硒元素与口腔癌发病关联的病例对照研究

目的 探讨硒元素与口腔癌发病的关联。方法 采用病例对照的研究方法,收集福建医科大学附属第一医院口腔颌面外科经手术病理确诊的口腔癌新发患者325例作为病例组,同期经性别、年龄频数匹配的医院的体检人群和社区健康人群共650名作为对照组。应用非条件logistic回归计算硒元素与口腔癌发病风险的aOR及其95% CI,并进行分层分析和相乘交互作用分析。结果 病例组血清硒水平［112.42（80.98～145.06） μg/L］低于对照组［164.85（144.44～188.53） μg/L］,差异有统计学意义（P<0.01）。无论是否吸烟、是否饮酒及摄入水果、鱼类的频次多少,血清硒与口腔癌的发病风险均存在负相关关系（P<0.05）。血清硒与吸烟、饮酒、摄入水果、鱼类之间在口腔癌的发生中存在相乘交互作用。结论 高水平血清硒是口腔癌发病的保护因素,且血清硒与吸烟、饮酒、摄入水果和摄入鱼类存在相乘交互作用,故减少烟酒消耗和适量增加水果鱼类的摄入可一定程度降低口腔癌的发病风险。     

基于倾向性评分匹配法评估血清铬对口腔癌发病的影响

  目的   经倾向性评分匹配法(propensity score matching, PSM)均衡组间协变量后, 评估血清铬(Chromium, Cr)对口腔癌(oral cancer, OC)发病的影响。   方法   采用病例对照研究, 收集2010年1月-2018年12月在福建医科大学附属第一医院新发确诊的395例OC患者为病例组, 选取同期社区健康人群1 240例为对照组, 并利用PSM设计, 按1:1匹配从对照组中选取与病例随机匹配的309名对照者。采用条件Logistic回归分析模型探讨Cr元素与OC发病的关系。   结果   病例组血清Cr水平178.91(121.83~284.19)μg/L, 低于对照组324.27(264.82~397.69)μg/L, 差异有统计学意义(P < 0.001)。剂量-反应分析表明, 随着血清Cr含量的增高, 患OC的风险逐渐下降, 呈明显负相关关系。条件Logistic回归分析模型结果显示, 相比于Q1组, Q2、Q3、Q4组血清Cr调整后的OR值分别为0.14(0.08~0.26)、0.15(0.08~0.28)和0.10(0.05~0.20), 且存在血清Cr含量越高保护作用越强的趋势(P_trend < 0.001)。无论是否吸烟、是否饮茶、摄入鱼类、水果、绿色蔬菜频次的多少及不饮酒人群中, 血清Cr与OC发病风险均呈负相关关系。   结论   高水平血清Cr可能是OC发病的保护因素, 且血清Cr浓度越高, OC的发病风险越低。     

中链饱和脂肪酸与口腔癌发病风险的关联性

  目的  探讨膳食中链饱和脂肪酸与口腔癌发病的关联。  方法  本病例对照研究以面访式问卷的形式调查2013年11月14日至2019年3月21日在福建医科大学附属第一医院口腔颌面外科确诊的225例新发口腔癌患者及527例健康对照。以对照组中能量校正后的各类脂肪酸每日摄入量的中位数进行分组,进行非条件Logistic回归分析模型分析、分层分析及相乘交互作用分析。  结果  高水平组的总中链饱和脂肪酸、辛酸、癸酸、十一烷酸及月桂酸等与口腔癌的发病风险呈正相关,其调整后的OR值及其95% CI值分别为3.19(95% CI: 2.17~4.69)、2.54(95% CI: 1.75~3.69)、2.56(95% CI: 1.76~3.71)、5.00(95% CI: 3.27~7.64)和3.09(95% CI: 2.10~4.54)。在不吸烟者中,辛酸和癸酸与口腔癌发生风险呈正相关,且无论是否饮酒,其均能增加口腔癌的发病风险;各亚组均发现高总中链饱和脂肪酸、十一烷酸及月桂酸摄入量与口腔癌发生风险呈正相关。此外,中链饱和脂肪酸与吸烟、饮酒存在相乘交互作用。  结论  较高水平的膳食中链饱和脂肪酸可能会增加口腔癌的发病风险。     

膳食因素与吸烟者和非吸烟者舌癌发病的关系

目的探讨膳食因素对吸烟和非吸烟人群舌癌发病的影响。方法采用病例-对照研究方法,收集2011年12月—2016年3月福州市某医院经病理学确诊的舌癌新发病例251例,同期收集来自福州市某社区的健康对照1382例。面访调查研究对象的吸烟、饮酒史以及一年前的膳食情况等内容,应用非条件Logistic回归模型计算膳食因素与舌癌发病风险的调整OR值及其95%CI,并进行吸烟与食畜肉类之间的相乘交互作用分析。结果进食鱼类≥3次/周、海鲜类≥1次/周、奶类及奶制品≥1次/周、绿叶蔬菜和非绿叶蔬菜≥1次/天以及新鲜水果≥3次/周均可降低舌癌的发病风险。按是否吸烟分层后,鱼类、海鲜类以及绿叶蔬菜和非绿叶蔬菜对舌癌的保护作用在吸烟人群中更加显著。而进食畜肉类≥3次/周仅与吸烟者舌癌的发病相关(调整OR=1.55,95%CI 1.02~2.34),且吸烟与食畜肉类存在正相乘交互作用(OR相乘=2.08,95%CI 1.43~3.03)。结论适量摄入新鲜的蔬菜水果、鱼及海鲜类、奶类及奶制品,以及在吸烟者中减少畜肉类的过量摄入可减少舌癌的发生。     

基于主成分分析的膳食脂肪酸模式与口腔癌的关系

  目的  探讨膳食脂肪酸模式与口腔癌发病的关联。  方法  采用病例对照研究设计，收集2013年11月14日至2019年3月21日在福建医科大学附属第一医院口腔颌面外科确诊的225例口腔癌新发病例以及同期在该医院进行健康体检的524例对照。应用主成分分析确定人群的膳食脂肪酸模式，并通过非条件Logistic回归分析模型计算膳食脂肪酸模式与口腔癌发病风险的OR值及其95% CI值。  结果  主成分分析共提取了6种膳食脂肪酸模式。以人群中占比最大的模式6(己酸、十三烷酸为主)为参照组，模式1(以长链饱和脂肪酸和单不饱和脂肪酸为主)和模式2(中链饱和脂肪酸和多不饱和脂肪酸为主)均可降低口腔癌的发病风险，其调整后的OR值及其95% CI值分别为0.47(95% CI:0.25~0.86)、0.45(95% CI:0.21~0.98)，其他模式未观察到与口腔癌发病风险有关联(均有P>0.05)。  结论  相对于以己酸、十三烷酸为主的模式6，以长链饱和脂肪酸和单不饱和脂肪酸为主的模式1和以中链饱和脂肪酸和多不饱和脂肪酸为主的模式2与口腔癌的发病风险呈负相关。科学合理摄入脂肪酸，可能降低口腔癌的发病风险。     

嚼槟榔与口腔癌关系的病例对照研究

目的 分析口腔癌发病的危险因素,并进一步探讨嚼槟榔与口腔癌的关系。 方法 采用以医院为基础的1:1病例对照研究方法,对2014年在湘潭市某综合医院确诊的口腔癌病例及同期该院其他科室就诊的非口腔疾病、非肿瘤病人共100对进行问卷调查。采用条件logistic回归对资料进行分析,计算OR值及95%CI,并分析嚼槟榔与吸烟、饮酒的交互作用。 结果 单因素条件logistic回归分析结果:吸烟(OR=3.441,95%CI:1.671～7.001,P=0.001)、饮酒(OR=3.010,95%CI:1.497～6.063,P=0.002)、嚼槟榔(OR=3.340,95%CI:1.423～7.844,P=0.006)是口腔癌的危险因素;而多因素条件logistic回归分析结果:吸烟(OR=2.700,95%CI:1.289～5.656,P=0.008)、饮酒(OR=2.257,95%CI:1.071～4.756,P=0.032)是口腔癌的危险因素,但未发现嚼槟榔(OR=2.070,95%CI:0.790～4.758,P=0.139)能独立升高口腔癌的发病风险。交互作用分析结果:嚼槟榔与吸烟(OR_相乘交互=0.696,95%CI:0.140～1.465,P=0.658)、饮酒(OR_相乘交互=1.416,95%CI:0.318～6.300,P=0.648)间不存在相乘交互作用。相加交互作用:嚼槟榔与吸烟之间不存在相加交互作用,相对超危险度比(RERI)的95%CI(-1.573～2.225),归因比(AP)的95%CI(-0.364～0.514)包括0,且交互作用指数(S)的95%CI (0.589～2.087)包括1。但嚼槟榔与饮酒之间存在相加交互作用,嚼槟榔且饮酒患口腔癌的危险性是不嚼槟榔不饮酒的5.034倍,RERI为2.263、AP为0.449、S为2.275。 结论 嚼槟榔、吸烟、饮酒都是口腔癌的主要危险因素。嚼槟榔与饮酒存在相加交互作用,可增加饮酒患口腔癌的发病风险。     

鸡蛋摄入与非酒精性脂肪肝病患病风险的病例对照研究

  目的   探讨鸡蛋摄入与非酒精性脂肪肝病（non-alcoholic fatty liver disease,NAFLD）患病风险的关系,为NAFLD的防控提供流行病学依据。   方法   收集2015年4月―2017年8月在南平市第一医院体检中心进行健康检查的体检者数据,以腹部彩超确诊的541名病例和按年龄性别随机抽取的541名对照进行病例对照研究。采用统一编制的结构式调查问卷及半定量食物频数问卷面对面调查研究对象的一般行为特征及膳食摄入情况。多因素非条件Logistic回归分析模型计算OR值及其95%CI,探索鸡蛋摄入与NAFLD患病风险的关系。   结果   与每天摄入鸡蛋相比,鸡蛋摄入频率为0患NAFLD的风险增高,其调整的OR值及其95% CI为1.86（95% CI:1.10~3.15）。敏感分析结果及亚组分析均显示从不摄入鸡蛋仍然是NAFLD的危险因素。   结论   从不摄入鸡蛋可能增高NAFLD的患病风险。     

AIF-1基因多态性、体质指数与口腔癌发病风险的关联研究

目的 探讨同种异体移植炎症因子-1（allograft inflammatory factor-1,AIF-1）基因多态性、体质指数（body mass index,BMI）及其交互作用与口腔癌易感性的关系。方法 采用病例对照研究,收集2010年9月~2016年12月经病理确诊的新发口腔癌患者300例及同期该医院体检人群445例。应用TaqMan探针技术检测AIF-1基因的单核苷酸多态性（single nucleotide polymorphisms,SNPs）。采用非条件Logistic回归分析计算比值比（odd ratios,OR）值及95%可信区间（confidence intervals,CI）,分析AIF-1基因多态性、BMI及其交互作用与口腔癌易感性的关系。结果 GG基因型在共显性模型（OR=0.522,95%CI:0.319～0.855）和隐性模型（OR=0.573,95%CI:0.368～0.893）中均可降低口腔癌的发病风险。进一步的分层分析表明GG基因型在男性、BMI≥24.0 kg/m2、吸烟、非饮酒亚组中同样可降低口腔癌的发病风险。此外,结果还显示BMI<18.5 kg/m2可增大口腔癌的发病风险,而BMI≥24.0 kg/m2则是口腔癌的保护因素,并且AIF-1基因与BMI之间存在相乘交互作用。结论 AIF-1基因rs2857595基因SNPs和BMI≥24.0 kg/m2能降低口腔癌的发病风险,且rs2857595与BMI存在相乘交互作用。     

顺德地区不同性别人群的肝癌影响因素分析

  目的  探讨顺德地区不同性别人群肝癌的影响因素,并了解男性肝癌影响因素的交互作用。  方法  应用交互效应超额相对危险度（relative excess risk of interaction,RERI）等指标评价两因素的交互作用,应用分类回归树（classification and regression tree,CART）模型评价多因素的交互作用。  结果  共纳入1 037例男性病例、1 069男性对照以及166例女性病例、185例女性对照。乙型肝炎病毒（hepatitis B virus,HBV）慢性感染和肝癌家族史均与男女性肝癌发病风险增高有统计学关联（均有P<0.001）。男性中,HBV慢性感染与吸烟、饮酒以及吸烟与饮酒之间存在正相加交互作用,其中HBV慢性感染与吸烟的RERI为121.90（95%CI:52.85%~190.95%）。运动与HBV慢性感染、吸烟之间有负相加交互作用。CART分析表明吸烟且饮酒的HBV慢性感染男性的肝癌风险最高。  结论  HBV慢性感染和肝癌家族史是男女性肝癌的共同危险因素。HBV慢性感染、吸烟和饮酒协同促进男性肝癌发病。运动可拮抗HBV慢性感染和吸烟的促肝癌效应。     

孤啡肽与孕期并发症的交互作用对产后抑郁症影响

  目的   探讨血清孤啡肽（orphanin FQ,OFQ）与孕期并发症及其交互作用对产后抑郁症（postpartum depression,PPD）影响。   方法   收集银川市与中卫市两所医院200名待产孕妇,应用酶联免疫分析法（enzyme-linked immuno sorbent assay,ELISA）测定血清OFQ水平,采用自行设计的问卷调查家庭因素及孕期并发症,采用爱丁堡产后抑郁量表（Edinburg postnatal depression scale,EPDS）评估产后42 d抑郁状况。   结果   产后抑郁症组血清OFQ水平48.52（37.56,57.13）pg/ml高于对照组18.37（16.63,25.35）pg/ml,差异有统计学意义（Z=-6.761,P< 0.001）。婆媳关系较差（P=0.014）、有孕期并发症（χ2=6.505,P=0.011）的产妇抑郁检出率高。非条件Logistic回归分析模型分析显示,血清OFQ（OR=21.464,95% CI:6.859~67.167,P< 0.001）与孕期并发症（OR=3.600,95% CI:1.013~12.794,P=0.048）为PPD的危险因素,交互作用模型分析显示血清OFQ与孕期并发症之间存在交互作用（OR=2.229,P=0.021）。   结论   血清OFQ与孕期并发症是PPD的危险因素,两者同时存在时可增加PPD发生的危险性。     

Folate intake, serum homocysteine and methylenetetrahydrofolate reductase (MTHFR) C677T genotype are not associated with oral cancer risk in Puerto Rico

We examined the relationships between folate and methionine intake, serum homocysteine levels (as a biomarker for folate metabolism), and methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism genotype and risk of oral cancer in a population-based, case-control study in Puerto Rico. Structured questionnaires were used to collect information on demographic factors, usual adult diet, and tobacco and alcohol use. Oral epithelial cells and blood samples were collected from a subset of subjects. Analyses were conducted by logistic regression, adjusting for age, sex, lifetime smoking and lifetime alcohol intake, with the following numbers of cases/controls, respectively: dietary data (341/521); MTHFR genotype (148/149); and homocysteine (60/90). Although increased folate intake was associated with decreased oral cancer risk [adjusted odds ratio (OR) in highest vs. lowest quartile = 0.6, 95% confidence interval (CI): 0.4, 1.0, P(trend) = 0.05)], this finding was due almost entirely to folate intake from fruit (adjusted OR = 0.4, 95% CI: 0.2, 0.6; P(trend) = 0.0001), whereas other dietary folate sources showed no clear association. Methionine intake and serum homocysteine levels were not associated with oral cancer risk. Subjects with the MTHFR C677T homozygous variant (TT) genotype had a nonsignificantly lower risk, and risk patterns tended to differ by level of folate, methionine, alcohol intake and smoking, although the power to detect significant associations in subgroups of these variables was low. Risks for oral cancer are not folate specific; preventive recommendations for this disease should emphasize the importance of a healthy diet, including substantial intake of fruits.     

Associations of dietary dark-green and deep-yellow vegetables and fruits with cervical intraepithelial neoplasia: modification by smoking

Smoking has been positively and fruit and vegetable intake has been negatively associated with cervical cancer, the second most common cancer among women worldwide. However, a lower consumption of fruits and reduced serum carotenoids have been observed among smokers. It is not known whether the smoking effect on the risk of cervical neoplasia is modified by a low intake of fruits and vegetables. The present study examined the combined effects of tobacco smoking and diet using a validated FFQ and serum carotenoid and tocopherol levels on cervical intraepithelial neoplasia grade 3 (CIN3) risk in a hospital-based case-control study conducted in S?o Paulo, Brazil, between 2003 and 2005. The sample comprised 231 incident, histologically confirmed cases of CIN3 and 453 controls. A low intake ( ≤ 39 g) of dark-green and deep-yellow vegetables and fruits without tobacco smoking had a lesser effect on CIN3 (OR 1·14; 95 % CI 0·49, 2·65) than among smokers with higher intake ( ≥ 40 g; OR 1·83; 95 % CI 0·73, 4·62) after adjusting for confounders. The OR for the joint exposure of tobacco smoking and low intake of vegetables and fruits was greater (3·86; 95 % CI 1·74, 8·57; P for trend < 0·001) compared with non-smokers with higher intake after adjusting for confounding variables and human papillomavirus status. Similar results were observed for total fruit, serum total carotene (including β-, α- and γ-carotene) and tocopherols. These findings suggest that the effect of nutritional factors on CIN3 is modified by smoking.     

Food and nutrient intake differences between smokers and non-smokers in the US.

Data from the Second National Health and Nutrition Examination Survey were analyzed to determine food and nutrient intake differences between current smokers (also categorized as light, moderate, and heavy smokers) and non-smokers. Smokers in several age-race-sex categories have lower intakes of vitamin C, folate, fiber, and vitamin A than non-smokers, and intake tended to decrease as cigarette consumption increased, particularly for vitamin C, fiber, and folate. Smokers were less likely to have consumed vegetables, fruits (particularly fruits and vegetables high in vitamins C and A), high fiber grains, low fat milk, and vitamin and mineral supplements than non-smokers. A negative linear trend was found between smoking intensity and intake of several categories of fruits and vegetables. These data suggest that the high cancer risk associated with smoking is compounded by somewhat lower intake of nutrients and foods which are thought to be cancer protective.     

蔬菜水果摄入与前列腺癌风险的Meta分析

目的 系统评价蔬菜水果摄入与前列腺癌(prostate cancer,PCa)风险之间的关系,为前列腺癌的预防策略提供相关依据.方法 计算机检索Pubmed、Embase、Web of science数据库,查找评价蔬菜和/或水果摄入与前列腺癌风险之间关系的队列研究以及相关文献,对纳入的文献进行质量评级,采用R软件(4...     

Folate status of adults living in the Canary Islands (Spain)

BACKGROUND AND AIM: Human studies support the hypothesized contribution of folate deficiency to carcinogenesis and vascular risk. We assess the nutritional folate status and its relationship to folate intake, smoking, alcohol consumption, oral contraceptive use, and multivitamin supplements. METHODOLOGY: A representative sample of 601 individuals from 18 to 75 years of age was selected from the participants in the Canary Islands Nutrition Survey. A food frequency questionnaire was administered. Serum and erythrocyte levels of folate were determined using a method of automated ionic capturing. RESULTS: Mean serum and red cell folate were 8.2 ng/mL and 214.3 ng/mL, respectively. Only one individual had serum folate below 3 ng/mL, and 21.7% showed moderate deficits (3-6 ng/mL); 10.7% of the sample had erythrocyte folate levels falling below 140 ng/mL, 61.3% between 140 and 240 ng/mL and the remaining 27.9% above 240 ng/mL. A positive significant association was observed between these two folate measurements, as well as between folate intake and each of these biomarkers (p < 0.001). Tobacco consumption was negatively correlated with folate status (p < 0.001). Alcohol consumption, oral contraceptive, and vitamin supplement use were not associated with serum and red cell folate levels. CONCLUSIONS: Even though nutritional folate status can be considered minimally acceptable, it may reflect the low level of fruit and vegetable consumption within the Canary Islands population.     

1982年与2012年中国6~17岁儿童蔬菜水果摄入比较

  目的  分析1982年与2012年我国6~17岁儿童蔬菜水果摄入量及其变化特征。  方法  以1982年全国营养调查18 237名与2012年中国居民营养与健康状况监测中的5 819名6~17岁儿童为对象,分别用称重记账法与3 d 24 h膳食调查法收集儿童食物摄入情况,分析并比较两个年份学龄儿童的蔬菜与水果摄入量及达到WHO推荐摄入量的情况。  结果  学龄儿童蔬菜摄入量从1982年的300.4 g下降到2012年的185.8 g(Z=45.9, P＜0.001);学龄儿童水果摄入量由1982年的28.2 g增加到2012年的45.9 g(Z=36.8, P＜0.001)。学龄儿童蔬菜水果总摄入量达到WHO推荐量80%及以上的比例由1982年的42.2%下降到2012年的21.6%(χ2 =809.9, P＜0.001)。1982年和2012年,男生蔬菜摄入量均高于女生,且随年龄增长而升高;水果摄入量均为城市儿童高于农村儿童。  结论  2012年与1982年相比,我国6~17岁儿童蔬菜摄入量下降较多,水果摄入量有所增加,2012年与1982年儿童蔬菜与水果摄入量均不足,建议采取综合干预措施提高儿童蔬菜与水果的消费,促进其健康成长。     

外周血白细胞端粒长度与轻度认知障碍老年人发生风险关联的病例对照研究

目的探讨轻度认知障碍(mild cognitive impairment,MCI)老年人外周血白细胞端粒长度(leukocyte telomere length,LTL)与MCI发生风险之间的关联。方法于2017年10月―2017年12月在天津市南开区王顶堤街道的5个社区纳入MCI和健康对照老年受试者进行病例对照设计,实施问卷调查和静脉血样采集,用实时荧光定量多聚核苷酸链式反应(real-time quantitative polymerase chain reaction,qPCR)进行LTL的测量。采用多元Logistic回归分析模型分析LTL不同水平与MCI发生风险之间的关联。结果两组受试对象都为183例。MCI组LTL水平(1.44±0.23)低于对照组(1.66±0.23),两组差异具有统计学意义(Z=-8.94,P<0.001)。调整年龄、性别、教育程度、吸烟、饮酒、糖尿病、高血压、心脏病后,较低水平LTL与MCI发生风险存在统计学意义关联(均有P<0.05);与LTL第一水平组相比,其二、三、四水平组MCI发生风险的比值比(odds ratio,OR)及95%置信区间(95%confidence interval,95%CI)分别为0.262(0.130~0.531)、0.088(0.043~0.180)、0.083(0.040~0.169)。结论外周血白细胞短端粒可能是MCI发生的独立危险因素,并且随着LTL缩短,MCI发生风险增加。     

Case-control analysis of dietary folate and risk of bladder cancer

Dietary folate, a water-soluble B vitamin found in a variety of fruits and vegetables, is of particular interest as a chemopreventive agent due to its role in DNA methylation and DNA synthesis and repair. We hypothesized that individuals with low folate intake would be at an increased risk for bladder cancer. Using an ongoing case-control study we assessed dietary folate in 409 incident bladder cancer patients and 451 healthy control subjects. A food-frequency questionnaire was used to estimate naturally occurring food folate (microg/kcal/day), dietary folate equivalents (DFE) from food sources (microg DFE/kcal/day), and DFE from all sources (microg DFE/kcal/day). Unconditional logistic regression analyses were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Bladder cancer patients reported a statistically significant lower intake of folate than control subjects for food folate and DFE from food sources (P < 0.001) but not for DFE from all sources (P = 0.061). In the highest quartile of food folate intake there was a 54% reduced risk for bladder cancer (OR = 0.46; 95% CI = 0.29-0.73) after adjusting for age, gender, ethnicity, smoking, and total energy intake. Similarly, the highest quartile of intake was associated with a 59% reduced risk for DFE from food sources (OR = 0.41; 95% CI = 0.26-0.65) and a 35% reduced risk for DFE from all sources (OR = 0.65; 95% CI = 0.42-1.00). In the joint-effects analyses using never smokers with high folate intake as the reference group (OR = 1.0), heavy smokers with low food folate intake had a 2.31-fold (95% CI = 1.11-4.82) increased risk, whereas heavy smokers with high folate intake had a reduced OR of 1.31 (95% CI = 0.53-3.26). Although the ORs were not statistically significant, light smokers and high folate intake exhibited a protective effect (OR = 0.62; 95% CI = 0.20-1.94), whereas an increased risk was observed for light smoking and low folate intake (OR = 1.41; 95% CI = 0.57-3.45). These patterns were consistent for the joint effects of smoking and DFE from food sources and DFE from all sources. In summary, high intake of dietary folate was associated with an overall decrease in bladder cancer risk. These data may have important implications for cancer prevention; however, large, hypothesis-driven, population-based clinical trials will be required to confirm these findings.