护士健康研究和卫生专业人员随访研究中肉类诱变剂与结直肠癌的前瞻性分析。
A Prospective Analysis of Meat Mutagens and Colorectal Cancer in the Nurses' Health Study and Health Professionals Follow-up Study.
作者信息
Le Ngoan Tran, Michels Fernanda Alessandra Silva, Song Mingyang, Zhang Xuehong, Bernstein Adam M, Giovannucci Edward L, Fuchs Charles S, Ogino Shuji, Chan Andrew T, Sinha Rashmi, Willett Walter C, Wu Kana
机构信息
Department of Occupational Health, Hanoi Medical University, Hanoi, Vietnam.
出版信息
Environ Health Perspect. 2016 Oct;124(10):1529-1536. doi: 10.1289/EHP238. Epub 2016 Apr 22.
BACKGROUND
Heterocyclic amines (HCAs) in cooked meats may play a role in colorectal cancer (CRC) development.
OBJECTIVES
We aimed to prospectively examine the association between estimated intakes of HCAs and meat-derived mutagenicity (MDM) in two cohorts of health professionals, the Health Professionals Follow-up Study (HPFS) and the Nurses' Health Study (NHS).
METHODS
In 29,615 men and 65,875 women, intake of the HCAs 2-amino-3,8-dimethylimidazo(4,5-j)quinoxaline (MeIQx), 2-amino-1-methyl-6-phenylimidazo(4,5-b)pyridine (PhIP), 2-amino-3,4,8-trimethylimidazo(4,5-f)quinoxaline (DiMeIQx), and MDM was estimated using a 1996 cooking questionnaire, the 1994 food frequency questionnaire, and an online database. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) and to adjust for potential confounders. Estimates for both cohorts were pooled using random-effects meta-analysis.
RESULTS
Between 1996 and 2010, 418 male and 790 female CRC cases were identified. Meat mutagen intake was not statistically significantly associated with risk of CRC [highest vs. lowest quintile, pooled HR (95% CI) for MeIQx: 1.12 (0.93, 1.34), p for trend 0.23; PhIP: 1.10 (0.90, 1.33), p for trend 0.35; MDM: 1.03 (0.86, 1.24), p for trend 0.75] or subtypes of CRC defined by tumor location (proximal or distal colon, or rectum). When analyzed by source of meat, PhIP from red but not from white meat was nonsignificantly positively associated with CRC and significantly positively associated with proximal cancers [HR (95% CI) per standard deviation increase of log-transformed intake: PhIP red meat: CRC: 1.06 (0.99, 1.12), proximal: 1.11 (1.02, 1.21); PhIP white meat: CRC: 0.99 (0.94, 1.04), proximal: 1.00 (0.93, 1.09)].
CONCLUSIONS
Estimated intakes of meat mutagens were not significantly associated with CRC risk over 14 years of follow-up in the NHS and HPFS cohorts. Results for PhIP from red but not from white meat warrant further investigation.
CITATION
Le NT, Michels FA, Song M, Zhang X, Bernstein AM, Giovannucci EL, Fuchs CS, Ogino S, Chan AT, Sinha R, Willett WC, Wu K. 2016. A prospective analysis of meat mutagens and colorectal cancer in the Nurses' Health Study and Health Professionals Follow-up Study. Environ Health Perspect 124:1529-1536; http://dx.doi.org/10.1289/EHP238.
背景
熟肉中的杂环胺（HCAs）可能在结直肠癌（CRC）的发生发展中起作用。
目的
我们旨在前瞻性地研究健康专业人员随访研究（HPFS）和护士健康研究（NHS）这两个队列中，估计的杂环胺摄入量与肉类致突变性（MDM）之间的关联。
方法
在29615名男性和65875名女性中，使用1996年烹饪问卷、1994年食物频率问卷和一个在线数据库来估计杂环胺2-氨基-3,8-二甲基咪唑并[4,5-j]喹喔啉（MeIQx）、2-氨基-1-甲基-6-苯基咪唑并[4,5-b]吡啶（PhIP）、2-氨基-3,4,8-三甲基咪唑并[4,5-f]喹喔啉（DiMeIQx）的摄入量以及肉类致突变性。使用Cox比例风险模型来估计风险比（HRs）和95%置信区间（CIs），并对潜在混杂因素进行调整。使用随机效应荟萃分析对两个队列的估计值进行合并。
结果
在1996年至2010年期间，共确定了418例男性和790例女性结直肠癌病例。肉类诱变剂摄入量与结直肠癌风险无统计学显著关联[最高五分位数与最低五分位数相比，MeIQx的合并HR（95%CI）：1.12（0.93，1.34），趋势p值为0.23；PhIP：1.10（0.90，1.33），趋势p值为0.35；MDM：1.03（0.86，1.24），趋势p值为0.75]，也与根据肿瘤位置定义的结直肠癌亚型（近端或远端结肠，或直肠）无关联。按肉类来源分析时，红肉中的PhIP而非白肉中的PhIP与结直肠癌呈非显著正相关，与近端癌症呈显著正相关[每标准差增加的对数转换摄入量的HR（95%CI）：红肉中的PhIP：结直肠癌：1.06（0.99，1.12），近端：1.11（1.02，1.21）；白肉中的PhIP：结直肠癌：0.99（0.94，1.04），近端：1.00（0.93，1.09）]。
结论
在NHS和HPFS队列14年的随访中，估计的肉类诱变剂摄入量与结直肠癌风险无显著关联。红肉中PhIP的结果值得进一步研究。
引用文献
Le NT, Michels FA, Song M, Zhang X, Bernstein AM, Giovannucci EL, Fuchs CS, Ogino S, Chan AT, Sinha R, Willett WC, Wu K. 2016. A prospective analysis of meat mutagens and colorectal cancer in the Nurses' Health Study and Health Professionals Follow-up Study. Environ Health Perspect 124:1529-1536; http://dx.doi.org/10.1289/EHP238.
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