背景:除了酒精和咖啡,其他饮食因素之间的关系,包括特定的蔬菜和水果,和肝脏的结果仍然知之甚少。
目的:评估水果和蔬菜摄入与肝癌风险和慢性肝病(CLD)死亡率之间的关系。
方法:本研究基于美国国立卫生研究院-美国退休人员协会饮食与健康研究,包括1995年至1996年年龄在50-71岁之间的485,403名参与者。使用经过验证的食物频率问卷估计水果和蔬菜的摄入量。Cox比例风险回归用于估计肝癌发病率和CLD死亡率的多变量风险比(HR)和95%置信区间(CI)。
结果:在15.5年的中位随访期间,确认了947例肝癌和986例CLD死亡(肝癌除外)。蔬菜总摄入量较高与肝癌风险较低相关(HRQuintile5vs.五等1=0.72,95%CI:0.59,0.89;Ptrend<0.001)。当进一步细分为植物学组时,观察到的逆关联主要是由莴苣和十字花科(西兰花,花椰菜,卷心菜,卷心菜等。)(Ptrend<0.005)。此外,较高的蔬菜总摄入量与较低的CLD死亡率风险相关(HRQuintile5与Quintile1=0.61,95%CI:0.50,0.76;Ptrend<0.001)。观察到生菜的反向关联,红薯,十字花科蔬菜,豆类,和具有CLD死亡率的胡萝卜(所有Ptrend<0.005)。相比之下,总水果摄入量与肝癌或CLD死亡率无关.
结论:总蔬菜摄入量较高,尤其是生菜和十字花科蔬菜,与较低的肝癌风险相关。生菜的摄入量较高,红薯,十字花科蔬菜,豆类,胡萝卜与CLD死亡风险较低相关。
Beyond alcohol and coffee, the relationship between other dietary factors, including specific vegetables and fruits, and liver outcomes remains poorly understood.
To evaluate the associations between fruit and vegetable intake with the risk of liver cancer and chronic liver disease (CLD) mortality.
This
study was based on the National Institutes of Health-American Association of Retired Persons Diet and Health
Study, including 485,403 participants aged 50-71 y from 1995 to 1996. Fruit and vegetable intake was estimated using a validated food frequency questionnaire. Cox proportional hazards regression was used to estimate the multivariable hazard ratios (HR) and 95% confidence intervals (CI) for liver cancer incidence and CLD mortality.
During a median follow-up of 15.5 y, 947 incident liver cancers and 986 CLD deaths (other than liver cancer) were confirmed. A higher intake of total vegetables was associated with a lower risk of liver cancer (HRQuintile 5 vs. Quintile 1 = 0.72, 95% CI: 0.59, 0.89; Ptrend < 0.001). When further subclassified into botanical groups, the observed inverse association was mainly driven by lettuce and the cruciferous family (broccoli, cauliflower, cabbage, etc.) (Ptrend < 0.005). Additionally, higher total vegetable intake was associated with a lower risk of CLD mortality (HRQuintile5 vs. Quintile1 = 0.61, 95% CI: 0.50, 0.76; Ptrend < 0.001). Inverse associations were observed for
lettuce, sweet potatoes, cruciferous vegetables, legumes, and carrots with CLD mortality (all Ptrend < 0.005). In contrast, total fruit intake was not associated with liver cancer or CLD mortality.
Higher intakes of total vegetables, especially
lettuce and cruciferous vegetables, were associated with lower liver cancer risk. Higher intakes of
lettuce, sweet potatoes, cruciferous vegetables, legumes, and carrots were associated with a lower risk of CLD mortality.