School of Public Health, China Medical University, Shenyang, Liaoning, P. R. China.
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Int J Epidemiol. 2019 Dec 1;48(6):1863-1871. doi: 10.1093/ije/dyz146.
Epidemiological evidence on the associations between meat intake and risk of hepatocellular carcinoma (HCC) was limited and inconsistent.
We prospectively examined the association between consumption of meats and meat mutagens with HCC risk using data from the Nurses' Health Study and the Health Professionals Follow-up Study. Cox proportional-hazards regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) after adjusting for known liver-cancer risk factors.
During up to 32 years of follow-up, we documented 163 incident HCC cases. The HRs of HCC for the highest vs the lowest tertile intake levels were 1.84 (95% CI: 1.16-2.92, Ptrend = 0.04) for processed red meats and 0.61 (95% CI: 0.40-0.91, Ptrend = 0.02) for total white meats. There was a null association between unprocessed red meats and HCC risk (HR = 1.06, 95% CI: 0.68-1.63, Ptrend = 0.85). We found both poultry (HR = 0.60, 95% CI: 0.40-0.90, Ptrend = 0.01) and fish (HR = 0.70, 95% CI: 0.47-1.05, Ptrend = 0.10) were inversely associated with HCC risk. The HR for HCC risk was 0.79 (95% CI: 0.61-1.02) when 1 standard deviation of processed red meats was substituted with an equivalent amount of poultry or fish intake. We also found a suggestive positive association of intake of meat-derived mutagenicity or heterocyclic amines with risk of HCC.
Processed red meat intake might be associated with higher, whereas poultry or possibly fish intake might be associated with lower, risk of HCC. Replacing processed red meat with poultry or fish might be associated with reduced HCC risk.
关于肉类摄入量与肝细胞癌(HCC)风险之间的关联,流行病学证据有限且不一致。
我们使用来自护士健康研究和健康专业人员随访研究的数据,前瞻性地检查了肉类和肉类诱变剂的消耗与 HCC 风险之间的关联。使用 Cox 比例风险回归模型,在调整已知的肝癌风险因素后,计算危险比(HR)和 95%置信区间(CI)。
在长达 32 年的随访期间,我们记录了 163 例 HCC 病例。最高与最低三分位摄入量水平的 HCC HR 分别为加工红肉的 1.84(95%CI:1.16-2.92,Ptrend = 0.04)和总白肉的 0.61(95%CI:0.40-0.91,Ptrend = 0.02)。未加工的红肉与 HCC 风险之间无关联(HR = 1.06,95%CI:0.68-1.63,Ptrend = 0.85)。我们发现禽肉(HR = 0.60,95%CI:0.40-0.90,Ptrend = 0.01)和鱼类(HR = 0.70,95%CI:0.47-1.05,Ptrend = 0.10)与 HCC 风险呈负相关。用 1 个标准差的加工红肉代替等量的禽肉或鱼类摄入时,HCC 风险的 HR 为 0.79(95%CI:0.61-1.02)。我们还发现肉类诱变剂或杂环胺的摄入量与 HCC 风险呈正相关。
摄入加工红肉可能与更高的 HCC 风险相关,而摄入禽肉或可能的鱼类可能与更低的 HCC 风险相关。用禽肉或鱼类代替加工红肉可能与降低 HCC 风险相关。