饮食中的碳水化合物、血糖生成指数和血糖负荷与BCDDP队列中结直肠癌的风险

Dietary carbohydrate, glycemic index, and glycemic load and the risk of colorectal cancer in the BCDDP cohort.

作者信息

Strayer Lori, Jacobs David R, Schairer Catherine, Schatzkin Arthur, Flood Andrew

机构信息

Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, USA.

出版信息

Cancer Causes Control. 2007 Oct;18(8):853-63. doi: 10.1007/s10552-007-9030-8. Epub 2007 Jun 29.

DOI:10.1007/s10552-007-9030-8

PMID:17605083

Abstract

BACKGROUND

There is considerable support for associations between insulin and IGF-I levels and colorectal cancer. Diet may relate to colorectal cancer through this mechanism, for example, diets high in glycemic index, glycemic load and/or carbohydrate are hypothesized to increase insulin load and the risk of insulin resistance, hyperinsulinemia. Case-control studies support this hypothesis, but prospective cohorts have had mixed results.

METHODS

In the Breast Cancer Detection Demonstration Project (BCDDP) follow-up cohort of 45,561 women, we used Cox proportional hazards regression to assess the distribution of 490 incident cases of colorectal cancer ascertained during 8.5 years of follow-up across quintiles of carbohydrate intake, glycemic index, and glycemic load. We also stratified by combined BMI and physical activity levels.

RESULTS

We found reductions in colorectal cancer risk for diets high in carbohydrate (RR for Q5 vs. Q1 = 0.70, 95% CI: 0.50-0.97) and glycemic index (0.75, 95% CI: 0.56-1.00), and no significant association for glycemic load (0.91, 95% CI: 0.70-1.20). Inverse associations were weakest in normal weight active persons. The inverse association for glycemic index was strongest for the portion from dairy food.

CONCLUSIONS

These results do not support an association between diets high in carbohydrate, glycemic index or glycemic load and colorectal cancer.

摘要

背景

胰岛素和胰岛素样生长因子-I（IGF-I）水平与结直肠癌之间的关联得到了相当多的支持。饮食可能通过这种机制与结直肠癌相关，例如，高血糖指数、血糖负荷和/或碳水化合物的饮食被假设会增加胰岛素负荷以及胰岛素抵抗、高胰岛素血症的风险。病例对照研究支持这一假设，但前瞻性队列研究的结果却参差不齐。

方法

在乳腺癌检测示范项目（BCDDP）对45561名女性的随访队列中，我们使用Cox比例风险回归分析，评估在8.5年随访期间确诊的490例结直肠癌病例在碳水化合物摄入量、血糖指数和血糖负荷五分位数中的分布情况。我们还按体重指数（BMI）和身体活动水平进行了分层。

结果

我们发现，高碳水化合物饮食（Q5与Q1相比的风险比RR = 0.70，95%置信区间CI：0.50 - 0.97）和高血糖指数饮食（0.75，95% CI：0.56 - 1.00）可降低结直肠癌风险，而血糖负荷与结直肠癌无显著关联（0.91，95% CI：0.70 - 1.20）。在体重正常且活跃的人群中，这种负相关最弱。血糖指数与结直肠癌的负相关在来自乳制品的部分中最强。