency matched to case subjects on age and race. Proportional hazards models estimated hazard ratios (HR) and 95% confidence intervals (CI) for associations between fatty acids and prostate cancer risk overall and by grade. All statistical tests were two-sided.Compared with men in the lowest quartiles of LC?-3PUFA, men in the highest quartile had increased risks for low-grade (HR 1.44, 95% CI 1.08 to 1.93), high-grade (HR 1.71, 95% CI 1.00 to 2.94), and total prostate cancer (HR 1.43, 95% CI 1.09 to 1.88). Associations were similar for individual long-chain ?-3 fatty acids. Higher linoleic acid (?-6) was associated with reduced risks of low-grade (HR 0.75, 95% CI 0.56 to 0.99) and total prostate cancer (HR 0.77, 95% CI 0.59 to 1.01); however, there was no dose response.This study confirms previous reports of increased prostate cancer risk among men with high blood concentrations of LC?-3PUFA. The consistency of these findings suggests that these fatty acids are involved in prostate tumorigenesis. Recommendations to increase LC?-3PUFA intake should consider its potential risks.