Abstract：
BACKGROUND: Evidence of an association between dietary fiber intake and risk of advanced and aggressive forms of prostate cancer (PC) and PC mortality is limited.
OBJECTIVE: The aim of this study was to examine associations between intakes of dietary fiber overall and by food source and risk of advanced and aggressive forms of PC.
METHODS: The study design was a pooled analysis of the primary data from 15 cohorts in 3 continents. Baseline dietary fiber intake was assessed using a validated food frequency questionnaire or diet history in each study.
METHODS: There were 842 149 men followed for up to 9 to 22 years between 1985 and 2009 across studies.
METHODS: The primary outcome measures were advanced (stage T4, N1, or M1 or PC mortality), advanced restricted (excluded men with missing stage and those with localized PC who died of PC), and high-grade PC (Gleason score ≥8 or poorly differentiated/undifferentiated) and PC mortality.
METHODS: Study-specific multivariable hazard ratios (MVHR) were calculated using Cox proportional hazards regression and pooled using random effects models.
RESULTS: Intake of dietary fiber overall, from fruits, and from vegetables was not associated with risk of advanced (n = 4863), advanced restricted (n = 2978), or high-grade PC (n = 9673) or PC mortality (n = 3097). Dietary fiber intake from grains was inversely associated with advanced PC (comparing the highest vs lowest quintile, MVHR 0.84; 95% CI 0.76-0.93), advanced restricted PC (MVHR 0.85; 95% CI 0.74-0.97), and PC mortality (MVHR 0.78; 95% CI 0.68-0.89); statistically significant trends were noted for each of these associations (P ≤ .03), and a null association was observed for high-grade PC for the same comparison (MVHR 1.00; 95% CI 0.93-1.07). The comparable results were 1.06 (95% CI 1.01-1.10; P value, test for trend = .002) for localized PC (n = 35,199) and 1.05 (95% CI 0.99-1.11; P value, test for trend = .04) for low/intermediate grade PC (n = 34 366).
CONCLUSIONS: Weak nonsignificant associations were observed between total dietary fiber intake and risk of advanced forms of PC, high-grade PC, and PC mortality. High dietary fiber intake from grains was associated with a modestly lower risk of advanced forms of PC and PC mortality.
OBJECTIVE: The aim of this study was to examine associations between intakes of dietary fiber overall and by food source and risk of advanced and aggressive forms of PC.
METHODS: The study design was a pooled analysis of the primary data from 15 cohorts in 3 continents. Baseline dietary fiber intake was assessed using a validated food frequency questionnaire or diet history in each study.
METHODS: There were 842 149 men followed for up to 9 to 22 years between 1985 and 2009 across studies.
METHODS: The primary outcome measures were advanced (stage T4, N1, or M1 or PC mortality), advanced restricted (excluded men with missing stage and those with localized PC who died of PC), and high-grade PC (Gleason score ≥8 or poorly differentiated/undifferentiated) and PC mortality.
METHODS: Study-specific multivariable hazard ratios (MVHR) were calculated using Cox proportional hazards regression and pooled using random effects models.
RESULTS: Intake of dietary fiber overall, from fruits, and from vegetables was not associated with risk of advanced (n = 4863), advanced restricted (n = 2978), or high-grade PC (n = 9673) or PC mortality (n = 3097). Dietary fiber intake from grains was inversely associated with advanced PC (comparing the highest vs lowest quintile, MVHR 0.84; 95% CI 0.76-0.93), advanced restricted PC (MVHR 0.85; 95% CI 0.74-0.97), and PC mortality (MVHR 0.78; 95% CI 0.68-0.89); statistically significant trends were noted for each of these associations (P ≤ .03), and a null association was observed for high-grade PC for the same comparison (MVHR 1.00; 95% CI 0.93-1.07). The comparable results were 1.06 (95% CI 1.01-1.10; P value, test for trend = .002) for localized PC (n = 35,199) and 1.05 (95% CI 0.99-1.11; P value, test for trend = .04) for low/intermediate grade PC (n = 34 366).
CONCLUSIONS: Weak nonsignificant associations were observed between total dietary fiber intake and risk of advanced forms of PC, high-grade PC, and PC mortality. High dietary fiber intake from grains was associated with a modestly lower risk of advanced forms of PC and PC mortality.
摘要：
背景：膳食纤维摄入与晚期和侵袭性前列腺癌（PC）和PC死亡率之间的关系的证据有限。
目的：研究膳食纤维的总体摄入量和食物来源与晚期和侵袭性PC风险之间的关系。
方法：对三大洲15个队列的主要数据进行汇总分析。在每个研究中使用经过验证的食物频率问卷或饮食史评估基线膳食纤维摄入量。
方法：在1985-2009年期间，对842,149名男性进行了长达9-22年的随访。
方法：主要结局指标为晚期（T4、N1或M1或PC死亡率），高级限制（不包括缺少舞台的男性和因PC死亡的本地化PC的男性），高级（格里森评分≥8或低分化/未分化）PC，和PC死亡率。
方法：使用Cox比例风险回归计算特定研究的多变量风险比（MVHR），并使用随机效应模型进行汇总。
结果：总体膳食纤维摄入量，从水果,和蔬菜与晚期风险无关(n=4863)，高级限制(n=2,978)，或高级别PC（n=9,673）或PC死亡率（n=3,097）。谷物中的膳食纤维摄入量与高级PC成反比（MVHR比较最高与最低五分位数=0.84，95%置信区间[CI]0.76-0.93)，高级受限PC(MVHR=0.85，95CI0.74-0.97)，和PC死亡率（MVHR=0.78，95CI0.68-0.89）；这些关联中的每一个都有统计学上的显着趋势（p≤0.03），而在相同的比较中，高级PC的相关性为零（MVHR=1.00，95CI0.93-1.07）。可比结果为1.06（95CI1.01-1.10，p值，局部（n=35,199）和1.05（95CI0.99-1.11，，p值,趋势测试=0.04)对于低/中等等级(n=34,366)PC。
结论：观察到总膳食纤维摄入量与高级形式PC的风险之间存在弱的非显著关联，高档PC,和PC死亡率。从谷物中摄入高膳食纤维与PC晚期形式和PC死亡率的风险适度降低相关。
目的：研究膳食纤维的总体摄入量和食物来源与晚期和侵袭性PC风险之间的关系。
方法：对三大洲15个队列的主要数据进行汇总分析。在每个研究中使用经过验证的食物频率问卷或饮食史评估基线膳食纤维摄入量。
方法：在1985-2009年期间，对842,149名男性进行了长达9-22年的随访。
方法：主要结局指标为晚期（T4、N1或M1或PC死亡率），高级限制（不包括缺少舞台的男性和因PC死亡的本地化PC的男性），高级（格里森评分≥8或低分化/未分化）PC，和PC死亡率。
方法：使用Cox比例风险回归计算特定研究的多变量风险比（MVHR），并使用随机效应模型进行汇总。
结果：总体膳食纤维摄入量，从水果,和蔬菜与晚期风险无关(n=4863)，高级限制(n=2,978)，或高级别PC（n=9,673）或PC死亡率（n=3,097）。谷物中的膳食纤维摄入量与高级PC成反比（MVHR比较最高与最低五分位数=0.84，95%置信区间[CI]0.76-0.93)，高级受限PC(MVHR=0.85，95CI0.74-0.97)，和PC死亡率（MVHR=0.78，95CI0.68-0.89）；这些关联中的每一个都有统计学上的显着趋势（p≤0.03），而在相同的比较中，高级PC的相关性为零（MVHR=1.00，95CI0.93-1.07）。可比结果为1.06（95CI1.01-1.10，p值，局部（n=35,199）和1.05（95CI0.99-1.11，，p值,趋势测试=0.04)对于低/中等等级(n=34,366)PC。
结论：观察到总膳食纤维摄入量与高级形式PC的风险之间存在弱的非显著关联，高档PC,和PC死亡率。从谷物中摄入高膳食纤维与PC晚期形式和PC死亡率的风险适度降低相关。
