A summary measure of pro- and anti-oxidant exposures and risk of incident, sporadic, colorectal adenomas.
Despite compelling basic science evidence, the search for causal associations linking specific pro- and anti-oxidants to presumably oxidative stress-related neoplasms, such as colorectal adenoma, has produced inconsistent results. We developed an oxidative balance score (OBS) to characterize the pro-oxidant and anti-oxidant exposures of 2,305 participants in a case-control study of colorectal adenoma that used both endoscopy-confirmed and community controls. Twelve lifestyle medical and dietary factors with known pro- or anti-oxidant properties were considered. Each high anti-oxidant exposure and low pro-oxidant exposure was awarded one or two points depending on the level of exposure, and the points for each OBS component were summed. We observed a significant inverse association between OBS (continuous variable) and colorectal adenoma in the analyses with either community, or endoscopy controls (each p-trend < 0.01). When the OBS was treated as an ordinal variable and a score of <or=3 points was used as the referent category, in the analyses with the endoscopy controls the adjusted odds ratios for scores of 4-6, 7-9, 10-12, 13-15, and 16+, were 0.42, 0.32, 0.22, 0.20, and 0.19, respectively, with all 95% confidence intervals excluding 1.0. The corresponding analysis for community controls showed a similar trend. Our findings are in line with the basic science evidence supporting the role of oxidative stress in colorectal neoplasia.
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA. mgoodm2@sph.emory.edu
Michael
M
Goodman
Roberd M
RM
Bostick
Chiranjeev
C
Dash
Paul
P
Terry
W Dana
WD
Flanders
Jack
J
Mandel
D000236:Adenoma / Q000209:etiology / Q000235:genetics / Q000473:pathology; D000975:Antioxidants / Q000008:administration & dosage*; D016022:Case-Control Studies; D015984:Causality; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000517:prevention & control; D016001:Confidence Intervals; D004032:Diet / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D018384:Oxidative Stress / Q000502:physiology*; D017382:Reactive Oxygen Species / Q000009:adverse effects; D012307:Risk Factors; D011795:Surveys and Questionnaires
D000975:Antioxidants; D017382:Reactive Oxygen Species