目的 基于美国国家健康与营养调查（NHANES）大样本队列数据,探究复合膳食抗氧化指数（composite dietary antioxidant index, CDAI）与女性特异性恶性肿瘤的流行病学关联,为女性癌症防控的膳食策略优化提供循证依据。方法 纳入2013–2023年NHANES中12 624例≥20岁女性（平均年龄51.2岁）,基于两次24 h膳食回顾数据计算CDAI（整合维生素A、C、E、锌、硒及类胡萝卜素摄入量）;应用Spearman相关分析初步评估CDAI与妇科肿瘤的关联;按CDAI四分位分组（Q1~Q4）构建多变量Logistic回归模型（分阶段校正人口学、社会经济及生活方式混杂因素）,计算调整后优势比（OR）及95%置信区间（95%CI）,并行亚组异质性检验。结果 CDAI与子宫癌（r=–0.023, P=0.01）、宫颈癌（r=–0.25, P=0.005）风险呈显著负相关,与乳腺癌及卵巢癌风险无统计学显著关联（均P>0.05）;多因素模型显示,CDAI最高四分位组（Q4）子宫癌风险显著低于Q1组（OR=0.488, 95%CI：0.285-0.834,P=0.011）;亚组分析提示年龄<60岁及肥胖人群中CDAI与子宫癌风险的负相关性更显著,且无年龄、种族等因素的交互作用（均P>0.05）。结论 膳食抗氧化成分的协同作用与子宫癌风险降低相关,其中维生素C、E及锌的协同摄入模式具有潜在预防意义。
Abstract
Objective This cross-sectional study utilized National Health and Nutrition Examination Survey (NHANES) data to investigate the epidemiological relationship between Composite Dietary Antioxidant Index (CDAI) and female-specific malignancies, providing evidence for optimizing dietary strategies in female cancer prevention. Methods A total of 12 624 women aged ≥20 years (mean age: 51.2 years) from NHANES (2013-2023) were included. CDAI was calculated from two 24-hour dietary recalls by integrating intakes of vitamins A,C,E, zinc, selenium, and carotenoids. Spearman correlation analysis was used to initially assess linear associations between CDAI and gynecological cancers. Multivariable logistic regression models (adjusted for demographic, socioeconomic, and lifestyle confounders) were applied to estimate odds ratios (ORs) and 95% confidence intervals (CIs) across the CDAI quartiles (Q1-Q4). Subgroup heterogeneity was examined. Results CDAI was significantly and inversely correlated with uterine cancer (r=–0.023, P=0.01) and cervical cancer (r=–0.25, P=0.005), but not significantly associated with breast or ovarian cancer (P>0.05). Multivariate models revealed that the risk of uterine cancer in the highest quartile group (Q4) of CDAI was significantly lower than that in the Q1 group (OR=0.488, 95%CI: 0.285-0.834, P=0.011). Subgroup analyses indicated a more pronounced negative correlation between CDAI and endometrial cancer risk in individuals aged <60 years and those with obesity, with no interaction effects by age or race (P>0.05). Conclusion Synergistic intakes of dietary antioxidants are associated with a reduced risk of uterinecancer. Among them, the synergistic intake of vitamin C, E, and zinc has potential preventive significance.
关键词
复合膳食抗氧化指数 /
美国健康与营养调查 /
妇科肿瘤 /
子宫癌 /
横断面研究
Key words
composite dietary antioxidant index /
NHANES /
gynecological cancers /
uterine cancer /
cross-sectional study
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基金
博士后国际交流计划引进项目（No. YJ20220181）
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