J Natl Cancer Inst:营养干预能抗肿瘤?能延长寿命?

2018-12-04 吴星 环球医学

有研究证明,依靠营养干预的作用,能控制或降低慢性疾病发生的风险,达到维护和增进健康的目的。2018年11月,发表在《J Natl Cancer Inst.》的一项5.25年中国林县营养干预试验的25年试验后随访调查了,营养干预对总死亡率和癌症死亡率的影响。

有研究证明,依靠营养干预的作用,能控制或降低慢性疾病发生的风险,达到维护和增进健康的目的。2018年11月,发表在《J Natl Cancer Inst.》的一项5.25年中国林县营养干预试验的25年试验后随访调查了,营养干预对总死亡率和癌症死亡率的影响。

背景:观察到硒、维生素E和β-胡萝卜素对中国人群总死亡率和癌症死亡率有获益影响,且获益在干预后仍持续10年,但是否会持续长久尚不清楚。

方法:1986年至1991年在中国林县开展一项随机、双盲、安慰剂对照试验;29584例年龄在40岁至69岁的居民基于析因设计每天使用补充剂:A类因素(视黄醇/锌)、B类因素(核黄素/烟酸)、C类因素(维生素C /钼)和/或D类因素(硒/维生素E /β-胡萝卜素),或安慰剂,为期5.25年,随访至25年。使用Cox比例风险模型,估算干预对死亡影响的风险比(HRs)和95%置信区间(CIs)。

结果:至2016年,干预对总死亡率没有影响。既往报告的D类因素对总死亡率的保护作用在干预后10年丧失。D类因素对癌的保护作用衰减(HR = 0.93,95% CI = 0.85~1.01),但发现B类因素对食管癌的保护作用凸显(HR = 0.92,95% CI = 0.85~1.00,双边P = 0.04)。观察到其他特定原因死亡的保护/不良相关性。在基线年龄低于55岁的人群中,观察到A类因素对非上消化道癌死亡的保护作用(HR = 0.80,95% CI = 0.69~0.92),C类因素对卒中死亡的保护作用(HR = 0.89,95% CI = 0.82~0.96)。相比,55岁后开始C类因素(HR = 1.16,95% CI = 1.04~1.30)和D类因素(HR = 1.20,95% CI = 1.07~1.34)干预,食管癌风险增加。

结论:即使在营养不良的人群中,多年营养干预也不太可能在补充结束十多年后对死亡率产生有意义的影响。维持或重复干预是否会提供更长的效果需要进一步的研究。

原始出处:

Wang SM, Taylor PR, Fan JH, et al. Effects of Nutrition Intervention on Total and Cancer Mortality: 25-Year Post-trial Follow-up of the 5.25-Year Linxian Nutrition Intervention Trial. J Natl Cancer Inst. 2018 Nov 1;110(11):1229-1238. doi: 10.1093/jnci/djy043.

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    2019-07-08 qidongfanjian
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    2019-03-04 drj2003
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    2019-09-28 liye789132251
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