血浆同型半胱氨酸水平和生活饮食习惯与胃癌发病风险的关联研究

王莉娜; 柯巧; 陈文森; 周炎; 谈永飞; 王建明; 华召来; 王山喜; 徐耀初; 沈靖; 沈洪兵

Abstract

王莉娜,柯巧,陈文森,周炎,谈永飞,王建明,华召来,王山喜,徐耀初,沈靖,沈洪兵.血浆同型半胱氨酸水平和生活饮食习惯与胃癌发病风险的关联研究[J].Chinese journal of Epidemiology,2007,28(6):528-531

血浆同型半胱氨酸水平和生活饮食习惯与胃癌发病风险的关联研究

Study 0n the association between total plasma homocysteine levels, dietary habits and the risk of gastric cancer

DOI：

KeyWord: 胃肿瘤流行病学同型半胱氨酸吸烟饮酒

English Key Word: Gastric neoplasms Epidemiology Homocysteine smoking Drinking

FundProject:国家自然科学基金资助项目(30571605、30271148);江苏省自然科学基金资助项目(BK2005143)

Author Name	Affiliation	E-mail
WANG Li-na	Department of Epidemiology and Biostatistics, Cancer Reserch Centre for Najing Medical University, Nanjing 210029, China
KE Qiao	Department of Epidemiology and Biostatistics, Cancer Reserch Centre for Najing Medical University, Nanjing 210029, China
CHEN Wen-sen	Department of Epidemiology and Biostatistics, Cancer Reserch Centre for Najing Medical University, Nanjing 210029, China
ZHOU Yan	宜兴市人民医院
TAN Yong-fei	宜兴市人民医院
WANG Jian-ming	扬中市肿瘤研究所
HUA Zhao-lai	扬中市肿瘤研究所
WANG Shan-xi	Department of Epidemiology and Biostatistics, Cancer Reserch Centre for Najing Medical University, Nanjing 210029, China
XU Yao-chu	Department of Epidemiology and Biostatistics, Cancer Reserch Centre for Najing Medical University, Nanjing 210029, China
SHEN Jing	Department of Epidemiology and Biostatistics, Cancer Reserch Centre for Najing Medical University, Nanjing 210029, China
SHEN Hong-bing	Department of Epidemiology and Biostatistics, Cancer Reserch Centre for Najing Medical University, Nanjing 210029, China	hbshen@njmu.edu.cn

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Abstract:

目的探讨江苏省扬中和宜兴市胃癌高发区人群血浆总同型半胱氨酸(tHcy)水平、生活饮食习惯与胃癌易感性的关系。方法采用以人群为基础的病例对照研究。经组织学确诊的高发区胃腺癌病例391例, 并选择与病例年龄和性别频数匹配的人群对照608例, 通过酶转换法定量检测血浆tHcy的浓度, 比较不同tHcy水平与胃癌风险的关系, 并探讨摄入蔬菜、水果、吸烟、饮酒等因素在其中的影响。结果胃癌患者血浆tHcy平均水平显著高于对照组(P=0.002)。同时按照正常对照组人群的血浆tHcy四分位数(7/9、10.1、13/7弘nmI/L)分类, 以血浆tHcy≤7/9 umol／L为参照组, 随着tHcy的增加, 罹患胃癌的风险分别增加67％(调整OR=1.67, 95%a:1.12～2.48)、98%(调整OR=1.98, 95%CI:1.33～2.94)和112％(调整0R=2.12, 95%CI:1.44～3.15), 并且呈现显著的递增趋势(Y2=15.78, P<0.001)。同时摄入蔬菜、水果相对较多时可降低胃癌的发病风险。叉生分析表明, 较少摄入蔬菜、水果、吸烟和饮酒者同时血浆tHcy>15.0 umol/L时罹患胃癌的风险比两种因素单独作用时的风险增强, 但交互作用不显著。结论血浆高水平tHcy可增加罹患胃癌的风险, 同时较少摄入蔬菜、水果、吸烟和饮酒等不良饮食生活习惯均可增加患病风险。

English Abstract:

Objective To explore the relationship between total plasma homocysteine(tHcy)levels, dietary habits and susceptibility of gastric cancer(GC)in Yangzhong and Yixing cities, the two high GC risk areas in Jiangsu province.Methods A population-based case-control study was conducted including 391 histologically-confirmed adenocarcinoma GC cases and 608 age and sex frequency-matched Cancer free controls.The plasma tHcy concentration was measured by enzymatic biochemical assay of homocysteine on microtiter plates, using crude lysate containing recombinant methionine γ一lyase. The relationship between different tHcy levls and risk of GC was analyzed and factors as vegetables and fruits intake, smoking and drinking status were also evaluated together with tHcy levels on the risk of GC.ResultsThe average tHcy 1evels in GC cases were significantly higher than that in controls(P=O.002).In addition, according to the quartile levels(7.9, lo.1, 13.7 μmol/L)in the controls, the risks of GC had an increase of 67%(adjusted OR=1.67, 95%CI:1.12-2.48), 98%(adjusted OR=1.98, 95%CI：1.33-2.94)and 112%(adjusted OR=2.12, 95%CI:1.44-3.15)compared to the 10west quartile of tHcy(≤7.9 μmol/L), respectively while the increasing trend was significantly noticed(x²=15.78, P15.μmol/L could increase the GC risk, when compared to the effect on GC risk of each factor.Conclusion These findings supported the hypothesis that the high level of plasma tHcy and the badness dietary habits were associated to the increased risk of GC.Further larger scale and genetics involved studies on the environment and genetic factors were needed to confirm our findings.

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