■为了澄清关于膳食大蒜消费与结直肠癌(CRC)发病率之间关系的流行病学研究结果不一致,通过前瞻性地评估美国大量人口中的关联。
■来自前列腺的58,508名参与者(55-74岁)的数据,肺,结肠直肠,和卵巢癌(PLCO)筛查试验进行了分析。使用经过验证的问卷收集饮食数据。多变量Cox回归分析确定了风险比(HR)和95%置信区间(CI)。使用限制性三次样条回归来研究非线性关系,进行亚组分析以检查潜在的效应修饰剂。
■在12.05年的中位随访期间,记录了782例CRC病例,包括456个近端结肠癌病例,322例远端CRC病例,和4例未知位点的CRC病例。适度的饮食大蒜消费与总体CRC风险降低显着相关(HRquentle3vs。1:0.70,95%CI:0.54至0.91,p=0.007,趋势为P:0.434),表现出U形剂量反应模式,在分层Cox回归模型中,男性的总体CRC也是如此(模型2:HRquintile3vs。1:0.57,95%CI:0.40至0.81,p=0.002),但不是女性。这种保护性关联在男性中更为明显,高加索人,和那些酒精消耗较低的人。值得注意的是,对整体远端CRC观察到这些保护作用(HRquentle3vs.1:0.62,95%CI:0.42至0.93,p=0.021;和HRquenttile4vs。1:0.63,95%CI:0.43至0.92,p=0.018,趋势P:0.208);男性远端CRC(HRquintile3vs。1:0.40,95%CI:0.22至0.71,p=0.002,趋势为P:0.696),但不适用于近端CRC。
■在美国人群中,适量食用大蒜与降低CRC风险有关。具有基于CRC解剖亚位点的变异。需要进一步深入的前瞻性研究来验证不同人群中的这些发现,并探索亚位点特异性关联。
UNASSIGNED: To clarify the inconsistent findings of epidemiological studies on the association between dietary
garlic consumption and colorectal cancer (CRC) incidence, by prospectively assessing the association in a large US population.
UNASSIGNED: Data of 58,508 participants (aged 55-74) from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening
Trial were analyzed. Dietary data were collected using a validated questionnaire. Multivariable Cox regression analysis determined hazard ratio (HR) and 95% confidence interval (CI). Restricted cubic spline regression was used to investigate the non-linear relationship, and subgroup analysis was conducted to examine potential effect modifiers.
UNASSIGNED: During a median follow-up of 12.05 years, 782 CRC cases were documented, including 456 proximal colon cancer cases, 322 distal CRC cases, and 4 CRC cases with an unknown site. Moderate dietary
garlic consumption was significantly associated with a reduced risk of overall CRC (HRquintile 3vs. 1: 0.70, 95% CI: 0.54 to 0.91, p = 0.007, P for trend: 0.434), exhibiting a U-shaped dose-response pattern, and also with overall CRC in males in the stratified Cox regression model (Model 2: HRquintile 3vs. 1: 0.57, 95% CI: 0.40 to 0.81, p = 0.002), but not in females. The protective association was more pronounced in men, Caucasian, and those with lower alcohol consumption. Notably, these protective effects were observed for overall distal CRC (HRquintile 3vs. 1: 0.62, 95% CI: 0.42 to 0.93, p = 0.021; and HRquintile 4vs. 1: 0.63, 95% CI: 0.43 to 0.92, p = 0.018, P for trend: 0.208); and for distal CRC in males (HRquintile 3vs. 1: 0.40, 95% CI: 0.22 to 0.71, p = 0.002, P for trend: 0.696), but not for proximal CRC.
UNASSIGNED: Moderate consumption of dietary
garlic is associated with a decreased CRC risk in the US population, with variations based on CRC anatomic subsites. Further in-depth prospective studies are needed to validate these findings in different populations and to explore subsites-specific associations.