苏黎世大学最新研究:三种简单方式可让70岁以上老年人患癌风险降低61%!

2022-04-28 四五七 MedSci原创

Frontiers in Aging:通过三种简单方式——2000IU/天的维生素D、1克/天的omega-3s再加上简单的力量锻炼,就能够使70岁以上老年人

癌症被认为是一种衰老相关的疾病,人到中年,多种癌症发生风险开始上升。

在美国,所有死于癌症的人中,超过90%的癌症被诊断于50岁以上的中老年人,40岁以下的只占1.7%。

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图注:5种常见癌症以及2种最常见的白血病在各年龄段的发生率
图源:National Cancer Institute (www.seer.cancer.gov)

衰老和癌症之间存在着一些共同的生物学机制,衰老标志物如基因组不稳定性以及表观遗传改变,同样是癌症标志物,随着衰老引起的慢性炎症发生、免疫功能下降,为细胞恶变、增殖和转移提供了条件。

然而衰老并不总是伴随着癌症发生,一个很有意思的现象是,那些活得最久的百岁老人很少有患癌的,他们安度晚年,自然老死。

虽说百岁老人不常有,但如果我们选择健康的生活方式、降低风险因素甚至延缓衰老速度,或许能很大程度地避免老年患癌的结局。

近期,来自瑞士苏黎世大学的研究团队最新研究就为我们提供了一条思路:通过三种简单方式——2000IU/天的维生素D、1克/天的omega-3s(常见于深海鱼类和某些植物的不饱和脂肪酸)再加上简单的力量锻炼,就能够使70岁以上老年人患癌风险下降61%!该研究于4月25日发表在Frontiers in Aging。

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前期的机理实验表明,维生素D能够调节细胞增殖分化从而抑制肿瘤生长;omega-3s可以降低炎症水平、减少新生血管形成、诱导酸性癌细胞铁死亡;运动降低炎症、提高免疫功能,在观察性试验中,显示运动能够降低癌症风险,增加癌症病人存活率。

遗憾的是,在预防癌症的人体试验中,维生素D及omega-3s的效果并不显著,甚至有时候得到的结果是“毫无作用”,与前期的细胞、动物实验结果大相径庭。

但研究人员并不轻易放弃,我们知道在癌症治疗的过程中,常常会几种治疗手段或药物联用。那么,预防癌症能不能采用同样的思路,几种预防方式联用,使微小的预防效益累积起来达到可观的效果?

基于此,于是便诞生了这项旨在探究不同干预措施单独或联合应用预防癌症效果的研究,又称为DO-HEALTH试验。

研究人员在瑞士、法国、德国、奥地利和葡萄牙5个国家开展了为期3年的试验,共纳入2157名健康参与者,平均年龄在74.9岁,体力、认知能力良好。

为了测试“2000IU/天的维生素D、1克/天的omega-3s、简单的力量锻炼”这三种干预措施单独及合用的预防效果,参与者被随机分配到8个不同的组:

第一组:2000IU/天的维生素D+1克/天的omega-3s+简单的力量锻炼

第二组:2000IU/天的维生素D+1克/天的omega-3s

第三组:2000IU/天的维生素D+简单的力量锻炼

第四组:2000IU/天的维生素D

第五组:1克/天的omega-3s+简单的力量锻炼

第六组:1克/天的omega-3s

第七组:简单的力量锻炼

第八组:安慰剂组(试验组服用维生素D和omega-3s,安慰剂组服用葵花籽油,这些胶囊的外观和味道一模一样)

简单的力量锻炼包括:

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参与者在加入试验初期及其后第一、二、三年,每年进行一次临床身体检查,并且每3个月会接受一次电话回访。

试验结束时,共有81名参与者确诊为新发癌症,和安慰剂组相比:

单独服用维生素D,侵袭性癌症风险降低了24%(HR 0.76,0.49–1.18)

单独服用omega-3s,侵袭性癌症风险降低了30%(HR 0.70,0.44–1.09)

单独进行简单力量训练,侵袭性癌症风险降低了26%(HR 0.74,0.48–1.15)

维生素D、omega-3s联合简单力量训练,侵袭性癌症总体风险降低了61%(HR 0.39, 0.18–0.85)

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尽管这项试验作为一项以癌症为试验终点的研究来说,样本量还不够大,时间跨度也不够长,但表明了多种预防癌症方法联合使用,是有累加效果的,最终能够使癌症风险降低至具有统计学意义。

研究人员Bischoff-Ferrari表示,目前除了戒烟和防晒等预防性的建议外,面向中老年人的癌症预防工作主要是癌症筛查以及疫苗接种。

这是第一个随机对照实验,证明每日补充2000IU/天的维生素D、1克/天的omega-3s配合简单的力量锻炼能够有效预防70岁以上老年人罹患侵袭性癌症的风险。

考虑到未来人口老龄化很可能会造成老年癌症患者激增,给个人、家庭和社会带来沉重的医疗、经济负担,预防癌症的重要性越发显著,“治已病”还要“治未病”。

 

参考资料

[1]Combined Vitamin D, Omega-3 Fatty Acids, and a Simple Home Exercise Program May Reduce Cancer Risk Among Active Adults Aged 70 and Older: A Randomized Clinical Trial. https://www.frontiersin.org/articles/10.3389/fragi.2022.852643/full

[2]Laconi E, Marongiu F, DeGregori J. Cancer as a disease of old age: changing mutational and microenvironmental landscapes. Br J Cancer. 2020;122(7):943-952. doi:10.1038/s41416-019-0721-1

[3]White MC, Holman DM, Boehm JE, Peipins LA, Grossman M, Henley SJ. Age and cancer risk: a potentially modifiable relationship. Am J Prev Med. 2014;46(3 Suppl 1):S7-S15. doi:10.1016/j.amepre.2013.10.029

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    2022-09-22 贵阳
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    2023-01-05 sjq027
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    2022-04-29 lq0307
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    2022-04-28 weigq

    ???

    0

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    2022-04-28 15938038573红旗飘飘

    已学习已分享

    0

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细胞分裂是控制巨噬细胞渗透的关键过程,这确实是一个非常优雅的概念,具有强大的意义。