创作:aluba 审核:aluba 2021年11月28日
  • 纳入214,797名受试者,在5,278,048人-年的随访期间,共发生3217例结直肠癌;
  • 共519名受试者摄入硫代谢微生物饮食,表现为较多地摄入低卡路里饮料、炸薯条、红肉、加工肉类,较少地摄入水果、黄色蔬菜、全谷物、豆类、绿叶蔬菜、十字花科蔬菜;
  • 校正其它风险因素后,对硫代谢微生物饮食的高依从性与结直肠癌风险增加显著相关(HR=1.27);
  • 亚组分析显示,硫代谢微生物饮食与远端(而非近端)结直肠癌风险增加显著相关。
硫代谢细菌可饮食中的硫还原为硫化氢,并与结直肠癌风险相关。JAMA Network Open上发表的一项前瞻性队列研究结果,对超过20万名受试者进行20多年的随访后发现,硫代谢微生物饮食(可导致硫代谢细菌的富集)与结直肠癌风险增加相关。
JAMA Network Open [IF:8.483]

Association Between the Sulfur Microbial Diet and Risk of Colorectal Cancer



2021-11-12, Article

Abstract & Authors:展开

Importance: Sulfur-metabolizing bacteria that reduce dietary sulfur to hydrogen sulfide have been associated with colorectal cancer (CRC). However, there are limited studies investigating the association between diet and sulfur-metabolizing bacteria in the development of CRC.
Objective: To develop a dietary score that correlates with gut sulfur-metabolizing bacteria and to examine its association with CRC risk.
Design, Setting, and Participants: This prospective cohort study included data from the Health Professionals Follow-up Study (1986-2014), Nurses' Health Study (1984-2016), and Nurses' Health Study II (1991-2017). Participants were US male health professionals and female registered nurses who were free of inflammatory bowel disease and cancer at baseline, with a subsample of participants who provided stool samples from 2012 to 2014. Statistical analysis was conducted from September 1, 2020, to June 1, 2021.
Exposure: A dietary pattern, assessed by a food-frequency questionnaire, that most correlated with 43 sulfur-metabolizing bacteria identified through taxonomic and functional profiling of gut metagenome data.
Main Outcomes and Measures: Incident CRC.
Results: Among 214 797 participants comprising 46 550 men (mean [SD] age at baseline, 54.3 [9.7] years) and 168 247 women (mean [SD] age at baseline, 43.0 [9.2] years), 3217 incident cases of CRC (1.5%) were documented during 5 278 048 person-years of follow-up. The sulfur microbial diet, developed in a subsample of 307 men (mean [SD] age, 70.5 [4.3] years) and 212 women (mean [SD] age, 61.0 [3.8] years), was characterized by high intakes of low-calorie beverages, french fries, red meats, and processed meats and low intakes of fruits, yellow vegetables, whole grains, legumes, leafy vegetables, and cruciferous vegetables. After adjustment for other risk factors, greater adherence to the sulfur microbial diet was associated with an increased risk of CRC, with a hazard ratio (HR) of 1.27 (95% CI, 1.12-1.44) comparing the highest vs the lowest quintile of the diet score (linear trend of diet score quintiles; P < .001 for trend). When assessed by anatomical subsites, greater adherence to the sulfur microbial diet was positively associated with distal CRC (HR, 1.25; 95% CI, 1.05-1.50; P = .02 for trend) but not proximal colon cancer (HR, 1.13; 95% CI, 0.93-1.39; P = .19 for trend).
Conclusions and Relevance: Adherence to the sulfur microbial diet was associated with an increased risk of CRC, suggesting a potential mediating role of sulfur-metabolizing bacteria in the associaton between diet and CRC. Further research is needed to confirm these findings and to determine the underlying mechanisms.

First Authors:
Yiqing Wang

Correspondence Authors:
Curtis Huttenhower,Andrew T Chan

All Authors:
Yiqing Wang,Long H Nguyen,Raaj S Mehta,Mingyang Song,Curtis Huttenhower,Andrew T Chan


JAMA Network Open:含硫饮食或会增加个体患结直肠癌的风险