孕期蔬菜水果摄入少可能增加视网膜母细胞瘤患儿的比率

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原文载于：Cancer Epidemiol Biomarkers Prev. 2005 Jun;14(6):1433-40.

目的：散发性（非遗传性）视网膜母细胞瘤的病因尚不为人所知，墨西哥贫穷人口中该病患病率较高。水果蔬菜是类胡萝卜素和叶酸的主要来源。我们研究了是否孕期母亲摄入水果蔬菜量降低会引起散发性视网膜母细胞瘤的发生。

方法：在墨西哥Naciona儿科研究所，我们进行了一项基于医院病例的病例对照研究，以评估产前孕妇的膳食。使用膳食回顾问卷法和食物营养成分表，对101个患有视网膜母细胞瘤孩子的母亲和172个对照儿童的母亲的膳食水果、蔬菜摄入量进行了检测。结果：患儿母亲的平均每日水果、蔬菜摄入量比对照组低[蔬菜:对照组为 2.28, 病例组为1.75， P < 0.01; 水果: 对照组为2.13, 病例组为1.59，P = 0.07]。对照组每日蔬菜水果中平均叶酸摄入(103微克)比病例组(48微克)高（P < 0.05）。每日少于2份蔬菜摄入的母亲，生产患视网膜母细胞瘤儿童的危险性较高[优势比为3.4; 95%可信区间（2.0-6.0）]；蔬菜水果中叶酸摄入量低(OR, 3.9; 95% CI, 2.1, 7.3)或黄体素/玉米黄素摄入较低(OR, 2.6; 95% CI, 1.5-4.6)时，所产儿患视网膜母细胞瘤的危险性增加。

结论：孕期蔬菜水果摄入少，以及随之发生的叶酸、黄体素/玉米黄素等营养素（为DNA甲基化、DNA合成、视黄醇功能所必需）摄入降低，可能增加生产患视网膜母细胞瘤儿的可能性。

Fruit and vegetable intake during pregnancy and risk for development of sporadic retinoblastoma.

OBJECTIVE: Little is known about the causes of sporadic (noninherited) retinoblastoma. Rates seem to be somewhat higher among poorer populations in Mexico. Fruits and vegetables are important sources of carotenoids and folate. We examined whether decreased gestational maternal intake of fruits and vegetables may contribute to development of sporadic retinoblastoma.METHODS: At the Instituto Nacional de Pediatria in Mexico City, we conducted a hospital-based case-control study to evaluate prenatal maternal diet. We examined dietary intake of fruits and vegetables of mothers of 101 children with retinoblastoma and 172 control children using a dietary recall questionnaire and published food nutrient content tables.RESULTS: The reported number of mean daily servings of fruits and vegetables was lower among case mothers when compared with control mothers [vegetables: 2.28 in controls, 1.75 in cases (P < 0.01); fruits: 2.13 in controls, 1.59 in cases (P = 0.07)]. Mean daily maternal folate intake from both vegetables and fruits was higher in controls (103 microg) than in cases (48 microg; P < 0.05). Risk for having a child with retinoblastoma was increased for mothers consuming fewer than 2 daily servings of vegetables [odds ratios (OR), 3.4; 95% confidence interval (95% CI), 2.0-6.0] or with a low intake of folate (OR, 3.9; 95% CI, 2.1, 7.3), or lutein/zeaxanthin (OR, 2.6; 95% CI, 1.5-4.6) derived from fruits and vegetables. CONCLUSIONS: Decreased intake of vegetables and fruits during pregnancy and the consequent decreased intake of nutrients such as folate and lutein/zeaxanthin, necessary for DNA methylation, synthesis, and retinal function, may increase risk for having a child with sporadic retinoblastoma.


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