A large prospective study of meat consumption and colorectal cancer risk: an investigation of potential mechanisms underlying this association.
A large prospective study of meat consumption and colorectal cancer risk: an investigation of potential mechanisms underlying this association.
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DOI：
10.1158/0008-5472.can-09-3929
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发表时间：
2010-03-15
期刊：
影响因子：
11.2
通讯作者：
Sinha R
中科院分区：
文献类型：
--
作者：
Cross AJ;Ferrucci LM;Risch A;Graubard BI;Ward MH;Park Y;Hollenbeck AR;Schatzkin A;Sinha R
虽然红肉和加工肉摄入量与结直肠癌之间的关系在一些流行病学研究中已有报道，但很少有人研究潜在的机制。这项研究在一个大型的美国前瞻性队列中检查了多种潜在机制，其中包括一份关于肉类类型和肉类烹饪方法的详细问卷，该问卷与数据库相关联，用于估计高温烹饪肉类中形成的诱变剂（杂环胺，多环芳烃），血红素铁，硝酸盐和亚硝酸盐的摄入量。在7年的随访中，从300，948名男性和女性中确定了2，719例结直肠癌病例。比较第五个五分位数与第一个五分位数的红色（HR=1.24，95% CI：1.09-1.42; p趋势<0.001）和加工肉类（HR=1.16，95% CI：1.01-1.32; p趋势=0.017）摄入量的风险比（HR）和95%置信区间（CI）表明结直肠癌的风险升高。这种关系的潜在机制包括血红素铁（HR=1.13，95% CI：0.99-1.29; p趋势=0.022），加工肉类中的硝酸盐（HR=1.16，95% CI：1.02-1.32; p趋势=0.001）和杂环胺摄入（HR=1.19，95%CI：1.05-1.34; MeIQx的p趋势<0.001，HR=1.17，95%CI：1.05-1.29; DiMeIQx的p趋势<0.001）。一般来说，直肠癌的风险高于结肠癌，除了MeIQx和DiMeIQx，它们只与结肠癌相关。总之，我们发现红肉和加工肉类摄入量与结直肠癌呈正相关;来自肉类的血红素铁，硝酸盐/亚硝酸盐和杂环胺可以解释这些相关性。
Although the relation between red and processed meat intake and colorectal cancer has been reported in several epidemiologic studies, very few investigated the potential mechanisms. This study examined multiple potential mechanisms in a large U.S. prospective cohort with a detailed questionnaire on meat type and meat cooking methods linked to databases for estimating intake of mutagens formed in meats cooked at high temperatures (heterocyclic amines, polycyclic aromatic hydrocarbons), heme iron, nitrate and nitrite. During 7 years of follow-up, 2,719 colorectal cancer cases were ascertained from a cohort of 300,948 men and women. The hazard ratios (HR) and 95% confidence intervals (CI) comparing the fifth to the first quintile for both red (HR=1.24, 95% CI: 1.09-1.42; p-trend <0.001) and processed meat (HR=1.16, 95% CI: 1.01-1.32; p-trend=0.017) intake indicated an elevated risk for colorectal cancer. The potential mechanisms for this relation include heme iron (HR=1.13, 95% CI: 0.99-1.29; p-trend=0.022), nitrate from processed meats (HR=1.16, 95% CI: 1.02-1.32; p-trend=0.001) and heterocyclic amine intake (HR=1.19, 95% CI: 1.05-1.34; p-trend <0.001 for MeIQx and HR=1.17, 95% CI: 1.05-1.29; p-trend <0.001 for DiMeIQx). In general, the elevated risks were higher for rectal cancer than for colon cancer, with the exception of MeIQx and DiMeIQx, which were only associated with colon cancer. In conclusion, we found a positive association for red and processed meat intake and colorectal cancer; heme iron, nitrate/nitrite, and heterocyclic amines from meat may explain these associations.