Dietary factors and risk of uterine fibroids

 描述（由申请人提供）：子宫肌瘤（UL）是育龄妇女中最常见的盆腔肿瘤。尽管这些平滑肌肿瘤是良性的，但 UL 是一个重大的公共健康问题，每年有超过 200,000 例子宫切除术，大约四分之一的女性会患有引起临床关注的 UL。尽管与 UL 相关的发病率和医疗费用较高，但其病因尚不清楚，而且几乎没有发现可改变的保护性危险因素。饮食因素可能在 UL 病因学中发挥作用，因为它们有可能改变内源性激素及其炎症作用。假设/具体目标：我们的总体假设是，影响内源性激素和炎症反应的膳食成分的摄入量和血浆生物标志物水平与 UL 风险相关。很少有研究探讨饮食因素与 UL 之间的关联。据我们所知，只有一个前瞻性队列研究了乳制品和膳食脂肪摄入量与 UL 之间的关联，观察到随着乳制品消费量的增加以及与某些脂肪酸的关联，UL 风险降低。此外，尚无前瞻性研究检验其与维生素 D 水平的关联。使用前瞻性数据，我们将评估以下目标： 目标 1. 使用 NHSII 队列中 97,807 名完成饮食评估的女性的数据，评估膳食脂肪与子宫肌瘤发生风险之间的关联。在这些女性中，我们将检查循环脂肪酸水平与子宫肌瘤之间的关联。 目标 2. 乳制品摄入量与子宫肌瘤的风险相关。 目标 3。维生素 D 水平与子宫肌瘤的风险相关。研究设计：拟议的研究由护士健康研究 II 参与者组成，他们于 1991 年完成了有关其日常饮食的食物频率问卷 (FFQ)。后续 FFQ 于 1995 年、1999 年、2003 年和 2007 年完成。将生成膳食摄入量的五分位数或类别，并使用 Cox 比例风险模型来估计与每个饮食因素相关的 UL 发生率的风险比。在具有诊断前生物标志物的一部分女性中，将使用逻辑回归模型评估血浆维生素 D 和循环脂肪酸与 UL 风险之间的关联。前瞻性收集的 UL、饮食和协变量数据以及存储的血液样本的存在，可以经济有效地考虑疾病诊断的暂时性 - 支持潜在的可改变风险因素的识别。

 DESCRIPTION (provided by applicant): Uterine leiomyoma (UL) are the most common pelvic tumor in women of reproductive age. Despite the fact that these smooth muscle tumors are benign, UL are a significant public health problem, accounting for over 200,000 hysterectomies annually, and approximately 1 in 4 women will have a UL that comes to clinical attention. Despite the high morbidity and health care costs associated with UL, the etiology is not understood, and few modifiable, protective risk factors have been identified. Dietary factors may play a role in UL etiology due to their potential to modify endogenous hormones as well as their inflammatory effects. Hypothesis/Specific Aims: Our overall hypothesis is that intake and plasma biomarker levels of dietary components that influence endogenous hormonal and inflammatory response are associated with UL risk. Few studies have examined the association between dietary factors and UL. To our knowledge, only one prospective cohort has examined the association between dairy and dietary fat intake and UL observing a reduced risk of UL with increasing dairy consumption and associations with some fatty acids. In addition, no prospective studies have examined the association with vitamin D levels. Using prospective data we will evaluate the following aims: Aim 1. Evaluate the association between dietary fat and risk of incident uterine leiomyoma using data among 97,807 women in the NHSII cohort who completed a dietary assessment. In a subset of these women we will examine the association between circulating fatty acid levels and uterine leiomyoma. Aim 2. Dairy food intake is associated with risk of uterine leiomyoma. Aim 3. Vitamin D levels are associated with risk of uterine leiomyoma. Study Design: The proposed study consists of Nurses' Health Study II participants who completed a food frequency questionnaire (FFQ) about their usual diet in 1991. Follow-up FFQs were completed in 1995, 1999, 2003, and 2007. Quintiles or categories of dietary intake will be generated and Cox proportional hazards models will be used to estimate hazard ratios of UL incidence associated with each of the dietary factors. Among a subset of women with pre-diagnostic biomarkers, the association between plasma vitamin D and circulating fatty acids with UL risk will be assessed with logistic regression models. The presence of prospectively collected UL, dietary, and covariate data and stored blood samples, allows cost-efficient and valid consideration of the temporality of disease diagnosis - supporting the potential identification of modifiable risk factors.