Lin Jennifer, Zhang Shumin M, Cook Nancy R, Manson JoAnn E, Lee I-Min, Buring Julie E
Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02215, USA.
Am J Epidemiol. 2005 Apr 15;161(8):755-64. doi: 10.1093/aje/kwi101.
In vivo and in vitro studies have suggested a protective role of calcium and vitamin D in the development of colorectal cancer. However, epidemiologic data have been inconclusive. The authors prospectively assessed intakes of calcium and vitamin D in relation to risk of colorectal cancer in a large, prospective, female cohort from the US Women's Health Study. In 1993, 39,876 women aged > or = 45 years and free of cardiovascular disease and cancer were enrolled in the study. During an average follow-up of 10 years, 223 of 36,976 women eligible for the present study developed colorectal cancer. Intakes of calcium and vitamin D from dietary sources and supplements were assessed with a baseline food frequency questionnaire. Cox proportional hazards regression was used to estimate relative risks and 95% confidence intervals. Intakes of total calcium and vitamin D were not associated with risk of colorectal cancer; multivariate relative risks comparing the highest with the lowest quintile were 1.20 (95% confidence interval: 0.79, 1.85; p for trend = 0.21) for total calcium and 1.34 (95% confidence interval: 0.84, 2.13; p for trend = 0.08) for total vitamin D. Intakes of both nutrients from specific types of sources, including diet and supplements, were also not significantly associated with colorectal cancer risk. Data provide little support for an association of calcium and vitamin D intake with colorectal cancer risk.
体内和体外研究表明钙和维生素D在结直肠癌发生过程中具有保护作用。然而,流行病学数据尚无定论。作者在美国女性健康研究中的一个大型前瞻性女性队列中,前瞻性评估了钙和维生素D的摄入量与结直肠癌风险的关系。1993年,39876名年龄≥45岁且无心血管疾病和癌症的女性纳入该研究。在平均10年的随访期间,36976名符合本研究条件的女性中有223人患了结直肠癌。通过基线食物频率问卷评估饮食来源和补充剂中钙和维生素D的摄入量。采用Cox比例风险回归估计相对风险和95%置信区间。总钙和维生素D的摄入量与结直肠癌风险无关;总钙最高五分位数与最低五分位数相比的多变量相对风险为1.20(95%置信区间:0.79,1.85;趋势p值=0.21),总维生素D为1.34(95%置信区间:0.84,2.13;趋势p值=0.08)。特定来源类型(包括饮食和补充剂)的两种营养素摄入量也与结直肠癌风险无显著关联。数据几乎不支持钙和维生素D摄入量与结直肠癌风险之间存在关联。