Int J Cancer:意外发现:AGEs摄入量与肝癌风险呈负相关!

2021-05-28 Dr.Sun Nutrition & Health MedSci原创

与预期相反,在一项大型跨国队列研究中,较高的晚期糖基化终末产物(AGEs)膳食摄入量,包括来自油炸、烤制或烤制食品中的AGEs,与肝细胞癌(HCC)风险下降相关。

与预期相反,在一项大型跨国队列研究中,较高的晚期糖基化终末产物(AGEs)膳食摄入量,包括来自油炸、烤制或烤制食品中的AGEs,与肝细胞癌(HCC)风险下降相关。

然而,作者报告说,该队列中胆囊癌的风险增加与高AGEs摄入量相关。这项研究由法国里昂国际癌症研究机构的Ana‐Lucia Mayén领导。近日,研究结果发表在International Journal of Cancer上。

肝癌是2018年全球第六大常见癌症和第四大癌症相关死亡原因。最常见的肝癌类型是肝细胞癌(HCC)。HCC的高风险地区通常位于低收入和中等收入国家,主要原因是肝炎感染和黄曲霉毒素类暴露量高。然而,在高收入国家,HCC发病率正在上升,这些国家的肝炎和黄曲霉毒素暴露并不常见。在传统上的低风险国家,据说HCC发病率上升的原因包括肥胖、2型糖尿病和非酒精性脂肪性肝病的患病率上升。肥胖和相关的代谢性疾病部分与长期的不健康生活方式和饮食选择有关,例如过度摄入能量密集和热加工食品。

经过长时间的高温加工的食物,如油炸、烧烤或烤制,是晚期糖基化终末产物(AGEs)的丰富来源。AGEs是由还原糖类和蛋白质类之间的反应形成的,它能增强食物的风味、气味和外观,但也代表了食物中的一类促氧化剂。摄入的AGEs中大约10%被认为在胃肠道中吸收,约30%的吸收量通过肾脏排泄,其余的留在体内。肝脏是吸收的膳食AGEs的主要暴露器官,AGEs也在正常代谢期间内源性产生,并随着年龄的增加而在几种类型的身体组织中不可逆转地蓄积,特别是在葡萄糖耐量受损的状态下,目前还不清楚膳食AGEs对体内AGEs总量的贡献有多大。

AGEs可能因其促炎和促氧化特性而导致肝癌发生。但是关于AGEs摄入在肝癌病因学中的作用,人类证据很少。

研究人员在欧洲癌症和营养前瞻性调查前瞻性队列(n = 450 111)中研究了饮食AGEs与肝胆管癌风险之间的关联。使用与AGEs数据库相连的国家特异性膳食问卷评估三种AGEs,Nε-羧甲基赖氨酸 (CML)、Nε-[1-羧乙基赖氨酸 (CEL)和Nδ-[5-氢-5-甲基-4-咪唑酮-2-yl]- 鸟氨酸 (MG-H1)的膳食摄入量。使用多变量Cox比例风险回归模型评估膳食AGEs与肝细胞癌(HCC)、胆囊癌和胆管癌风险之间的关联的原因别危险比(HR)及其95%置信区间(CI)。

经过14.9年的中位随访时间,研究确定了255例HCC、100例胆囊癌和173例胆管癌。较高的膳食AGEs摄入量与HCC风险呈负相关(每增加1 SD, HR-CML = 0.87, 95% CI: 0.76-0.99、HR-CEL = 0.84, 95% CI: 0.74-0.96、HR-MH-G1 = 0.84, 95% CI: 0.74-0.97)。相比之下,观察到与胆囊癌风险呈正相关(每1 SD,HR-CML = 1.28, 95% CI: 1.05-1.56、HR-CEL = 1.17; 95% CI: 0.96-1.40、HR-MH-G1 = 1.27, 95% CI: 1.06-1.54)。与肝内和肝外胆管的癌症没有观察到相关性。这一研究发现表明,较高的饮食AGEs摄入量与肝细胞癌(HCC)风险呈负相关,与胆囊癌风险呈正相关。

三节点样条,经能量调整的饮食摄入量(A)CML、(B)CEL和(C)MG-H1与肝细胞癌(HCC)风险之间的关联。

此外,研究人员发现,导致CML摄入量排名前四的食品组是谷物和谷类制品(35%)、肉和肉类制品(19%)、蛋糕和饼干(14%)和乳制品(11%)。同样,导致CEL摄入量最大的食品组是肉和肉类制品(30%)、谷物和谷类制品(24%)、蛋糕和饼干(10%)和鱼(7%),而对于MG-H1,为谷物和谷物制品(45%),蛋糕和饼干(12%),肉和肉类制品(12%)和非酒精饮料(4%)。

研究人员分析,考虑到癌症的一个主要原因是氧化应激导致脱氧核糖核酸损伤,由于较高AGEs暴露所致的非癌性肝细胞氧化应激抵抗力升高,可能为这一关于HCC的发现提供可能的解释。

摄入的AGEs很大一部分蓄积在体内。重要的是,组织和器官之间在摄入的AGEs的蓄积方面似乎存在很大差异。在小鼠模型中,已经表明饮食CML蓄积在肾脏和肠道中特别高,而肝脏中CML蓄积要低20-30倍。这表明,饮食AGEs可能不会蓄积在肝脏组织中,尽管肝脏是AGEs代谢的主要器官之一。相比之下,可以想象,这种对长期AGEs暴露的适应在胆囊中很少发生。因此,这些组织蓄积的差异可能部分地解释了该研究在癌症部位的不同发现。

总之,较高的膳食AGEs摄入量与肝细胞癌(HCC)风险呈负相关,与胆囊癌风险呈正相关,未观察到与肝内和肝外胆管癌有关。该研究关于HCC的发现与膳食AGEs可能会增加癌症风险这一主流假设相反。总体而言,证据仍然很少,与HCC风险呈负相关的原因尚不清楚。需要进一步研究,以确认这一发现。

原始出处:

Ana-Lucia Mayén, Elom K Aglago et al. Dietary intake of advanced glycation endproducts and risk of hepatobiliary cancers: A multinational cohort study. Int J Cancer. 2021 Apr 25.  doi: 10.1002/ijc.33612.  Online ahead of print.

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    2021-12-21 lmm397
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    2021-10-01 sjq027
  4. [GetPortalCommentsPageByObjectIdResponse(id=1956567, encodeId=0abe195656eaf, content=<a href='/topic/show?id=9559e976b0' target=_blank style='color:#2F92EE;'>#GES#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7976, encryptionId=9559e976b0, topicName=GES)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b632500090, createdName=h.y200607_23674418, createdTime=Fri Dec 03 08:43:10 CST 2021, time=2021-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1860701, encodeId=e1dc1860e0111, content=<a href='/topic/show?id=830b5693631' target=_blank style='color:#2F92EE;'>#摄入量#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56936, encryptionId=830b5693631, topicName=摄入量)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Tue Dec 21 10:43:10 CST 2021, time=2021-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2062012, encodeId=6fd720620121a, content=<a href='/topic/show?id=e6e1e15509f' target=_blank style='color:#2F92EE;'>#癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71550, encryptionId=e6e1e15509f, topicName=癌风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d58a435, createdName=sjq027, createdTime=Fri Oct 01 21:43:10 CST 2021, time=2021-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1009699, encodeId=ad4c10096999a, content=厉害了, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJ42hR3zb89ZzkZVKorv74I6shMF3VlGLtBZczsr6uVSjeBF7ZAU2KLicPa2NekAOGfIglm1lDVwgA/132, createdBy=01945233793, createdName=杨三, createdTime=Fri Aug 20 12:33:24 CST 2021, time=2021-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1446561, encodeId=6c131446561dc, content=<a href='/topic/show?id=dbc020961c' target=_blank style='color:#2F92EE;'>#AGEs#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2096, encryptionId=dbc020961c, topicName=AGEs)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=298b5239347, createdName=clmlylxy, createdTime=Sun May 30 01:43:10 CST 2021, time=2021-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1573255, encodeId=1c6c15e325589, content=<a href='/topic/show?id=34009226531' target=_blank style='color:#2F92EE;'>#负相关#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92265, encryptionId=34009226531, topicName=负相关)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c2115837741, createdName=hmwwww, createdTime=Sun May 30 01:43:10 CST 2021, time=2021-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=969207, encodeId=6c7996920e5c, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=327b5320850, createdName=148aa5c4m83(暂无昵称), createdTime=Fri May 28 13:53:43 CST 2021, time=2021-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1040388, encodeId=6a111040388ba, content=肝癌,接下来就要细分了,对于体质好的病人,能否将PD-1类+抗血管新生+放疗等相结合,甚至有必要用TACE进行减负, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=留走人康, createdTime=Fri May 28 13:43:10 CST 2021, time=2021-05-28, status=1, ipAttribution=)]
    2021-08-20 杨三

    厉害了

    0

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    2021-05-30 clmlylxy
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    2021-05-30 hmwwww
  7. [GetPortalCommentsPageByObjectIdResponse(id=1956567, encodeId=0abe195656eaf, content=<a href='/topic/show?id=9559e976b0' target=_blank style='color:#2F92EE;'>#GES#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7976, encryptionId=9559e976b0, topicName=GES)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b632500090, createdName=h.y200607_23674418, createdTime=Fri Dec 03 08:43:10 CST 2021, time=2021-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1860701, encodeId=e1dc1860e0111, content=<a href='/topic/show?id=830b5693631' target=_blank style='color:#2F92EE;'>#摄入量#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56936, encryptionId=830b5693631, topicName=摄入量)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Tue Dec 21 10:43:10 CST 2021, time=2021-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2062012, encodeId=6fd720620121a, content=<a href='/topic/show?id=e6e1e15509f' target=_blank style='color:#2F92EE;'>#癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71550, encryptionId=e6e1e15509f, topicName=癌风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d58a435, createdName=sjq027, createdTime=Fri Oct 01 21:43:10 CST 2021, time=2021-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1009699, encodeId=ad4c10096999a, content=厉害了, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJ42hR3zb89ZzkZVKorv74I6shMF3VlGLtBZczsr6uVSjeBF7ZAU2KLicPa2NekAOGfIglm1lDVwgA/132, createdBy=01945233793, createdName=杨三, createdTime=Fri Aug 20 12:33:24 CST 2021, time=2021-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1446561, encodeId=6c131446561dc, content=<a href='/topic/show?id=dbc020961c' target=_blank style='color:#2F92EE;'>#AGEs#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2096, encryptionId=dbc020961c, topicName=AGEs)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=298b5239347, createdName=clmlylxy, createdTime=Sun May 30 01:43:10 CST 2021, time=2021-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1573255, encodeId=1c6c15e325589, content=<a href='/topic/show?id=34009226531' target=_blank style='color:#2F92EE;'>#负相关#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92265, encryptionId=34009226531, topicName=负相关)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c2115837741, createdName=hmwwww, createdTime=Sun May 30 01:43:10 CST 2021, time=2021-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=969207, encodeId=6c7996920e5c, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=327b5320850, createdName=148aa5c4m83(暂无昵称), createdTime=Fri May 28 13:53:43 CST 2021, time=2021-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1040388, encodeId=6a111040388ba, content=肝癌,接下来就要细分了,对于体质好的病人,能否将PD-1类+抗血管新生+放疗等相结合,甚至有必要用TACE进行减负, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=留走人康, createdTime=Fri May 28 13:43:10 CST 2021, time=2021-05-28, status=1, ipAttribution=)]
    2021-05-28 148aa5c4m83(暂无昵称)

    学习了,谢谢分享

    0

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    2021-05-28 留走人康

    肝癌,接下来就要细分了,对于体质好的病人,能否将PD-1类+抗血管新生+放疗等相结合,甚至有必要用TACE进行减负

    0

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