Shivappa Nitin, Hébert James R, Taborelli Martina, Montella Maurizio, Libra Massimo, Zucchetto Antonella, Crispo Anna, Grimaldi Maria, La Vecchia Carlo, Serraino Diego, Polesel Jerry
Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208, USA.
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
Cancer Causes Control. 2017 Jul;28(7):791-799. doi: 10.1007/s10552-017-0905-z. Epub 2017 May 13.
While dietary factors have been shown to play an important etiologic role in non-Hodgkin lymphoma (NHL), little is known about the association between inflammatory properties of diet and NHL risk.
We explored the association between the dietary inflammatory index (DII) and NHL risk in a multicenter Italian case-control study conducted between 1999 and 2014. Cases were 536 subjects with incident, histologically confirmed NHL from three areas in Italy. Controls were 984 subjects admitted to the same network of hospitals as the cases for acute, nonmalignant conditions, unrelated to diet. DII scores were computed based on 30 nutrients and food items assessed using a reproducible and validated 78-item food-frequency questionnaire. Odds ratios (ORs) were estimated through logistic regression models adjusting for age, total energy intake, and other recognized confounding factors.
Subjects in the highest quartile of DII scores (i.e., with the most pro-inflammatory diets) had a higher risk of NHL compared with subjects in the lowest quartile (i.e., with the most anti-inflammatory diets) (OR 1.61, 95% confidence interval CI 1.07-2.43; p-trend = 0.01). Stratified analyses produced stronger associations between DII and NHL among males (OR 2.14; 95% CI 1.25-3.67) with significant heterogeneity (p value = 0.02); when analyzed by histologic subtype, a significant association was observed with diffuse large B-cell lymphoma (OR 1.84; 95% CI 1.09-3.10).
A pro-inflammatory diet, as indicated by higher DII scores, is associated with elevated odds of NHL, especially among males.
虽然饮食因素已被证明在非霍奇金淋巴瘤（NHL）的病因中起重要作用，但关于饮食的炎症特性与NHL风险之间的关联知之甚少。
在1999年至2014年进行的一项多中心意大利病例对照研究中，我们探讨了饮食炎症指数（DII）与NHL风险之间的关联。病例为来自意大利三个地区的536例经组织学确诊的新发NHL患者。对照为984例因急性非恶性疾病入住与病例相同医院网络的患者，这些疾病与饮食无关。DII分数是根据使用经过可重复验证的78项食物频率问卷评估的30种营养素和食物项目计算得出的。通过对年龄、总能量摄入和其他公认的混杂因素进行调整的逻辑回归模型估计比值比（OR）。
与DII分数最低四分位数（即饮食最具抗炎性）的受试者相比，DII分数最高四分位数（即饮食最具促炎性）的受试者患NHL的风险更高（OR 1.61，95%置信区间CI 1.07 - 2.43；p趋势 = 0.01）。分层分析显示，男性中DII与NHL之间的关联更强（OR 2.14；95% CI 1.25 - 3.67），具有显著异质性（p值 = 0.02）；按组织学亚型分析时，观察到与弥漫性大B细胞淋巴瘤有显著关联（OR 1.84；95% CI 1.09 - 3.10）。
较高的DII分数表明的促炎性饮食与NHL的患病几率升高有关，尤其是在男性中。
