Vitamin D, alcohol, and risk of lymphomas in a prospective cohort of women

前瞻性女性队列中的维生素 D、酒精和淋巴瘤风险

• 批准号: 7769913
• 负责人: Ellen Ting-Yee Chang
• 金额: $ 7.25万
• 依托单位: CANCER PREVENTION INSTIT OF CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-03-01 至 2011-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7769913
• 关键词: Accounting; Address; Adverse effects; Age; Alcohol consumption; Alcohols; Antioxidants; Behavioral; Biological; California; Case-Control Studies; Cessation of life; Chemicals; Chemoprotective Agent; Chronic Lymphocytic Leukemia; Cohort Studies; Collection; Consumption; Dairy Products; Data; Development; Diagnosis; Diet; Diet Habits; Diet Modification; Dietary intake; Disease; Edible Plants; Employee Strikes; Epidemiologic Studies; Etiology; Exposure to; Fishes; Follicular Lymphoma; Food; Frequencies; Hodgkin Disease; Incidence; Intake; Investigation; Isothiocyanates; Lymphoma; Lymphomagenesis; Malignant Neoplasms; Malignant lymphoid neoplasm; Measurement; Measures; Modeling; Morbidity - disease rate; Multiple Myeloma; Non-Hodgkin' s Lymphoma; Nutrient; Phytoestrogens; Plants; Play; Prospective Studies; Questionnaires; Radiation; Relative Risks; Risk; Risk Factors; Role; Skin; Small-Cell Lymphoma; Source; Sun Exposure; Sunburn; Sunlight; Ultraviolet B Radiation; United States; Vitamin D; Woman; alcohol effect; alcohol risk; base; cancer diagnosis; cancer risk; cohort; design; development of lymphoid malignancy; dietary antioxidant; fruits and vegetables; hazard; indexing; large cell Diffuse non-Hodgkin' s lymphoma; lymphatic cancer; member; modifiable risk; mortality; nutritional guideline; prevent; prospective; teacher; ultraviolet

DESCRIPTION (provided by applicant): Lymphoid malignancies, including non-Hodgkin lymphoma (NHL), Hodgkin lymphoma (HL), and multiple myeloma (MM), comprise the fourth most commonly diagnosed cancer in the United States. Dietary and other modifiable behavioral changes may explain part of the striking increase in the incidence rate of NHL during recent decades. Previous epidemiological studies suggest that intake of alcohol, vitamin D, and plant foods are associated with lower risk of several types of lymphoma. Biological evidence of antilymphoproliferative effects of bioactive vitamin D, and anti-cancer effects of dietary antioxidants and certain phytonutrients, support a protective role against lymphoma development, whereas a chemoprotective effect of alcohol is less certain. To date, there have been few prospective studies of diet and NHL risk, and none of HL or MM risk; there has been no prospective investigation of sunlight and risk of these cancers. Therefore, we aim to investigate whether exposure to vitamin D from diet or sunlight; indices of dietary antioxidant intake; consumption of phytoestrogens or isothiocyanates; or consumption of alcohol at various ages is associated with reduced risk of lymphoid malignancies among 110,215 women in the large, prospective California Teachers Study cohort. Between completion of a baseline questionnaire in 1995-1996 and December 31, 2006, 515 cohort members were diagnosed with NHL, 32 with HL, and 84 with MM, making this the largest prospective study of lymphoma to date. We will use multivariate Cox proportional hazards analysis to estimate the relative risks of NHL, NHL subtypes, HL, and MM associated with baseline dietary intake of certain nutrients, phytonutrients, and foods; dietary antioxidant indices; alcohol consumption at various ages; frequency of severe sunburns; age at first severe sunburn; and skin sensitivity to sunlight. In addition, we will use a validated model based on nationwide ultraviolet-B radiation (UVB) measurements to compute average annual UVB exposure according to residential address. Our study's prospective design precludes recall bias, while collection of detailed exposure information enables adjustment for a wide range of potential confounders and modifiers. If vitamin D, dietary antioxidants, and/or phytonutrients indeed decrease the risk of lymphoma, then dietary modification could reduce the considerable morbidity and mortality due to these malignancies and their long-term adverse treatment effects.

描述(申请人提供)：淋巴系恶性肿瘤，包括非霍奇金淋巴瘤(NHL)、霍奇金淋巴瘤(HL)和多发性骨髓瘤(MM)，是美国第四种最常见的癌症。饮食和其他可改变的行为变化可能是近几十年来NHL发病率显著上升的部分原因。以前的流行病学研究表明，酒精、维生素D和植物性食物的摄入与几种类型的淋巴瘤的风险较低有关。生物活性维生素D抗淋巴增殖作用的生物学证据，以及饮食抗氧化剂和某些植物营养素的抗癌作用，支持对淋巴瘤发展的保护作用，而酒精的化学保护作用则不太确定。到目前为止，很少有关于饮食和非霍奇金淋巴瘤风险的前瞻性研究，也没有关于HL或MM风险的前瞻性研究；还没有关于阳光和这些癌症风险的前瞻性研究。因此，我们的目标是调查在110,215名未来的加州教师研究队列中，从饮食或阳光中暴露于维生素D，饮食中抗氧化剂摄入量的指数，植物雌激素或异硫氰酸酯的消费，或不同年龄段的酒精消费是否与降低淋巴系统恶性肿瘤风险相关。在1995-1996年完成基线问卷调查至2006年12月31日期间，515名队列成员被诊断为非霍奇金淋巴瘤，32名被诊断为非霍奇金淋巴瘤，84名被诊断为多发性骨髓瘤，这使这项研究成为迄今为止规模最大的淋巴瘤前瞻性研究。我们将使用多变量COX比例风险分析来评估NHL、NHL亚型、HL和MM的相对风险，这些风险与某些营养素、植物营养素和食物的基线饮食摄入量、饮食抗氧化指数、不同年龄的酒精消费、严重晒伤的频率、首次严重晒伤的年龄以及皮肤对阳光的敏感性有关。此外，我们将使用一个基于全国紫外线-B辐射(UVB)测量的经过验证的模型，根据住址计算UVB的年平均暴露剂量。我们研究的前瞻性设计排除了回忆偏差，而详细暴露信息的收集使人们能够对广泛的潜在混杂因素和修饰因素进行调整。如果维生素D、饮食抗氧化剂和/或植物营养素确实降低了淋巴瘤的风险，那么改变饮食可以降低这些恶性肿瘤及其长期不良治疗影响的相当大的发病率和死亡率。