肿瘤第一线 · 学术知识传播

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GUT 成年和青春期含糖饮料摄入量与女性早发性结直肠癌风险有关

2021-12-15 MedSci原创 MedSci原创

结肠癌是常见的发生于结肠部位的消化道恶性肿瘤,好发于直肠与乙状结肠交界处,以40~50岁年龄组发病率最高,男女之比为2~3:1。

在过去的 20 年中,许多高收入国家的早发性结直肠癌(EO-CRC,诊断时年龄<50岁)的发病率一直在上升。在 1950 年以后出生的美国人口中,EO-CRC的发病率在随后的出生队列中有所增加。与1950年左右出生的成年人相比,1990 年左右出生的人患结肠癌的风险是其两倍,直肠癌的风险是其四倍。


含糖饮料(SSB,例如软饮料、水果饮料、运动饮料和能量饮料)是美国饮食中添加糖的主要来源 (39%) 。SSB 可以在整个生命过程中产生不利的代谢影响。SSB也被认为是导致儿童肥胖和胰岛素抵抗的主要因素。有趣的是,儿童肥胖会在青春期加剧胰岛素抵抗并在之后中断葡萄糖稳态的恢复,这可能会留下持久的不良代谢后果。随着越来越多的证据支持代谢状况之间存在相互关系,包括成年和青少年肥胖以及 EO-CRC 的早发性 2 型糖尿病存在相关关系,因此,本项研究旨在探究患者整个生命过程中的 SSB 摄入量与 EO-CRC 风险之间的关系。
研究人员在美国护士健康研究II研究中,前瞻性地收集了成年和青春期 SSB 摄入量与 EO-CRC 风险之间的关联,95464名女性使用经过验证的食物频率问卷 (FFQ) 报告成年期饮料摄入量。41272 名参与者的子集使用 1998 年经过验证的高中 FFQ 报告了 13-18 岁的饮料摄入量。Cox 比例风险模型用于估计相对风险 (RR)。


本项研究最后总共收集到109 例 EO-CRC 病例,研究结果发现与成年后每周摄入<1份 SSB 的个体相比,每天摄入≥2份SSB的女性患EO-CRC的风险增加了一倍以上(RR 2.18;95% CI 1.10-4.35;P= 0.02),每份/天增加16%的风险(RR 1.16;95% CI 1.00-1.36)。13-18 岁每增加一份 SSB 摄入量与 EO-CRC 风险增加 32% 相关(RR 1.32;95% CI 1.00-1.75)。用人工加糖饮料、咖啡、低脂牛奶或全脂牛奶代替每份成人 SSB 摄入量与 EO-CRC 风险降低 17%-36%相关。


本项研究最后证实成年和青春期较高的 SSB 摄入量与女性患 EO-CRC 的风险较高有关。减少青少年和年轻人的 SSB 消费可能是减轻 EO-CRC 日益增加的潜在策略。

原始出处:
Jinhee Hur. Et al. Sugar-sweetened beverage intake in adulthood and adolescence and risk of early-onset colorectal cancer among women FREE. GUT.2021.

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    2022-09-17 lmm397
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    2022-11-16 sjq027
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