饮食相关炎症与加利福尼亚男性健康研究中前列腺癌的风险。
Diet-related inflammation and risk of prostate cancer in the California Men's Health Study.
机构信息
Department of Epidemiology and Biostatistics, University of South Carolina, Columbia.
Department of Epidemiology and Biostatistics, University of South Carolina, Columbia; Cancer Prevention and Control Program, University of South Carolina, Columbia; WJB Dorn Department of Veterans Affairs Medical Center, Columbia, SC.
出版信息
Ann Epidemiol. 2019 Jan;29:30-38. doi: 10.1016/j.annepidem.2018.10.008. Epub 2018 Nov 2.
PURPOSE
The purpose of the study was to examine the relationship between proinflammatory diet and prostate cancer risk.
METHODS
Energy-adjusted Dietary Inflammatory Index (E-DII) scores were computed among 40,161 participants in the California Men's Health Study. Over 9.7 ± 3.8 years of follow-up, 2707 incident prostate cancer cases were diagnosed and categorized as low-, intermediate-, or high-risk, based on disease grade and stage. Accelerated failure-time models assessed time to diagnosis of prostate cancer. Cox proportional hazard models estimated hazard ratios (HR) and 95% confidence intervals (95% CI). Nonlinear effects of E-DII were modeled as third-order polynomials.
RESULTS
Time to prostate cancer diagnosis did not differ by E-DII quartile. The HR for high-risk prostate cancer increased in the third E-DII quartile (HR = 1.36; 95% CI: 1.04-1.76), but not in the fourth (HR = 0.99; 95% CI: 0.74-1.32, P = .74), suggesting a nonlinear dose-response. HR curves for prostate cancer increased exponentially above an E-DII threshold of ≈+3.0. HR curves for high-risk prostate cancer had a much steeper incline above an E-DII threshold of ≈+2.5. Curves were higher among Blacks and Whites relative to other races and among overweight or obese men. No relationship was observed between E-DII scores and intermediate- or low-risk disease.
CONCLUSIONS
Relationships between proinflammatory diet and prostate cancer risk may be nonlinear, with an increased risk above an E-DII threshold of ≈+2.5.
目的
本研究旨在探讨促炎饮食与前列腺癌风险之间的关系。
方法
在加利福尼亚男性健康研究中，对 40161 名参与者进行了能量调整后的饮食炎症指数（E-DII）评分计算。在 9.7±3.8 年的随访期间，根据疾病分级和分期，诊断出 2707 例新发前列腺癌病例，并分为低危、中危或高危。加速失效时间模型评估了前列腺癌的诊断时间。Cox 比例风险模型估计了风险比（HR）和 95%置信区间（95%CI）。E-DII 的非线性效应采用三阶多项式进行建模。
结果
E-DII 四分位区间与前列腺癌诊断时间无差异。高危前列腺癌的 HR 在第三 E-DII 四分位数时增加（HR=1.36；95%CI：1.04-1.76），但在第四 E-DII 四分位数时未增加（HR=0.99；95%CI：0.74-1.32，P=0.74），提示存在非线性剂量反应关系。E-DII 约+3.0 以上，前列腺癌的 HR 曲线呈指数增加。E-DII 约+2.5 以上，高危前列腺癌的 HR 曲线斜率陡峭得多。在黑人和白人中，HR 曲线高于其他种族，在超重或肥胖男性中也高于其他种族。E-DII 评分与中危或低危疾病之间未见相关性。
结论
促炎饮食与前列腺癌风险之间的关系可能是非线性的，E-DII 约+2.5 以上风险增加。
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