Zhu Jingfen, Tu Huakang, Matin Surena F, Tannir Nizar M, Wood Christopher G, Wu Xifeng
Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
School of Public Health, Shanghai Jiaotong University, Shanghai 200025, China.
Carcinogenesis. 2017 Oct 26;38(11):1129-1135. doi: 10.1093/carcin/bgx083.
Carbohydrate intake affects postprandial glucose levels and insulin response, which plays a role in carcinogenesis. The relationship between carbohydrate intake, dietary glycemic index (GI) and glycemic load (GL), and risk of renal cell carcinoma (RCC) remains unclear. We conducted a case-control study including 854 patients with newly diagnosed RCC (cases) and 1255 healthy participants (controls) recruited since 2002. GI, GL and carbohydrate intake were obtained via a validated food frequency questionnaire. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression, adjusting for potential confounders. We found that higher GI was significantly associated with RCC risk with an OR of 1.32 (95% CI, 0.99-1.74; Ptrend = 0.026) (the highest versus the lowest quartiles). We also observed an inverse association between fiber intake and RCC risk with OR of 0.70 (95% CI = 0.50-0.99) as well as between starch intake and risk of RCC with OR of 0.65 (95% CI = 0.49-0.87). Individuals with a high-GI diet and hypertension or high body mass index (BMI) had a 2.7 times (OR = 2.67, 95% CI = 1.96-3.64) and two times (OR = 1.95, 95% CI = 1.29-2.92) higher RCC risk, respectively, than those without these factors. Our findings suggest that a high-GI diet is associated with an increased risk of RCC, whereas increased fiber and starch intakes appear to be associated with a decreased risk of RCC. We found that reducing GI levels and increasing fiber intake could be a dietary strategy to decrease RCC risk, especially for individuals with hypertension or high BMI.
碳水化合物摄入量会影响餐后血糖水平和胰岛素反应，而这在癌症发生过程中起一定作用。碳水化合物摄入量、饮食血糖生成指数（GI）和血糖负荷（GL）与肾细胞癌（RCC）风险之间的关系仍不明确。我们进行了一项病例对照研究，纳入了自2002年起招募的854例新诊断的RCC患者（病例组）和1255名健康参与者（对照组）。通过一份经验证有效的食物频率问卷获取GI、GL和碳水化合物摄入量。使用多变量逻辑回归估计比值比（OR）和95%置信区间（CI），并对潜在混杂因素进行校正。我们发现，较高的GI与RCC风险显著相关，OR为1.32（95%CI，0.99 - 1.74；P趋势 = 0.026）（最高四分位数与最低四分位数相比）。我们还观察到纤维摄入量与RCC风险之间呈负相关，OR为0.70（95%CI = 0.50 - 0.99），淀粉摄入量与RCC风险之间也呈负相关，OR为0.65（95%CI = 0.49 - 0.87）。高GI饮食且患有高血压或高体重指数（BMI）的个体患RCC的风险分别比没有这些因素的个体高2.7倍（OR = 2.67，95%CI = 1.96 - 3.64）和2倍（OR = 1.95，95%CI = 1.29 - 2.92）。我们的研究结果表明，高GI饮食与RCC风险增加相关，而纤维和淀粉摄入量增加似乎与RCC风险降低相关。我们发现，降低GI水平和增加纤维摄入量可能是降低RCC风险的一种饮食策略，尤其是对于患有高血压或高BMI的个体。
