Lifestyle factors, obesity and the risk of colorectal adenomas in EPIC-Heidelberg
Lifestyle factors, obesity and the risk of colorectal adenomas in EPIC-Heidelberg
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DOI：
10.1007/s10552-009-9366-3
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发表时间：
2009-10-01
影响因子：
2.3
通讯作者：
Linseisen, Jakob
中科院分区：
文献类型：
--
作者：
Hermann, Silke;Rohrmann, Sabine;Linseisen, Jakob
目的前瞻性研究生活方式和肥胖与结直肠腺瘤风险的关系。方法在1994年至1998年招募期间，对25,540名EPIC-Heidelberg队列参与者的饮食、人体测量、生活方式和药物等方面的信息进行评估。截至2007年6月，共发现536例确诊的结直肠腺瘤。结果在多因素Logistic回归分析中，饮酒量高的受试者与饮酒量最低的受试者相比，腺瘤的危险性增加(优势比[OR]=1.63；95%可信区间1.21~2.22)。叶酸摄入改变了乙醇效应(p交互作用=0.03)。与从不吸烟者相比，吸烟者发生腺瘤的风险显著增加(OR=1.40；95%CI为1.16~1.84)。与非吸毒者相比，经常服用非甾体类抗炎药的受试者报告至少两次服用非类固醇抗炎药的风险较低(OR=0.70；95%CI为0.53-0.93)。体力活动、体重指数、腰臀比与结肠腺瘤的风险并不一致。结论前瞻性队列研究结果显示，饮酒和吸烟是结直肠腺瘤的重要危险因素，经常使用非甾体抗炎药可降低风险。饮酒和腺瘤风险之间的关系被叶酸摄入量改变。然而，我们不能确定肥胖或体力活动对腺瘤风险的影响。
Objective We investigated the association of lifestyle and obesity with colorectal adenoma risk in a prospective setting.Methods At recruitment (1994-1998), information on diet, anthropometry, lifestyle, and medication was assessed in 25,540 participants of the EPIC-Heidelberg cohort. Until June 2007, 536 verified incident colorectal adenomas were identified. Furthermore, participants with negative colonoscopy (n = 3966) were included in the analytic cohort.Results In multivariate logistic regression analyses, participants with highest alcohol intake had an increased adenoma risk (odds ratio [OR] = 1.63; 95% CI 1.21-2.22) compared with lowest intake group. Folate consumption modified the ethanol effect (p-interaction = 0.03). Current smokers had a significantly increased adenoma risk compared with never smokers (OR = 1.40; 95% CI 1.16-1.84). Regular NSAID intake was associated with lower risk in subjects who reported their use at least twice compared with nonusers (OR = 0.70; 95% CI 0.53-0.93). Physical activity, body mass index, and waist-to-hip ratio were not consistently associated with adenoma risk.Conclusions The results of this prospective cohort study showed that alcohol intake and smoking are important risk factors for colorectal adenoma, and regular NSAID use decreases the risk. The relationship between alcohol consumption and adenoma risk was modified by folate intake. However, we could not confirm an effect of obesity or physical activity on adenoma risk.