期刊
AMERICAN JOURNAL OF EPIDEMIOLOGY
卷 178, 期 4, 页码 610-624出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwt007
关键词
case-control studies; colorectal tumors; methodological study; oxidative stress; weighting
资金
- National Cancer Institute [P01 CA50305, R01 CA66539, R01 CA116795]
- Fullerton Foundation
- Franklin Foundation
- Georgia Cancer Coalition Distinguished Scholar award
Identifying associations of risk factors sharing the same pathway with disease risk is complicated by small individual effects and intercorrelated components; this can be addressed by creating comprehensive exposure scores. We developed and validated 3 novel weighting methods (literature review-derived, study data-based, and a Bayesian method that combines prior knowledge with study data) to incorporate components into a pathway score for oxidative balance in addition to a commonly used method that assumes all components contribute equally to the score. We illustrate our method using pooled data from 3 US case-control studies of sporadic colorectal adenoma (1991-2002). We created 4 oxidative balance scores (OBS) to reflect combined summary measures of dietary and nondietary antioxidant and prooxidant exposures. A higher score represents a predominance of antioxidant exposures over prooxidant exposures. In the pooled data, the odds ratios comparing the highest tertile of OBS with the lowest for adenoma risk ranged from 0.38 to 0.54 for the 4 measures; all were statistically significant. These findings suggest that 1) OBS are indicators of oxidative balance and may be inversely associated with colorectal adenoma risk and 2) using comprehensive exposure scores may be preferable to investigating individual component-disease associations for complex exposures, such as oxidative balance.
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