PROSPECTIVE-STUDY OF TOENAIL SELENIUM LEVELS AND CANCER AMONG WOMEN
PROSPECTIVE-STUDY OF TOENAIL SELENIUM LEVELS AND CANCER AMONG WOMEN
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DOI：
10.1093/jnci/87.7.497
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发表时间：
1995-04-05
期刊：
影响因子：
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通讯作者：
HUNTER, DJ
中科院分区：
文献类型：
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作者：
GARLAND, M;MORRIS, JS;HUNTER, DJ
背景资料：在动物研究、生态学研究以及一些病例对照和前瞻性研究中，已经观察到硒水平与癌症风险之间的负相关性。尽管一些前瞻性研究的结果表明硒水平与癌症之间存在总体负相关性，但其他前瞻性研究未能证实这一发现。目的：本研究的目的是前瞻性地检查脚趾甲中硒水平之间的关系，（以前显示反映硒摄入量）和女性癌症发病率，方法：护士健康研究队列始于1976年，共有121700名年龄在30-55岁之间的女性护士，居住在美国11个州。1982年，我们要求队列成员剪下脚趾甲，在41个月的随访中，503例乳腺癌以外的癌症病例对于每个病例患者，对照受试者选自未诊断出癌症的女性，按年龄和指甲返回日期匹配。未观察到趾甲硒水平与癌症风险之间存在负相关。趾甲硒水平最高与最低五分位数相比，年龄和吸烟调整的相对风险（RR）为1.44（95%置信区间[CI] = 0.97-2.13），五分位数之间的趋势略微显著（双侧P = .06），比较最高和最低十分位数，RR（年龄和吸烟调整）为1.77（95%CI = 1.04-3.02），当这些数据与来自434例乳腺癌病例患者及其匹配的对照受试者的数据相结合时，最高与最低五分位数比较的RR为1.24（95%CI = 0.93-1.65），趾甲硒水平与任何主要部位的癌症（包括子宫癌、结直肠癌、黑色素瘤、卵巢癌或肺癌）均无负相关性（调整吸烟后）;事实上，在几个地点观察到非显著的正相关，结论：在这项研究中，趾甲硒水平与癌症风险不呈负相关。这些数据，结合以前的研究结果，脚趾甲硒状态和乳腺癌风险之间没有关联，这强烈表明，在大多数美国妇女的硒摄入量范围内，较高的硒摄入量（如脚趾甲硒水平所反映的）对妇女的总体癌症发病率没有保护作用。
Background: Inverse associations between selenium status and cancer risk have been observed in animal studies, ecologic studies, and some case-control and prospective studies, Whereas results of some prospective studies have suggested an overall inverse relationship between selenium levels and cancer, other prospective studies have failed to confirm this finding, Prospective data on women are particularly limited because fewer women than men have been studied prospectively, Purpose: The aim of this study was to prospectively examine the relationship between selenium levels in toenails (previously shown to reflect selenium intake) and incidence of cancer among women, Methods: The Nurses' Health Study cohort began in 1976 with 121 700 female nurses aged 30-55 years living in 11 U.S. states, In 1982, we requested toenail clippings from the members of the cohort, and 62 641 participants with no history of cancer returned these clippings, During 41 months of follow-up, 503 cases of cancer other than breast cancer (results previously reported) or nonmelanoma skin cancer were analyzed, For each case patient, a control subject was chosen from women who remained free of diagnosed cancer, matched by age and by date of nail return, Results: No inverse association was observed between selenium levels in toenails and cancer risk, The age- and smoking-adjusted relative risk (RR), comparing the highest with the lowest quintile of toenail selenium level, was 1.44 (95% confidence interval [CI] = 0.97-2.13), and the trend across quintiles was marginally significant (two-sided P = .06), Comparing the highest with the lowest decile, the RR (age- and smoking-adjusted) was 1.77 (95% CI = 1.04-3.02), When these data were combined with the data from 434 breast cancer case patients and their matched control subjects identified in parallel from this same cohort, the RR comparing the highest with the lowest quintile was 1.24 (95 % CI = 0.93-1.65), Toenail selenium level was not inversely associated with cancer at any major site, including uterine cancer, colorectal cancer, melanoma, ovarian cancer, or lung cancer (after adjusting for smoking); in fact, nonsignificant positive associations were observed at several sites, Conclusions: Toenail selenium levels were not inversely associated with cancer risk in this study, Implications: These data, in conjunction with previous findings of no association between toenail selenium status and breast cancer risk, strongly suggest that higher selenium intake within the range consumed by most U.S. women (as reflected by toenail selenium levels) is not protective against overall cancer incidence in women.