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目的已有研究显示,维生素D(Vitmin D,Vit D)与多种肿瘤发病相关,而膳食摄入是人体获得Vit D的重要途径,本研究采用病例对照研究及膳食调查法探讨膳食Vit D摄入对非小细胞肺癌(non-small cell lung cancer,NSCLC)发病风险的影响。方法采用1∶1配对病例对照研究方法,选择2014-12-15-2015-03-28青岛大学附属医院(58例)和青岛大学附属海慈医院(116例)及平度市中医医院(26例)确诊的200例NSCLC患者,选取同时期3家医院健康体检中心性别、年龄(±3岁)匹配的200名健康查体者为对照,通过包含79条项目的食物频率问卷(food frequency questionnaire,FFQ)调查研究对象既往1年膳食Vit D摄入情况。条件Logistic回归分析Vit D摄入量对NSCLC发病风险的影响,χ2趋势检验分析两者之间的剂量-反应关系。结果病例组和对照组膳食Vit D日平均摄入量分别为(5.41±1.19)μg和(7.53±1.58)μg,差异有统计学意义,Z=3.87,P<0.001。单因素条件logistic回归分析显示,与Vit D摄入量最低四分位组(Vit D摄入量<4μg/d)相比,第2分位组(Vit D摄入量4~7μg/d)的OR(95%CI)值为0.67(0.37~1.18)、第3分位组(Vit D摄入量7~10μg/d)OR(95%CI)值为0.56(0.32~0.97)、第4分位组(Vit D摄入量>10μg/d)OR(95%CI)值为0.48(0.27~0.85),随着膳食Vit D日平均摄入量的增加,NSCLC发病的OR值逐渐下降,两者之间存在剂量-反应关系,χ2=45.28,P<0.001。在校正体质指数、教育程度、家庭收入、肿瘤家族史、户外活动、吸烟、被动吸烟、接受饮食健康指导、维生素A、维生素C、维生素E及硒的日平均摄入量后,上述负性关联仍然存在,与Vit D摄入量最低四分位组相比,第2分位组调整OR(95%CI)值为0.71(0.43~0.94)、第3分位组调整OR(95%CI)值为0.54(0.34~0.71)、第4分位组调整OR(95%CI)值为0.39(0.24~0.64)。结论膳食Vit D摄入不足增加NSCLC发病风险。
OBJECTIVE Studies have shown that vitamin D (Vit D) is associated with a variety of oncological diseases, and dietary intake is an important way for the body to obtain Vit D. In this study, case-control study and dietary survey were used to investigate the effects of dietary Vit D Into the non-small cell lung cancer (non-small cell lung cancer, NSCLC) risk. Methods A matched case-control study was conducted with a 1: 1 ratio and selected 2014-12-15-2015-03-28 Affiliated Hospital of Qingdao University (58 cases) and Qingdao University Affiliated Haitai Hospital (116 cases) and Pingdu City Hospital of Traditional Chinese Medicine (26 cases) For example, 200 patients with NSCLC diagnosed were enrolled in this study. 200 healthy subjects matched by gender and age (± 3 years) from 3 hospitals in the same period were selected as control. The food frequency questionnaire (79 items) , FFQ) Surveyed dietary vitamin D intake for the previous year. Conditional Logistic regression analysis of Vit D intake on the incidence of NSCLC risk, χ2 trend test analysis of the dose-response relationship between the two. Results The average dietary vitamin D daily intake of patients and controls were (5.41 ± 1.19) μg and (7.53 ± 1.58) μg, respectively, with a significant difference (Z = 3.87, P <0.001). Univariate conditional logistic regression analysis showed that in the second quintile (Vit D intake 4-7 μg / d) compared with the lowest quartile Vit D (Vit D intake <4 μg / d) OR (95% CI) was 0.67 (0.37-1.18), OR (95% CI) was 0.56 (0.32-0.97) in the third quintile (Vit D intake 7-10μg / d) OR (95% CI) was 0.48 (0.27-0.85) in quantile group (Vit D intake> 10μg / day). The OR value of NSCLC decreased gradually with the increase of dietary Vit D daily intake, There was a dose-response relationship between the two, χ2 = 45.28, P <0.001. The above negative correlation was observed after adjusting for the daily average intake of body mass index, education level, family income, family history of cancer, outdoor activities, smoking, passive smoking, dietary health guidance, vitamin A, vitamin C, vitamin E and selenium (95% CI) was 0.71 (0.43-0.94) in the second quintile, and OR (95% CI) in the third quintile, compared with the lowest quartile of vitamin D intake Value of 0.54 (0.34 ~ 0.71), the fourth sub-group adjusted OR (95% CI) value of 0.39 (0.24 ~ 0.64). Conclusion Inadequate dietary vitamin D increases the risk of NSCLC.