多不饱和植物脂肪饮食可降低患肝癌的风险

StephenW

Diets high in polyunsaturated, vegetable fats reduce liver cancer risk

Yang W, et al. Clin Gastroenterol Hepatol. 2019;doi:10.1016/j.cgh.2020.01.003.
January 10, 2020

Diets consisting of higher vegetable fat and polyunsaturated fat intake correlated with a lower risk for hepatocellular carcinoma, including cases in which individuals replaced other animal, dairy, or saturated fats with vegetable and polyunsaturated fats, according to data.

While HCC rates continue to increase in the U.S., approximately 35% of cases cannot be explained by currently known risk factors, such as hepatitis B and hepatitis C, alcohol intake, smoking, and metabolic disorders, according to Wanshui Yang, PhD, from Brigham and Women’s Hospital and Harvard Medical School in Boston, Massachusetts, and colleagues.
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“Identifying other modifiable factors such as diet to prevent development of HCC is crucial to decrease the morbidity and mortality of HCC,” they wrote. “We investigated the associations of total and specific dietary fats, and fats from different food sources with risk of developing HCC.”

Using data from two previously published studies comprised of 138,483 men and women, the researchers found that intake levels of energy percentage from animal fats decreased in both men and women between 1986 and 2010, while the consumption of energy percentage from vegetable fats increased during the same period.

Yang and colleagues identified 160 incident cases of HCC during an average follow-up of 26.6 years. Multivariate analysis showed that intake of vegetables fats (HR = 0.61; 95% CI, 0.39-0.96) correlated with a lower HCC risk compared with no such association for animal and dairy fats. Additionally, replacing animal or dairy fats with the equivalent amount of vegetable fats lowered HCC risk (HR = 0.79; 95% CI, 0.65-0.97).

Intake of monounsaturated fats (HR = 0.76; 95% CI, 0.47-1.25) and polyunsaturated fats (HR = 0.71; 95% CI, 0.46-1.08), including both n-3 and n-6 polyunsaturated fatty acids, showed similar HCC risk reduction.

Although there was no association between saturated fat intake and HCC risk, replacing saturated fats with an equivalent amount of monounsaturated or polyunsaturated fats correlated with a lowered risk (HR = 0.77; 95% CI, 0.64-0.92).

Yang and colleagues noted that similar studies have shown inconsistent findings regarding the correlation between dietary fats and HCC risk, and suggested that this may be in part due to different intake levels and food sources of fats among different study populations.

“Given the limited number of HCC cases and inconsistent results in previous studies, more studies are warranted to confirm our findings, ideally with pooled analysis across cohorts in different populations,” they concluded. “These findings, if validated, have important public health and clinical relevance.” – by Talitha Bennett

Disclosures: Yang reports receiving grants and personal fees from Bayer Pharma AG and personal fees from Pfizer and Janssen. The remaining authors report no relevant financial disclosures.

StephenW

多不饱和植物脂肪饮食可降低患肝癌的风险

杨威，等。 Castro Gastroenterol Hepatol。 2019; doi：10.1016 / j.cgh.2020.01.003。
2020年1月10日

根据数据，高植物脂肪和多不饱和脂肪摄入量的饮食与肝细胞癌的风险较低相关，包括个体用植物和多不饱和脂肪替代其他动物，乳制品或饱和脂肪的情况。

Brigham的Wanshui Yang博士表示，尽管在美国，HCC发病率持续上升，但大约35％的病例无法用目前已知的危险因素来解释，例如乙型肝炎和丙型肝炎，饮酒，吸烟和代谢紊乱。马萨诸塞州波士顿的妇女医院和哈佛医学院以及同事。
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他们写道：“确定其他可调节因素，例如饮食以预防肝癌的发展，对于降低肝癌的发病率和死亡率至关重要。” “我们调查了总和特定饮食中的脂肪，以及来自不同食物来源的具有发展为HCC风险的脂肪之间的联系。”

利用之前发表的两项研究中的138,483名男性和女性的数据，研究人员发现，在1986年至2010年之间，男性和女性中动物脂肪的能量摄入百分比均下降，而同一时期植物脂肪的能量消耗百分比则上升了。期。

Yang和他的同事在平均26.6年的随访中发现了160例HCC事件。多变量分析表明，与动物脂肪和乳制品脂肪没有这种关联相比，摄入植物脂肪（HR = 0.61； 95％CI，0.39-0.96）与较低的HCC风险相关。此外，用等量的植物脂肪代替动物脂肪或乳制品脂肪可降低HCC风险（HR = 0.79； 95％CI，0.65-0.97）。

显示单不饱和脂肪（HR = 0.76; 95％CI，0.47-1.25）和多不饱和脂肪（HR = 0.71; 95％CI，0.46-1.08）的摄入量，包括n-3和n-6多不饱和脂肪酸类似的降低HCC风险。

尽管饱和脂肪摄入与HCC风险之间没有关联，但用等量的单不饱和或多不饱和脂肪替代饱和脂肪与降低的风险相关（HR = 0.77; 95％CI，0.64-0.92）。

Yang及其同事指出，相似的研究显示出饮食脂肪与HCC风险之间的相关性不一致，并暗示这可能部分是由于不同研究人群之间脂肪的摄入量和食物来源不同所致。

他们总结说：“鉴于以前的研究中HCC病例的数量有限且结果不一致，因此有必要进行更多的研究来证实我们的发现，理想的情况是对不同人群的人群进行汇总分析。” “这些发现如果得到验证，将具有重要的公共卫生和临床意义。” – Talitha Bennett

披露：Yang报告说从拜耳制药公司获得赠款和个人费用，并从辉瑞公司和扬森公司获得个人费用。其余作者报告没有相关财务披露。