Dietary flavonoids and colorectal adenoma recurrence in the polyp prevention trial
Dietary flavonoids and colorectal adenoma recurrence in the polyp prevention trial
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DOI：
10.1158/1055-9965.epi-07-0747
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发表时间：
2008-06-01
影响因子：
3.8
通讯作者：
Lanza, Elaine
中科院分区：
文献类型：
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作者：
Bobe, Gerd;Sansbury, Leah B.;Lanza, Elaine
最近的两项病例对照研究表明，一些类黄酮亚群可能在预防结直肠癌中发挥作用。以前的前瞻性队列研究通常没有报告相关性;然而，只有一小部分类黄酮进行了评估，并使用了部分类黄酮数据库。我们使用新构建的美国农业部类黄酮数据库来研究总黄酮、6个类黄酮亚组和29个类黄酮与息肉预防试验中腺瘤性息肉复发之间的关系。息肉预防试验是一项随机饮食干预试验，旨在研究低脂、高纤维、高水果和高蔬菜饮食对腺瘤复发的有效性。黄酮类化合物的摄入量通过食物频率问卷进行评估。采用多变量逻辑回归模型（根据年龄、体重指数、性别、定期使用非甾体抗炎药和膳食纤维摄入量进行调整），在能量调整的类黄酮摄入量的四分位数内（基线、试验期间和试验期间的变化），估计任何和晚期腺瘤复发的比值比和95%置信区间。总黄酮摄入量与任何或晚期腺瘤复发无关。然而，在豆类、洋葱、苹果和茶中含量更高的黄酮醇的高摄入量与晚期腺瘤复发风险降低相关（试验期间的第四个四分位数与第一个四分位数;比值比，0.24; 95%置信区间，0.11，0.53; P趋势= 0.0006）。类似的反向关联，观察到在较小程度上的黄酮醇山奈酚，和黄染料木黄酮和芒柄花黄素。我们的数据表明，富含黄酮醇的饮食可以降低晚期腺瘤复发的风险。
Two recent case-control studies suggested that some flavonoid subgroups may play a role in preventing colorectal cancer. Previous prospective cohort studies generally reported no association; however, only a small subset of flavonoids was evaluated and partial flavonoid databases were used. We used the newly constructed U.S. Department of Agriculture flavonoid database to examine the association between consumption of total flavonoids, 6 flavonoid subgroups, and 29 individual flavonoids with adenomatous polyp recurrence in the Polyp Prevention Trial. The Polyp Prevention Trial was a randomized dietary intervention trial, which examined the effectiveness of a low-fat, high-fiber, high-fruit, and high-vegetable diet on adenoma recurrence. Intakes of flavonoids were estimated from a food frequency questionnaire. Multivariate logistic regression models (adjusted for age, body mass index, sex, regular non-steroidal anti-inflammatory use, and dietary fiber intake) were used to estimate odds ratios and 95% confidence intervals for both any and advanced adenoma recurrence within quartiles of energy-adjusted flavonoid intake (baseline, during the trial, and change during the trial). Total flavonoid intake was not associated with any or advanced adenoma recurrence. However, high intake of flavonols, which are at greater concentrations in beans, onions, apples, and tea, was associated with decreased risk of advanced adenoma recurrence (4th versus 1st quartile during the trial; odds ratio, 0.24; 95% confidence interval, 0.11, 0.53; P-trend = 0.0006). Similar inverse associations were observed to a smaller extent for isoflavonoids, the flavonol kaempferol, and the isoflavonoids genistein and formononetin. Our data suggest that a flavonol-rich diet may decrease the risk of advanced adenoma recurrence.