Tabung Fred K, Steck Susan E, Liese Angela D, Zhang Jiajia, Ma Yunsheng, Johnson Karen C, Lane Dorothy S, Qi Lihong, Snetselaar Linda, Vitolins Mara Z, Ockene Judith K, Hebert James R
Departments of Nutrition and Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA.
Cancer Prevention and Control Program, University of South Carolina, Columbia, USA.
Breast Cancer Res Treat. 2016 Aug;159(1):139-49. doi: 10.1007/s10549-016-3925-6. Epub 2016 Jul 30.
We utilized the dietary inflammatory index (DII) to investigate associations between patterns of change in, and history of the inflammatory potential of diet and risk of breast cancer in the Women's Health Initiative (WHI). We included 70,998 postmenopausal women aged 50-79 years recruited from 1993 to 1998 into the WHI Observational Study and Dietary Modification trial control group and followed through August 29, 2014. We utilized data from food frequency questionnaires administered at baseline and Year 3, to calculate average DII scores, patterns of change in DII, and used these measures in multivariable-adjusted Cox regression models to estimate hazards ratios (HR) and 95 % confidence intervals (CI) for incident invasive breast cancer and its subtypes. After 1,093,947 person-years of follow-up, 3471 cases of invasive breast cancer were identified. There was no substantial association between average DII scores or patterns of change in DII and risk of overall invasive breast cancer (HR, 1.03; 95 % CI, 0.90, 1.17; P-trend = 0.79; comparing extreme average DII quintiles). However, there was a significant nonlinear association between average DII scores and the ER-, PR-, HER2+, subtype (HR, 2.37; 95 % CI, 1.08, 5.20; P-trend = 0.18; comparing extreme quintiles). For patterns of change in DII, the age-adjusted association with ER-, PR-, HER2+ subtype comparing women in the proinflammatory stable to those in the anti-inflammatory stable categories (HR, 1.82; 95 % CI, 1.06, 3.13) persisted in the multivariable-adjusted model but was less precise (HR, 1.85; 95 % CI, 0.96, 3.55; P = 0.06). Dietary inflammatory potential may differentially influence the development of specific breast cancer phenotypes.
我们利用饮食炎症指数（DII）来研究女性健康倡议（WHI）中饮食炎症潜力的变化模式、历史与乳腺癌风险之间的关联。我们纳入了1993年至1998年招募到WHI观察性研究和饮食调整试验对照组的70998名50 - 79岁的绝经后女性，并随访至2014年8月29日。我们利用基线和第3年时进行的食物频率问卷调查数据，计算平均DII得分、DII的变化模式，并将这些指标用于多变量调整的Cox回归模型，以估计浸润性乳腺癌及其亚型的风险比（HR）和95%置信区间（CI）。经过1093947人年的随访，共确诊3471例浸润性乳腺癌病例。平均DII得分或DII变化模式与总体浸润性乳腺癌风险之间无显著关联（HR = 1.03；95% CI：0.90，1.17；P趋势 = 0.79；比较极端平均DII五分位数）。然而，平均DII得分与ER - 、PR - 、HER2 + 亚型之间存在显著的非线性关联（HR = 2.37；95% CI：1.08，5.20；P趋势 = 0.18；比较极端五分位数）。对于DII的变化模式，在多变量调整模型中，与促炎稳定组女性相比，抗炎稳定组女性中与ER - 、PR - 、HER2 + 亚型的年龄调整关联（HR = 1.82；95% CI：1.06，3.13）仍然存在，但精度较低（HR = 1.85；95% CI：0.96，3.55；P = 0.06）。饮食炎症潜力可能对特定乳腺癌表型的发展产生不同影响。
