Augustin L S, Dal Maso L, La Vecchia C, Parpinel M, Negri E, Vaccarella S, Kendall C W, Jenkins D J, Francesch S
Servizio di Epidemiologia, Centro di Riferimento Oncologico, Istituto Nazionale Tumori, Aviano, Italy.
Ann Oncol. 2001 Nov;12(11):1533-8. doi: 10.1023/a:1013176129380.
Certain types of carbohydrates increase glucose and insulin levels to a greater extent than others. In turn, insulin may raise levels of insulin-like growth factors, which may influence breast cancer risk. We analyzed the effect of type and amount of carbohydrates on breast cancer risk, using the glycemic index and the glycemic load measures in a large case-control study conducted in Italy.
Cases were 2,569 women with incident, histologically-confirmed breast cancer interviewed between 1991 and 1994. Controls were 2588 women admitted to the same hospital network for a variety of acute, non-neoplastic conditions. Average daily glycemic index and glycemic load were calculated from a validated 78-item food frequency questionnaire.
Direct associations with breast cancer risk emerged for glycemic index (odds ratio, OR for highest vs. lowest quintile = 1.4; P for trend <0.01) and glycemic load (OR = 1.3; P < 0.01). High glycemic index foods, such as white bread, increased the risk of breast cancer (OR = 1.3) while the intake of pasta, a medium glycemic index food, seemed to have no influence (OR = 1.0). Findings were consistent across different strata of menopausal status, alcohol intake, and physical activity level.
This study supports the hypothesis of moderate, direct associations between glycemic index or glycemic load and breast cancer risk and, consequently, a possible role of hyperinsulinemia/insulin resistance in breast cancer development.
某些类型的碳水化合物比其他类型的碳水化合物更能提高血糖和胰岛素水平。反过来，胰岛素可能会提高胰岛素样生长因子的水平，这可能会影响患乳腺癌的风险。在意大利进行的一项大型病例对照研究中，我们使用血糖指数和血糖负荷指标分析了碳水化合物的类型和数量对乳腺癌风险的影响。
病例为1991年至1994年间接受访谈的2569名患有原发性组织学确诊乳腺癌的女性。对照为因各种急性非肿瘤性疾病入住同一医院网络的2588名女性。根据一份经过验证的包含78个项目的食物频率问卷计算每日平均血糖指数和血糖负荷。
血糖指数（最高五分位数与最低五分位数的比值比，OR = 1.4；趋势P值<0.01）和血糖负荷（OR = 1.3；P < 0.01）与乳腺癌风险呈直接关联。高血糖指数食物，如白面包，会增加患乳腺癌的风险（OR = 1.3），而中等血糖指数食物面食的摄入量似乎没有影响（OR = 1.0）。在绝经状态、酒精摄入量和身体活动水平的不同分层中，研究结果一致。
本研究支持血糖指数或血糖负荷与乳腺癌风险之间存在适度直接关联的假设，因此，高胰岛素血症/胰岛素抵抗在乳腺癌发展中可能发挥作用。
