Abe Sarah Krull, Inoue Manami, Sawada Norie, Ishihara Junko, Iwasaki Motoki, Yamaji Taiki, Shimazu Taichi, Sasazuki Shizuka, Tsugane Shoichiro
AXA Department of Health and Human Security, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Epidemiology and Prevention Group, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
Cancer Causes Control. 2016 Apr;27(4):583-93. doi: 10.1007/s10552-016-0733-6. Epub 2016 Mar 9.
The aim of this study was for the first time to assess the association between glycemic index (GI), glycemic load (GL), and colorectal cancer using a prospective Japanese population-based cohort.
In our study participants aged 40-69 at baseline of the Japan Public Health Center-based prospective Study (JPHC Study) in 10 prefectural public health centers (PHC) were included. Subjects responding to the five-year follow-up survey (1995-1999) without previous history of cancer and missing data were included in the current analysis n = 73,501 (men n = 34,560 and women n = 38,941). We reported results as hazard ratios (HR) and 95% confidence intervals (CI) by Cox proportional hazards modeling.
The average follow-up time was 12.5 years (919,276 person-years). A total of 1,468 colorectal cancer cases were detected. Overall, no significant results were observed; however, GL was inversely nonsignificantly associated with colon cancer in men HR = 0.74 (95% CI 0.51-1.09) and rectal cancer in women 0.52 (95% CI 0.24-1.14). The GL tended to be inversely associated with proximal colon cancer among men 0.62 (95% CI 0.36-1.08), while a positive association with the GI was observed among women 1.37 (95% CI 0.88-2.14). Sensitivity analyses excluding the first three years of observation showed similar results. Results stratified by diabetes status, BMI, smoking and red meat were nonsignificant.
In conclusion, the prospective JPHC Study suggests that the GI and GL do not have a substantial impact on the risk of colorectal cancer in Japanese adults.
本研究旨在首次利用基于日本人群的前瞻性队列评估血糖生成指数（GI）、血糖负荷（GL）与结直肠癌之间的关联。
我们纳入了日本公共卫生中心前瞻性研究（JPHC研究）中10个县公共卫生中心（PHC）基线年龄在40 - 69岁的研究参与者。对五年随访调查（1995 - 1999年）做出回应且无癌症病史和缺失数据的受试者纳入本次分析，共73,501人（男性34,560人，女性38,941人）。我们通过Cox比例风险模型报告结果为风险比（HR）和95%置信区间（CI）。
平均随访时间为12.5年（919,276人年）。共检测到1468例结直肠癌病例。总体而言，未观察到显著结果；然而，GL与男性结肠癌呈非显著负相关，HR = 0.74（95%CI 0.51 - 1.09），与女性直肠癌呈非显著负相关，HR = 0.52（95%CI 0.24 - 1.14）。GL在男性中与近端结肠癌呈负相关趋势，HR = 0.62（95%CI 0.36 - 1.08），而在女性中观察到GI与近端结肠癌呈正相关，HR = 1.37（95%CI 0.88 - 2.14）。排除前三年观察期的敏感性分析显示结果相似。按糖尿病状态、BMI、吸烟和红肉分层的结果无统计学意义。
总之，前瞻性JPHC研究表明，GI和GL对日本成年人患结直肠癌的风险没有实质性影响。
