膳食维生素D摄入与非小细胞肺癌发病风险的病例对照研究

Dietary intake of vitamin D and risk of non-small cell lung cancer:A case control study

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,P10μg/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＆lt;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 Vitamin D（Vit D） has been reported to be associated with several tumors, and dietary intake is the main source of Vit D. The objective of this study was to explore the association between dietary intake of Vit D and risk of non-small cell lung cancer （NSCLC）. METHODS From December 15th, 2014 to March 28th, 2015, a 1 ： 1 matched case control study was conducted. Respondents included 200 NSCLC cases （58 cases from the Affiliated Hospital of Qingdao University, 116 cases from Qingdao University Affiliated Hiser Hospital, 26 cases from Pingdu Hospital of Traditional Chinese Medicine）, and 200 sex- and age-matched （± 3 years） controls from the physical examination center of the same hospital. Face to face interviews were performed to get the information on covariates. The habitual dietary intake was determined by a 79-item food frequency questionnaire. Conditional logistic regression was adapted to analysis the association between dietary intake of Vit D and the risk of NSCLC. Trend of chi-square test was adapted to analysis dose-response relationship between them. RESULTS The dietary intake of vitamin D in NSCLC patients was （5. 41±1.19） μg, which was lower compared with （7.53±1.58） μg in controls（z= 3.87,P〈0. 001）. The univariate logistic analysis showed that the NSCLC odds ratios （95%CI） for the quartile 2 was 0. 67（0. 37-1.18） , for the quartile 3 was 0. 56（0. 32-0. 97） , for the quartile 4 was 0. 48（0. 27-0. 85） , according to the lowest quartile of Vit D dietary intake. There is a dose-response relationship between NSCLC odds ratios and Vit D dietary intake. With the increasing of Vit D dietary intake, the odds ratios of NSCLC dropped. After adjustment for potential covariates in demography, socioeconomics, health behaviors, body mass index and some nutrients, the negtive associations was still significant. According to the lowest quartile of Vit D dietary intake, the adjusted odds ratios for the quartile 2 was 0. 71（0. 43-0. 94） , for the quartile 3 was 0. 54（0. 34-0. 71） , for the quartile 4 was 0. 39（0. 24-0. 64）. CONCLUSION Deficiency in dietary intake of vitamin D is associated with higher risk of NSCLC.