Lifestyle Factors and Their Combined Impact on the Risk of Colorectal Polyps
Lifestyle Factors and Their Combined Impact on the Risk of Colorectal Polyps
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DOI：
10.1093/aje/kws157
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发表时间：
2012-11-01
影响因子：
5
通讯作者：
Zheng, Wei
中科院分区：
文献类型：
--
作者：
Fu, Zhenming;Shrubsole, Martha J.;Zheng, Wei
了解结肠直肠息肉的共同和特定类型的病因模式可能有助于了解结直肠癌的发生。作者在一项基于结肠镜的病例对照研究中首次系统地比较了结直肠息肉类型的危险因素，该研究纳入了3764例无息肉对照和2543例息肉患者，其中包括1444例单纯腺瘤、662例单纯增生性息肉（HPPs）和437例同时存在HPPs和腺瘤。完成调查以获取日常饮食摄入量和其他生活方式因素的信息。六种生活方式因素，包括吸烟、肥胖、不经常使用非甾体抗炎药、大量摄入红肉、低纤维摄入和低钙摄入，被发现与息肉的风险独立相关。息肉的风险随着不良生活方式因素的增加而逐渐增加。与没有或只有1个危险因素的参与者相比，只有腺瘤的风险比为2.72(95可信区间：1.94,3.79)，只有HPPs的风险比为4.12(95可信区间：2.78,6.09)，同步HPPs和腺瘤的风险比为9.03（95可信区间：5.69,14.34）。这项研究提供了强有力的证据，表明生活方式的改变对于预防结直肠息肉，特别是晚期和多发性腺瘤是重要的，这是结直肠癌的先兆。
Understanding patterns of shared and type-specific etiologies for colorectal polyps may provide insights into colorectal carcinogenesis. The authors present the first systematic comparison of risk factors by colorectal polyp type in a large colonoscopy-based case-control study of 3,764 polyp-free controls and 2,543 polyp patients, including 1,444 cases with adenomas only, 662 cases with hyperplastic polyps (HPPs) only, and 437 cases with synchronous HPPs and adenomas. Surveys were completed to obtain information on usual dietary intake and other lifestyle factors. Six lifestyle factors, including cigarette smoking, obesity, no regular use of nonsteroidal anti-inflammatory drugs, high intake of red meat, low intake of fiber, and low intake of calcium, were found to be independently associated with the risk of polyps. The risk of polyps increased progressively with an increasing number of adverse lifestyle factors. Compared with participants with no or only 1 risk factor, odds ratios for those with 5 to 6 risk factors were 2.72 (95 confidence interval: 1.94, 3.79) for adenoma only, 4.12 (95 confidence interval: 2.78, 6.09) for HPPs only, and 9.03 (95 confidence interval: 5.69, 14.34) for synchronous HPPs and adenomas. This study provides strong evidence that lifestyle modification is important for the prevention of colorectal polyps, especially advanced and multiple adenomas, which are established precursors of colorectal cancer.