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.
Ann Epidemiol. 2019 Jan;29:30-38. doi: 10.1016/j.annepidem.2018.10.008. Epub 2018 Nov 2.
The purpose of the study was to examine the relationship between proinflammatory diet and prostate cancer risk.
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.
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.
Relationships between proinflammatory diet and prostate cancer risk may be nonlinear, with an increased risk above an E-DII threshold of ≈+2.5.
本研究旨在探讨促炎饮食与前列腺癌风险之间的关系。
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。
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。
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。
