1Department of Medical Statistics and Epidemiology,School of Public Health,Sun Yat-sen University,Guangzhou 510080,People's Republic of China.
3State Key Laboratory of Oncology in South China,Department of Colorectal Surgery,Sun Yat-sen University Cancer Center,Collaborative Innovation Center for Cancer Medicine,651 Dongfeng Road East,Guangzhou 510060,People's Republic of China.
Br J Nutr. 2018 Apr;119(8):937-948. doi: 10.1017/S000711451800051X.
A carbohydrate-rich diet results in hyperglycaemia and hyperinsulinaemia; it may further induce the carcinogenesis of colorectal cancer. However, epidemiological evidence among Chinese population is quite limited. The aim of this study was to investigate total carbohydrate, non-fibre carbohydrate, total fibre, starch, dietary glycaemic index (GI) and glycaemic load (GL) in relation to colorectal cancer risk in Chinese population. A case-control study was conducted from July 2010 to April 2017, recruiting 1944 eligible colorectal cancer cases and 2027 age (5-year interval) and sex frequency-matched controls. Dietary information was collected by using a validated FFQ. The OR and 95 % CI of colorectal cancer risk were assessed by multivariable logistic regression models. There was no clear association between total carbohydrate intake and colorectal cancer risk. The adjusted OR was 0·85 (95 % CI 0·70, 1·03, P trend=0·08) comparing the highest with the lowest quartile. Total fibre was related to a 53 % reduction in colorectal cancer risk (adjusted ORquartile 4 v. 1 0·47; 95 % CI 0·39, 0·58). However, dietary GI was positively associated with colorectal cancer risk, with an adjusted ORquartile 4 v. 1 of 3·10 (95 % CI 2·51, 3·85). No significant association was found between the intakes of non-fibre carbohydrate, starch and dietary GL and colorectal cancer risk. This study indicated that dietary GI was positively associated with colorectal cancer risk, but no evidence supported that total carbohydrate, non-fibre carbohydrate, starch or high dietary GL intake were related to an increased risk of colorectal cancer in a Chinese population.
富含碳水化合物的饮食会导致高血糖和高胰岛素血症；它可能进一步诱导结直肠癌的发生。然而，中国人群的流行病学证据相当有限。本研究旨在探讨总碳水化合物、非纤维碳水化合物、总膳食纤维、淀粉、膳食血糖生成指数（GI）和血糖负荷（GL）与中国人群结直肠癌风险的关系。本病例对照研究于 2010 年 7 月至 2017 年 4 月进行，共纳入 1944 例符合条件的结直肠癌病例和 2027 例年龄（每 5 年间隔）和性别频数匹配的对照。通过验证的 FFQ 收集饮食信息。多变量逻辑回归模型评估结直肠癌风险的 OR 和 95%CI。总碳水化合物摄入量与结直肠癌风险之间没有明显关联。与最低四分位数相比，最高四分位数的调整 OR 为 0.85（95%CI 0.70，1.03，P 趋势=0.08）。总膳食纤维与结直肠癌风险降低 53%相关（调整后的四分位数 4 与 1 的 OR0.47；95%CI 0.39，0.58）。然而，膳食 GI 与结直肠癌风险呈正相关，四分位数 4 与 1 的调整 OR 为 3.10（95%CI 2.51，3.85）。非纤维碳水化合物、淀粉和膳食 GL 的摄入量与结直肠癌风险之间没有显著关联。本研究表明，膳食 GI 与结直肠癌风险呈正相关，但没有证据表明总碳水化合物、非纤维碳水化合物、淀粉或高膳食 GL 摄入与中国人群结直肠癌风险增加有关。
