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.
Goodman
Michael
M
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA. mgoodm2@sph.emory.edu
Bostick
Roberd M
RM
Dash
Chiranjeev
C
Terry
Paul
P
Flanders
W Dana
WD
Mandel
Jack
J
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