Dairy, soy, and risk of breast cancer: those confounded milks
Dairy, soy, and risk of breast cancer: those confounded milks
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DOI：
10.1093/ije/dyaa007
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发表时间：
2020-10-01
影响因子：
7.7
通讯作者：
Knutsen, Synnove
中科院分区：
文献类型：
--
作者：
Fraser, Gary E.;Jaceldo-Siegl, Karen;Knutsen, Synnove
背景：大豆、乳制品摄入量与乳腺癌风险之间的关系并不一致。没有研究存在大量的乳制品消费者和大豆消费者，以评估相互confounding.Methods：研究队列包含52 795北美妇女，最初没有癌症，随后为7.9年（29.7%是黑人）。膳食摄入量估计食物频率问卷，并为1011校准研究对象，从6个结构化的24小时饮食回忆。侵袭性乳腺癌的发病率主要通过与癌症登记处的匹配来检测。分析采用多变量比例风险regression.Results：参与者（平均年龄57.1岁）在随访期间经历了1057例新发乳腺癌病例。大豆制品和乳腺癌之间没有明显的联系，独立于乳制品。然而，较高的乳制品热量和牛奶摄入量分别与1.22 [95%置信区间（CI）：1.051.40]和1.50（95% CI 1.22-1.84）的风险比（HR）相关，比较第90和第10次摄入量。全脂和低脂牛奶产生了类似的结果。奶酪和酸奶之间没有重要的联系。用豆奶消费者的中位摄入量替代牛奶消费者的中位摄入量，HR为0.68（95%CI：0.55-0.85）。在绝经前和绝经后的病例中发现了类似大小的关联，CI也排除了雌激素受体（ER+，ER-）和孕激素受体（PR+）癌症中的无效。偏差较小的校准测量误差调整回归表现出更强的，但不太精确，HR和CI仍然排除了null.Conclusions：较高的牛奶摄入量与乳腺癌的风险更大，调整大豆摄入量时。目前的牛奶消费指南可以谨慎看待。
Background: Associations between soy, dairy intakes and breast cancer risk are inconsistent. No studies exist with large numbers of dairy consumers and soy consumers to assess mutual confounding.Methods: The study cohort contains 52 795 North American women, initially free of cancer, followed for 7.9 years (29.7% were Black). Dietary intakes were estimated from food frequency questionnaires and, for 1011 calibration study subjects, from six structured 24h dietary recalls. Incident invasive breast cancers were detected mainly by matching with cancer registries. Analyses used multivariable proportional hazards regression.Results: The participants (mean age of 57.1 years) experienced 1057 new breast cancer cases during follow-up. No clear associations were found between soy products and breast cancer, independently of dairy. However, higher intakes of dairy calories and dairy milk were associated with hazard ratios (HRs) of 1.22 [95% confidence interval (CI): 1.051.40] and 1.50 (95% CI 1.22-1.84), respectively, comparing 90th to 10th percentiles of intakes. Full fat and reduced fat milks produced similar results. No important associations were noted with cheese and yogurt. Substituting median intakes of dairy milk users by those of soy milk consumers was associated with HR of 0.68 (95% CI: 0.55-0.85). Similar-sized associations were found among pre- and post-menopausal cases, with CIs also excluding the null in estrogen receptor (ER+, ER-), and progesterone receptor (PR+) cancers. Less biased calibrated measurement-error adjusted regressions demonstrated yet stronger, but less precise, HRs and CIs that still excluded the null.Conclusions: Higher intakes of dairy milk were associated with greater risk of breast cancer, when adjusted for soy intake. Current guidelines for dairy milk consumption could be viewed with some caution.