PROSPECTIVE STUDY OF DIET AND COLORECTAL ADENOMA

结直肠腺瘤是癌症的明确前兆; 防止腺瘤的发生或生长，我们希望最终 预防癌症。因此，我们建议继续进行前瞻性研究， 在护士参与的结直肠腺瘤的饮食决定因素 健康研究和卫生专业人员随访研究。具体地说， 我们计划在队列成员中进行巢式病例对照分析， 已完成一份或多份食物频率问卷，并已提供 血液样本案件将是3,100预计男女与第一 在1,980年至2000年之间诊断出结直肠腺瘤， 是那些接受过乙状结肠镜检查或结肠镜检查呈阴性的人 在相同的时间间隔内的腺瘤。我们将获得病理报告 对所有病例确诊为腺瘤性息肉，并记录 解剖部位和息肉大小。 使用估计的营养摄入量和生化措施的基础上存档 血液，我们将解决的假设，摄入量或生物标志物的叶酸 酸与蛋氨酸和酒精消耗相互作用，并与遗传 与亚甲基四氢叶酸低活性相关的多态性 还原酶，以调节结直肠腺瘤的风险。我们将研究是否 较高的维生素D摄入量和较高的血浆水平会降低结直肠癌的发生率。 腺瘤的风险，特别是在已知的多态性的存在下， 维生素D受体基因，对应于较低的反式激活， 维生素D刺激我们还将检验腺瘤。 高体重的生长促进影响，腹部分布， 肥胖和缺乏运动是通过胰岛素和胰岛素介导的， 像生长因子水平，并将检查高的特定成分， 红肉低纤维或蔬菜的饮食模式，以评估为什么这种饮食 会增加腺瘤的风险这些假设也将被检查， 复发性腺瘤分层分析和多元Logistic回归 将用于控制潜在混杂因素并检查效应 通过肥胖、吸烟、运动、特定遗传因素以及 结直肠癌家族史，以及其他营养素。

Colorectal adenomas are well-established precursors of cancer; by preventing the occurrence or growth of adenomas, we hope ultimately to prevent cancer. Thus, we propose to continue the prospective study of dietary determinants of colorectal adenomas in participants of the Nurses' Health Study and the Health Professionals Follow-Up Study. Specifically, we plan to conduct nested case-control analyses among cohort members who have completed one or more food frequency questionnaires and have provided a blood specimen. Cases will be 3,100 projected men and women with a first diagnosis of colorectal adenoma between 1,980 and 2000, and non-cases will be those who have undergone a sigmoidoscopy or a colonoscopy negative for adenomas during the same time interval. We will obtain pathology reports to confirm the diagnosis of adenomatous polyp for all cases, and record anatomic site and polyp size. Using estimated nutrient intake and biochemical measures based on archived blood, we will address the hypothesis that intake or biomarkers of folic acid interact with methionine and alcohol consumption, and with a genetic polymorphism associated with low activity of methylene tetrahydrofolate reductase, to modulate risk of colorectal adenoma. We will examine whether higher intake and higher plasma levels of vitamin D reduce colorectal adenoma risk, particularly in the presence of known polymorphisms of the vitamin D receptor gene which correspond to lower transactivation of the vitamin D stimulus. We will also examine the hypothesis that the adenoma. growth-promoting influence of high body mass, abdominal distribution of obesity, and physical inactivity is mediated through insulin and insulin- like growth factor levels, and will examine specific components of a high red meat-low fiber or vegetable dietary pattern to assess why this diet increases the risk of adenoma. These hypotheses will also be examined for recurrent adenomas. stratified analyses and multiple logistic regression will be used to control for potential confounding and to examine effect modification by obesity, smoking, exercise, specific genetic factors, and family history-of colorectal cancer, as well as by other nutrients.