Epidemiological Study on Lifestyle Factors and Precancerous Lesion of the Large Bowel

通过将生活方式问卷纳入自卫队退休前健康检查，我们整合了关于生活方式因素和疾病预防的表皮病学数据库。受试者是男性自卫官员，年龄大多在50岁出头。研究结果如下：1.先前发现糖尿病合并乙状结肠腺瘤的风险增加。在两个独立的人群中，一致发现糖尿病与近端结肠腺瘤的风险增加有关，但与远端结肠腺瘤的风险增加无关。探讨载脂蛋白E、谷胱甘肽S转移酶和亚甲基四氢叶酸还原酶基因多态性与结直肠腺瘤的关系。载脂蛋白E4等位基因与近端结肠腺瘤发病风险降低相关，血浆叶酸水平与MTFHR基因型间存在交互作用。胰岛素样生长因子IGF-I和结合蛋白IGFBP-3与结直肠癌的发生有关。特别是在调整了IGFBP-3和负荷后2小时血糖后，与血浆IGF-I水平升高相关的结直肠腺瘤的风险增加，也表明体重指数与IGF-I和IGFBP-3都有很强的相关性。后一结果提示，不同人群的体重指数与IGF-I、IGFBP-3的关系可能不同。结直肠癌和胆结石似乎在一定程度上有共同的病因，因此，对胆结石的病因学研究可能有助于揭示与结直肠癌相关的因素。虽然吸烟与胆结石无关，但饮酒被发现对形成胆结石有保护作用。没有证据表明摄入咖啡或咖啡因可以预防胆结石。研究还发现，糖尿病与肝损伤密切相关。

By incorporating a lifestyle questionnaire in the preretirement health examination in the Self Defense Forces, we have integrated an epiderniological database regarding lifestyle factors and diease prevention. Subjects were male self-defense officials mostly aged early 50s. The following results were obtained:1. An increased risk of sigmoid colon adenomas associated with diabetes mellitus had been observed previously. In two independent populations, it was consistently found that diabetes mellitus was associated with an increased risk of adenomas of the proximal colon, but not of the distal colon.2. The relation of genetic polymorphisms of apolipoprotein E, glutathione S transferase and MTHFR to colorectal adenomas was examined. Apolipoprotein E4 allele was associated with a decreased risk of proximal colon adenomas, and there was a suggestive interaction between plasma folate levels and MTFHR genotype.3. Insulin-like growth factor IGF-I and binding protein IGFBP-3 have been implicated in colorectal carcinogenesis. An increased risk of colorectal adenomas associated with elevated levels of plasma IGF-I was observed especially after adjustment for IGFBP-3 and post-load 2-hour plasma glucose, It was also shown that body mass index was strongly related to both IGF-I and IGFBP-3. The latter findings indicate that the relation of body mass index to IGF-I and IGFBP-3 may differ in different populations.4. Colorectal cancer and gallstones seem to share common etiologies partly, and thus etiological research of gallstones may shed light on factors associated with colorectal cancer. While smoking was unrelated to gallstones, alcohol use was found to be protective in the formation gallstones. There was no evidence that coffee or caffeine intake is protective against gallstones. It is also found that diabetes mellitus was strongly related to liver injury.