Higginbotham Susan, Zhang Zuo-Feng, Lee I-Min, Cook Nancy R, Buring Julie E, Liu Simin
Department of Epidemiology, UCLA School of Public Health, University of California at Los Angeles (UCLA), Los Angeles, California, USA.
Cancer Epidemiol Biomarkers Prev. 2004 Jan;13(1):65-70. doi: 10.1158/1055-9965.epi-03-0066.
A diet with a high glycemic load (GL) may contribute to a metabolic environment that enhances tumorigenesis. Little is known, however, about whether high glycemic diets increase breast cancer risk in women. We examined the associations between baseline measurements of dietary GL and overall glycemic index (GI) and subsequent breast cancer in a cohort of 39,876 women, ages 45 years or older, participating in the Women's Health Study. During a mean of 6.8 years of follow-up there were 946 confirmed cases of breast cancer. We found no association between dietary GL [multivariable-adjusted relative risk (RR), 1.01; confidence interval (CI), 0.76-1.35, comparing extreme quintiles; P for trend = 0.96] or overall GI (corresponding RR, 1.03; CI, 0.84-1.28; P for trend = 0.66) and breast cancer risk in the cohort as a whole. Exploratory analyses stratified by baseline measurements of menopausal status, physical activity, smoking history, alcohol use, and history of diabetes mellitus, hypertension, or hypercholesterolemia showed no significant associations, except in the subgroup of women who were premenopausal and reported low levels of physical activity (GL multivariable-adjusted RR, 2.35; CI, 1.03-5.37; P for trend = 0.07; GI multivariable-adjusted RR, 1.56; CI, 0.88-2.78; P for trend = 0.02, comparing extreme quintiles). Although we did not find evidence that a high glycemic diet increases overall breast cancer risk, the increase in risk in premenopausal women with low levels of physical activity suggests the possibility that the effects of a high glycemic diet may be modified by lifestyle and hormonal factors. Prospective studies of a larger sample size and longer duration are warranted to confirm our findings.
高血糖负荷（GL）的饮食可能会导致一种促进肿瘤发生的代谢环境。然而，对于高糖饮食是否会增加女性患乳腺癌的风险，人们知之甚少。我们在一项针对39876名年龄在45岁及以上、参与女性健康研究的女性队列中，研究了饮食GL和总体血糖指数（GI）的基线测量值与后续乳腺癌之间的关联。在平均6.8年的随访期间，有946例确诊的乳腺癌病例。我们发现，在整个队列中，饮食GL（多变量调整相对风险（RR）为1.01；置信区间（CI）为0.76 - 1.35，比较极端五分位数；趋势P值 = 0.96）或总体GI（相应RR为1.03；CI为0.84 - 1.28；趋势P值 = 0.66）与乳腺癌风险之间无关联。按绝经状态、身体活动、吸烟史、饮酒情况以及糖尿病、高血压或高胆固醇血症病史的基线测量值进行分层的探索性分析显示，除了绝经前且报告身体活动水平低的女性亚组外，均无显著关联（GL多变量调整RR为2.35；CI为1.03 - 5.37；趋势P值 = 0.07；GI多变量调整RR为1.56；CI为0.88 - 2.78；趋势P值 = 0.02，比较极端五分位数）。虽然我们没有发现高糖饮食会增加总体乳腺癌风险的证据，但绝经前身体活动水平低的女性风险增加表明，高糖饮食的影响可能会受到生活方式和激素因素的改变。有必要进行更大样本量和更长时间的前瞻性研究来证实我们的发现。
