Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NF, Canada.
Clinical Epidemiology Unit, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NF, Canada.
Nutr J. 2018 May 25;17(1):55. doi: 10.1186/s12937-018-0362-x.
Dietary patterns are commonly used in epidemiological research, yet there have been few studies assessing if and how research results may vary across dietary patterns. This study aimed to estimate the risk of mortality/recurrence/metastasis using different dietary patterns and comparison amongst the patterns.
Dietary patterns were identified by Cluster Analysis (CA), Principal Component Analysis (PCA), Alternate Mediterranean Diet score (altMED), Recommended Food Score (RFS) and Dietary Inflammatory Index (DII) scores using a 169-item food frequency questionnaire. Five hundred thirty-two colorectal cancer patients diagnosed between 1999 and 2003 in Newfoundland were followed-up until 2010. Overall Mortality (OM) and combined Mortality, Recurrence or Metastasis (cMRM) were identified. Comparisons were made with adjusted Cox proportional Hazards Ratios (HRs), correlation coefficients and the distributions of individuals in defined clusters by quartiles of factor and index scores.
One hundred and seventy cases died from all causes and 29 had a cancer recurrence/metastasis during follow-up. Processed meats as classified by PCA (HR 1.82; 95% confidence interval (CI) 1.07-3.09), clusters characterized by meat and dairy products (HR 2.19; 95% CI 1.03-4.67) and total grains, sugar, soft drinks (HR 1.95; 95% CI 1.13-3.37) were associated with a higher risk of cMRM. Poor adherence to AltMED increased the risk of all-cause OM (HR 1.62; 95% CI 1.04-2.56). Prudent vegetable, high sugar pattern, RFS and DII had no significant association with both OM and cMRM.
Estimation of OM and cMRM varied across dietary patterns which is attributed to the differences in the foundation of each pattern.
饮食模式在流行病学研究中被广泛应用，但目前关于研究结果在不同饮食模式之间是否存在差异以及如何存在差异的研究较少。本研究旨在使用不同的饮食模式来评估死亡率/复发/转移的风险，并比较不同模式之间的差异。
通过聚类分析（CA）、主成分分析（PCA）、替代地中海饮食评分（altMED）、推荐食物评分（RFS）和膳食炎症指数（DII）评分，使用 169 项食物频率问卷来识别饮食模式。1999 年至 2003 年间在纽芬兰诊断出的 532 名结直肠癌患者进行了随访，随访至 2010 年。确定了总死亡率（OM）和死亡率、复发率或转移率（cMRM）的综合结果。通过调整后的 Cox 比例风险比（HRs）、相关系数以及根据因子和指数得分的四分位数分布来比较个体的分布情况。
170 例患者死于各种原因，29 例患者在随访期间发生癌症复发/转移。PCA 分类的加工肉类（HR 1.82；95%置信区间（CI）1.07-3.09）、以肉类和奶制品为特征的聚类（HR 2.19；95%CI 1.03-4.67）和全谷物、糖、软饮料（HR 1.95；95%CI 1.13-3.37）与更高的 cMRM 风险相关。对 AltMED 的低依从性增加了全因 OM 的风险（HR 1.62；95%CI 1.04-2.56）。谨慎的蔬菜、高糖模式、RFS 和 DII 与 OM 和 cMRM 均无显著相关性。
OM 和 cMRM 的评估因每种模式的基础差异而有所不同。
