Vidal Adriana C, Williams Christina D, Allott Emma H, Howard Lauren E, Grant Delores J, McPhail Megan, Sourbeer Katharine N, Hwa Lin Pao, Boffetta Paolo, Hoyo Cathrine, Freedland Stephen J
Department of Obstetrics and Gynecology, Division of Clinical Epidemiologic Research, Program of Cancer Detection, Prevention and Control, Duke University School of Medicine, Durham, North Carolina; Section of Urology, Department of Surgery, Durham VA Medical Center, Durham, North Carolina; Duke Prostate Center, Division of Urology, Department of Surgery, Duke University Medical Center, Durham, North Carolina.
Prostate. 2015 Mar 1;75(4):430-9. doi: 10.1002/pros.22929. Epub 2014 Nov 21.
Reported associations between dietary carbohydrate and prostate cancer (PC) risk are poorly characterized by race.
We analyzed the association between carbohydrate intake, glycemic index (GI), and PC risk in a study of white (N = 262) and black (N = 168) veterans at the Durham VA Hospital. Cases were 156 men with biopsy-confirmed PC and controls (N = 274) had a PSA test but were not recommended for biopsy. Diet was assessed before biopsy with a self-administered food frequency questionnaire. Logistic regression models were used to estimate PC risk.
In multivariable analyzes, higher carbohydrate intake, measured as percent of energy from carbohydrates, was associated with reduced PC risk (3rd vs. 1st tertile, OR = 0.41, 95% CI 0.21-0.81, P = 0.010), though this only reached significance in white men (p-trend = 0.029). GI was unrelated to PC risk among all men, but suggestively linked with reduced PC risk in white men (p-trend = 0.066) and increased PC risk in black men (p-trend = 0.172), however, the associations were not significant. Fiber intake was not associated with PC risk (all p-trends > 0.55). Higher carbohydrate intake was associated with reduced risk of high-grade (p-trend = 0.016), but not low-grade PC (p-trend = 0.593).
Higher carbohydrate intake may be associated with reduced risk of overall and high-grade PC. Future larger studies are needed to confirm these findings.
饮食中碳水化合物与前列腺癌（PC）风险之间的关联在不同种族中特征不明确。
在达勒姆退伍军人事务医院对白人（N = 262）和黑人（N = 168）退伍军人进行的一项研究中，我们分析了碳水化合物摄入量、血糖生成指数（GI）与PC风险之间的关联。病例为156名经活检确诊为PC的男性，对照组（N = 274）进行了前列腺特异性抗原（PSA）检测，但不建议进行活检。在活检前，通过自行填写的食物频率问卷评估饮食情况。使用逻辑回归模型估计PC风险。
在多变量分析中，以碳水化合物提供的能量百分比衡量，较高的碳水化合物摄入量与降低的PC风险相关（第三三分位数与第一三分位数相比，OR = 0.41，95% CI 0.21 - 0.81，P = 0.010），不过这仅在白人男性中具有统计学意义（P趋势 = 0.029）。在所有男性中，GI与PC风险无关，但在白人男性中提示与降低的PC风险相关（P趋势 = 0.066），在黑人男性中与增加的PC风险相关（P趋势 = 0.172），然而，这些关联均无统计学意义。纤维摄入量与PC风险无关（所有P趋势 > 0.55）。较高的碳水化合物摄入量与高级别PC风险降低相关（P趋势 = 0.016），但与低级别PC风险无关（P趋势 = 0.593）。
较高的碳水化合物摄入量可能与总体及高级别PC风险降低相关。未来需要更大规模的研究来证实这些发现。
