Supplementary Material for: Associations of dietary factors with cutaneous melanoma: a case-control study in Greece with literature review

Introduction: It has been postulated that nutrition may influence the risk for cutaneous melanoma (CM); therefore, we aimed to assess the associations of food groups and individual nutrient intakes with CM in a Greek population.
Methods: In this case-control study, 151 patients with histologically confirmed CM, newly diagnosed and treated in the Oncology Department of the ‘Laikon’ University Hospital (Athens, Greece), and 151 age- and sex-matched healthy individuals residing in the Athens metropolitan area, recruited among participants for routine health examinations were included. All participants completed a questionnaire comprising anthropometric measurements, sociodemographic, lifestyle and health-related variables. A validated, semiquantitative food frequency questionnaire was used to assess average consumption of 136 food items during the 12 months preceding the onset of disease. Multivariate conditional regression models were used to derive odds ratios (ORs) with 95% confidence intervals (95% CI) regarding the association of nine food groups and seven macronutrients with CM.
Results: Statistically significant positive associations with CM were found with higher energy intake (OR: 1.67, 95% CI: 1.22-2.30) and intake of saturated fatty acids (OR: 2.28, 95% CI: 1.00-5.28), after adjusting for sun sensitivity, major depression history and alcohol intake. Inverse associations with higher intake of milk and dairy products (OR: 0.65, 95% CI: 0.48-0.88), fruits (OR: 0.68, 95% CI: 0.51-0.90), added lipids (OR: 0.65, 95% CI: 0.47-0.91) and sugars and syrups (OR: 0.70, 95% CI: 0.53-0.93), were also observed.
Conclusions: Beyond intrinsic risk factors, our results support associations of CM with multiple food groups and nutrients; if confirmed by prospective studies, these findings can add further knowledge for this fatal cancer.

引言：已有研究假说指出，营养状况可能影响皮肤黑色素瘤（cutaneous melanoma, CM）的发病风险，故此本研究旨在探究希腊人群中各类食物组别及单一营养素摄入与皮肤黑色素瘤的关联。
方法：本项病例对照研究共纳入151例经组织学确诊的新发皮肤黑色素瘤患者，这些患者均在希腊雅典"莱孔"（Laikon）大学医院肿瘤科接受诊断与治疗；同时纳入151名年龄、性别匹配的健康个体，这些受试者均居住在雅典都会区，通过常规健康体检项目招募。所有受试者均填写了涵盖人体测量学指标、社会人口学特征、生活方式及健康相关变量的调查问卷。研究采用经过验证的半定量食物频率问卷，评估受试者在疾病发病前12个月内136种食物的平均摄入量。采用多因素条件回归模型，计算9类食物组别及7种宏量营养素与皮肤黑色素瘤关联的比值比（odds ratios, ORs）及95%置信区间（95% confidence intervals, 95% CI）。
结果：在校正了日光敏感性、重度抑郁症病史及酒精摄入情况后，研究发现较高的能量摄入（OR: 1.67, 95% CI: 1.22~2.30）以及饱和脂肪酸摄入（OR: 2.28, 95% CI: 1.00~5.28）与皮肤黑色素瘤存在统计学意义的正相关。同时还观察到，较高的奶类及奶制品摄入（OR: 0.65, 95% CI: 0.48~0.88）、水果摄入（OR: 0.68, 95% CI: 0.51~0.90）、添加油脂摄入（OR: 0.65, 95% CI: 0.47~0.91）以及糖和糖浆摄入（OR: 0.70, 95% CI: 0.53~0.93）与皮肤黑色素瘤存在负相关。
结论：除内在风险因素外，本研究结果证实皮肤黑色素瘤与多种食物组别及营养素存在关联；若该结论能得到前瞻性研究的验证，将为这一致命性癌症的相关研究补充新的科学认知。