Mediterranean dietary components are inversely associated with advanced colorectal polyps:A case-control study

作     者：Naomi Fliss-Isakov Revital Kariv Muriel Webb Dana Ivancovsky Dana Margalit Shira Zelber-Sagi 

作者机构：Department of Gastroenterology Tel Aviv Medical CenterTel Aviv 6423906Israel Sackler Faculty of MedicineTel Aviv UniversityTel Aviv 6423906Israel School of Public HealthUniversity of HaifaHaifa 3498838Israel 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2018年第24卷第24期

页      面：2617-2627页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Fish intake Sugar-sweetened beverages Red meat intake Dietary adherence Cancer 

摘      要：AIM To evaluate the association between the Mediterranean diet(MD) pattern and its components, and advanced colorectal polyps(adenoma and serrated adenoma).METHODS A case-control study among patients undergoing screening, diagnostic or surveillance colonoscopies during 2010-2015 at the Tel-Aviv Medical Center, Gastroenterology Department. Cases with advanced polyps were defined as: Advanced adenoma [ 10 mm, with features of high grade dysplasia(HGD) or villous histology], advanced serrated adenoma( 10 mm or with dysplasia) or multiple(≥ 3) non-advanced adenomas or serrated adenomas. Cases of non-advanced adenomas were defined as adenomas 10 mm, without features of HGD or villous histology. Controls were defined as those without polyps at the current colonoscopy and without a history of colorectal polyps. Data collection included: anthropometrics measured according to a standardized protocol, fasting blood tests performed at the same lab, medical history recorded by a structured interview and dietary intake evaluated by a 116-item food frequency questionnaire. Adherence to the MD components was evaluated according to intake above/below the sample median, for potentially beneficial/detrimental components respectively, as accepted. RESULTS We recruited 206 cases with advanced polyps, 192 cases with non-advanced adenoma and 385 controls. The number of adhered MD components was inversely associated with a diagnosis of advanced polyps in a dose-response manner(OR = 0.34, 95%CI: 0.17-0.65; OR = 0.22, 95%CI: 0.11-0.43; and OR = 0.18, 95%CI: 0.07-0.47 for 3-4, 5-7 and 8-10 components, respectively), but not with non-advanced adenomas(OR = 0.54, 95%CI: 0.25-1.13; OR = 0.48, 95%CI: 0.23-0.99; and OR = 0.43, 95%CI: 0.16-1.12 for 3-4, 5-7 and 8-10 components, respectively). Low intake of sugar-sweetened beverages and red meat, as well as high intake of fish, were inversely associated with advanced polyps(OR = 0.56, 95%CI: 0.36-0.87; OR = 0.63, 95%CI: 0.42-0.95; and OR = 0.66