Prediagnostic plasma vitamin C and risk of gastric adenocarcinoma and esophageal squamous cell carcinoma in a Chinese population
Prediagnostic plasma vitamin C and risk of gastric adenocarcinoma and esophageal squamous cell carcinoma in a Chinese population
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DOI：
10.3945/ajcn.113.061267
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发表时间：
2013-11-01
影响因子：
7.1
通讯作者：
Abnet, Christian C.
中科院分区：
文献类型：
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作者：
Lam, Tram Kim;Freedman, Neal D.;Abnet, Christian C.
背景：中国是世界上胃腺癌（GA）和食管鳞状细胞癌（ESCC）发病率最高的国家。前瞻性研究表明，维生素C可以降低风险；然而，由于样本量有限，其相关性尚不清楚。目的：探讨诊断前血浆维生素C与GA和ESCC风险的关系。设计：在普通人群营养干预试验中，一项病例队列研究用于评估诊断前血浆维生素C与GA （n = 467）和ESCC （n = 618）发病率之间的关系。使用多变量Cox比例风险模型，我们估计hr和95% ci。我们还对截至2012年10月1日的文献进行了荟萃分析，研究循环维生素C与胃癌发病率之间的关系。纳入两项队列研究和本研究以评估证据体。结果：对于GA，血浆维生素C每增加20 μ mol/L，风险降低14% （HR: 0.86; 95% CI: 0.76, 0.96）。与血浆维生素C浓度低（28 μ mol/L）的个体相比，GA的风险降低了27% （HR: 0.73; 95% CI: 0.56, 0.94）。维生素C浓度与ESCC之间没有关联。荟萃分析显示，血浆维生素C浓度最高的人群发生GA的风险比最低的人群低31%（随机效应-合并优势比0.69;95% CI: 0.54, 0.89）。结论：我们的数据提供了高循环维生素C与GA事件风险降低相关的证据，但与ESCC没有关联。
Background: China has some of the highest incidence rates for gastric adenocarcinoma (GA) and esophageal squamous cell carcinoma (ESCC) in the world. Prospective studies suggested that vitamin C may reduce risks; however, associations are unclear because of limited sample size.Objective: The objective was to examine the relation between prediagnostic plasma vitamin C and the risk of GA and ESCC.Design: A case-cohort study was used to assess the association between prediagnostic plasma vitamin C and incidence of GA (n = 467) and ESCC (n = 618) in the General Population Nutrition Intervention Trial. With the use of multivariate Cox proportional hazards models, we estimated the HRs and 95% CIs. We also conducted a meta-analysis of the literature up to 1 October 2012 on the relation between circulating vitamin C and gastric cancer incidence. Two cohort studies and the current study were included to assess the body of evidence.Results: For GA, each 20-mu mol/L increase in plasma vitamin C was associated with a 14% decrease in risk (HR: 0.86; 95% CI: 0.76, 0.96). Compared with individuals with low plasma vitamin C concentrations (28 mu mol/L) had a 27% reduced risk of GA (HR: 0.73; 95% CI: 0.56, 0.94). No association between vitamin C concentrations and ESCC was seen. Meta-analysis showed that the risk of incident GA among those with the highest concentration of plasma vitamin C was 31% lower (random-effects-pooled-odds ratio 0.69; 95% CI: 0.54, 0.89) than those in the lowest category.Conclusion: Our data provide evidence that higher circulating vitamin C was associated with a reduced risk of incident GA, but no association was seen for ESCC.