Table 1_The association between dietary creatine intake and cancer in U.S. adults: insights from NHANES 2007–2018.docx

BackgroundCreatine has anti-inflammatory, antioxidant, and immunomodulatory effects. However, its impact on tumors remains uncertain.
MethodsThis study used data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018 to investigate the relationship between dietary creatine intake and cancer in American adults. A total of 25,879 participants aged 20 years and older were included, and their medical information, dietary creatine intake, and covariates were collected. Multiple logistic regression models were used to assess the relationships between age, dietary creatine intake, and cancer risk. Restricted cubic spline (RCS) analysis explored the nonlinear relationships between dietary creatine intake, age, and cancer prevalence.
ResultsRCS analysis revealed a linear, negative association between dietary creatine intake and cancer risk. For each standard deviation (SD) increase in dietary creatine intake, cancer risk decreased by 5% (adjusted odds ratio (OR) = 0.95, 95% CI: 0.91–0.99, p = 0.025). This negative association was strongest among males (adjusted OR = 0.93, 95% CI: 0.88–0.99, p = 0.021) and overweight participants (adjusted OR = 0.92, 95% CI: 0.84–0.99, p = 0.044). Interaction results indicated specific age group effects. Further analysis showed that higher dietary creatine intake was significantly inversely associated with cancer risk among older adults (adjusted OR = 0.86, 95% CI: 0.77–0.97, p = 0.014). RCS analysis revealed a linear, positive correlation between age and cancer risk. For each SD increase in age, cancer risk increased by 3.27 times (adjusted OR = 3.27, 95% CI: 3.07–3.48, p < 0.001).
ConclusionThese findings suggest that higher dietary creatine intake may reduce cancer risk in a nationally representative adult population. Further prospective studies are needed to clarify the relationship between dietary creatine intake and cancer risk.

背景 肌酸（Creatine）具有抗炎、抗氧化及免疫调节作用，但其对肿瘤的影响仍不明确。
方法 本研究采用2007-2018年美国国家健康与营养检查调查（National Health and Nutrition Examination Survey, NHANES）的数据，探究美国成年人膳食肌酸摄入与癌症的关联。本研究共纳入25879名20岁及以上的受试者，收集其医疗信息、膳食肌酸摄入情况及协变量。采用多因素logistic回归模型评估年龄、膳食肌酸摄入与癌症风险之间的关联；通过限制性立方样条（Restricted Cubic Spline, RCS）分析探究膳食肌酸摄入、年龄与癌症患病率之间的非线性关联。
结果 限制性立方样条分析显示，膳食肌酸摄入与癌症风险呈线性负相关。膳食肌酸摄入每增加1个标准差（Standard Deviation, SD），癌症风险降低5%（校正后比值比（Odds Ratio, OR）=0.95，95%置信区间（Confidence Interval, CI）：0.91~0.99，p=0.025）。该负相关在男性（校正后OR=0.93，95%CI：0.88~0.99，p=0.021）及超重受试者中最为显著。交互分析结果显示存在特定年龄组效应。进一步分析表明，在老年人群中，较高的膳食肌酸摄入与癌症风险呈显著负相关（校正后OR=0.86，95%CI：0.77~0.97，p=0.014）。限制性立方样条分析还显示，年龄与癌症风险呈线性正相关：年龄每增加1个标准差，癌症风险升高3.27倍（校正后OR=3.27，95%CI：3.07~3.48，p<0.001）。
结论 本研究结果表明，在具有全国代表性的成年人群中，较高的膳食肌酸摄入或可降低癌症风险。未来需开展进一步的前瞻性研究，以明确膳食肌酸摄入与癌症风险之间的关联。