Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Spain.
Haematologica. 2018 Nov;103(11):1881-1888. doi: 10.3324/haematol.2018.192526. Epub 2018 Jun 28.
Diet is a modifiable risk factor for several neoplasms but evidence for chronic lymphocytic leukemia (CLL) is sparse. Previous studies examining the association between single-food items and CLL risk have yielded mixed results, while few studies have been conducted on overall diet, reporting inconclusive findings. This study aimed to evaluate the association between adherence to three dietary patterns and CLL in the multicase-control study (MCC-Spain) study. Anthropometric, sociodemographic, medical and dietary information was collected for 369 CLL cases and 1605 controls. Three validated dietary patterns, Western, Prudent and Mediterranean, were reconstructed in the MCC-Spain data. The association between adherence to each dietary pattern and CLL was assessed, overall and by Rai stage, using mixed logistic regression models adjusted for potential confounders. High adherence to a Western dietary pattern (i.e. high intake of high-fat dairy products, processed meat, refined grains, sweets, caloric drinks, and convenience food) was associated with CLL [ORQ4 Q1=1.63 (95%CI 1.11; 2.39); -trend=0.02; OR 1-SD increase=1.19 (95%CI: 1.03; 1.37)], independently of Rai stages. No differences in the association were observed according to sex, Body Mass Index, energy intake, tobacco, physical activity, working on a farm, or family history of hematologic malignancies. No associations were observed for Mediterranean and Prudent dietary patterns and CLL. This study provides the first evidence for an association between a Western dietary pattern and CLL, suggesting that a proportion of CLL cases could be prevented by modifying dietary habits. Further research, especially with a prospective design, is warranted to confirm these findings.
饮食是多种肿瘤的可改变风险因素,但慢性淋巴细胞白血病 (CLL) 的证据有限。之前研究检查单项食物与 CLL 风险之间的关联,结果不一,而很少有研究关注整体饮食,结果尚无定论。本研究旨在评估多病例对照研究 (MCC-Spain 研究) 中三种饮食模式与 CLL 之间的关联。为 369 例 CLL 病例和 1605 例对照收集了人体测量学、社会人口统计学、医学和饮食信息。在 MCC-Spain 数据中重建了三种经过验证的饮食模式,即西方模式、谨慎模式和地中海模式。使用混合逻辑回归模型调整潜在混杂因素后,评估了每种饮食模式与 CLL 之间的关联,总体上以及按 Rai 分期进行评估。高度遵循西方饮食模式(即大量摄入高脂肪乳制品、加工肉类、精制谷物、甜食、高卡路里饮料和方便食品)与 CLL 相关 [ORQ4 Q1=1.63(95%CI 1.11;2.39);-趋势=0.02;OR 1-SD 增加=1.19(95%CI:1.03;1.37)],与 Rai 分期无关。根据性别、体重指数、能量摄入、烟草、体力活动、在农场工作或血液恶性肿瘤家族史,观察到关联没有差异。地中海和谨慎饮食模式与 CLL 之间没有关联。本研究首次提供了西方饮食模式与 CLL 之间关联的证据,表明通过改变饮食习惯,可预防一部分 CLL 病例。需要进一步的研究,特别是前瞻性设计,来证实这些发现。