Folate intake, alcohol consumption, cigarette smoking, and risk of colorectal adenomas
Folate intake, alcohol consumption, cigarette smoking, and risk of colorectal adenomas
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DOI：
10.1093/jnci/90.1.57
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发表时间：
1998-01-07
期刊：
影响因子：
--
通讯作者：
Greenberg, ER
中科院分区：
文献类型：
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作者：
Baron, JA;Sandler, RS;Greenberg, ER
背景：最近的证据表明，叶酸(及其衍生物)可能有助于水果和蔬菜预防结肠癌的作用，另有证据表明，饮酒和吸烟可能会损害叶酸的生物学作用。我们使用一项腺瘤预防试验的数据来研究结直肠腺瘤(结直肠癌的可能先兆)的发生与叶酸摄入、饮酒和吸烟的关系，方法：至少有一个新近发生的大肠腺瘤的患者在合格的结肠检查后1年和4年进行结肠镜检查。第一年检查后发现的腺瘤作为终点。在研究开始时和研究结束时进行食物频率问卷调查；研究开始时的营养摄入量在这项分析中使用。所有的统计检验都是双侧的，结果：在调整卡路里摄入量后，饮食中的叶酸与大肠腺瘤复发的风险有显著的保护性关联(趋势=0.04)。然而，通过进一步调整膳食纤维和脂肪的摄入量，这种相反的关联被减弱了，使用叶酸补充剂与风险的降低无关，酒精摄入量(每周七杯或更多的饮料)与风险的增加相关(优势比=2.04；95%可信区间=1.28-3.26)，吸烟，甚至长期吸烟，与腺瘤复发无关。结论：这些数据仅为先前叶酸对结直肠腺瘤风险有益影响的研究结果提供了适度的支持。我们没有发现吸烟会增加风险的证据，但这些发现确实表明饮酒会大幅增加风险。
Background: Recent evidence suggests that folic acid (and derivatives) could contribute to the protective effect of fruits and vegetables against the risk of large-bowel cancer, Other evidence indicates that alcohol drinking and cigarette smoking may impair the biologic actions of folate. We used data from an adenoma prevention trial to investigate the occurrence of colorectal adenomas (possible precursors of colorectal cancer) in association with folate intake, alcohol consumption, and cigarette smoking, Methods: Patients with at least one recent large-bowel adenoma were followed with colonoscopy 1 year and 4 years after their qualifying colon examinations. Adenomas detected after the year 1 examination were used as end points. A food-frequency questionnaire was administered at study entry and at study completion; nutrient intake at study entry was used in this analysis. All statistical tests were two-sided, Results: After adjustment for caloric intake, dietary folate had a significant protective association with the risk of recurrence of large-bowel adenoma (P for trend = .04). However, this inverse association was attenuated by further adjustment for intake of dietary fiber and fat, Use of folate supplements was not associated with a reduction in risk, Alcohol intake (seven or more drinks/week) was associated with increased risk (odds ratio = 2.04; 95% confidence interval = 1.28-3.26), Cigarette smoking, even smoking for long duration, was not related to adenoma recurrence. Conclusions: These data provide only modest support for previous findings suggesting beneficial effects of folate on colorectal adenoma risk. We find no evidence that cigarette smoking increases risk, These findings do suggest a substantial increase in risk with alcohol consumption.