Kim Kyeezu, Kong Angela, Flanigan Robert C, Quek Marcus L, Hollowell Courtney M P, Vidal Patricia P, Branch Jefferey, Dean Leslie A, Macias Virgilia, Kajadacsy-Balla Andre A, Fitzgibbon Marian L, Cintron Daisy, Liu Li, Freeman Vincent L
Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago School of Public Health, Chicago, IL, USA.
Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA.
Cancer Causes Control. 2019 Mar;30(3):271-279. doi: 10.1007/s10552-019-1134-4. Epub 2019 Feb 7.
An association between dietary carbohydrate intake and prostate cancer (PCa) prognosis is biologically plausible, but data are scarce. This prospective cohort study examined the relation between pre-diagnostic carbohydrate intake and treatment failure following radical prostatectomy for clinically early-stage PCa.
We identified 205 men awaiting radical prostatectomy and assessed their usual dietary intake of carbohydrates using the 110-item Block food frequency questionnaire. We also evaluated carbohydrate intake quality using a score based on the consumption of sugars relative to fiber, fat, and protein. Logistic regression analyzed their associations with the odds of treatment failure, defined as a detectable and rising serum prostate-specific antigen (PSA) or receiving androgen deprivation therapy (ADT) within 2 years.
Sucrose consumption was associated with a higher odds and fiber consumption with a lower odds of ADT after accounting for age, race/ethnicity, body mass index, and tumor characteristics (odds ratio [OR] (95% confidence interval [CI]) 5.68 (1.71, 18.9) for 3rd vs. 1st sucrose tertile and 0.88 (0.81, 0.96) per gram of fiber/day, respectively). Increasing carbohydrate intake quality also associated with a lower odds of ADT (OR (95% CI) 0.78 (0.66, 0.92) per unit increase in score, range 0-12).
Pre-diagnostic dietary carbohydrate intake composition and quality influence the risk of primary treatment failure for early-stage PCa. Future studies incorporating molecular aspects of carbohydrate metabolism could clarify possible underlying mechanisms.
膳食碳水化合物摄入量与前列腺癌（PCa）预后之间的关联在生物学上是合理的，但数据稀少。这项前瞻性队列研究探讨了临床早期PCa患者在根治性前列腺切除术前的碳水化合物摄入量与治疗失败之间的关系。
我们确定了205名等待根治性前列腺切除术的男性，并使用110项的Block食物频率问卷评估了他们日常碳水化合物的摄入量。我们还根据糖相对于纤维、脂肪和蛋白质的摄入量计算得分，以此评估碳水化合物摄入质量。采用逻辑回归分析它们与治疗失败几率的关联，治疗失败定义为在2年内血清前列腺特异性抗原（PSA）可检测且上升或接受雄激素剥夺治疗（ADT）。
在考虑年龄、种族/民族、体重指数和肿瘤特征后，蔗糖摄入量与接受ADT的较高几率相关，纤维摄入量与较低几率相关（第三三分位数蔗糖摄入量与第一三分位数相比的比值比[OR]（95%置信区间[CI]）为5.68（1.71，18.9），每克纤维/天的OR为0.88（0.81，0.96））。碳水化合物摄入质量的提高也与接受ADT的较低几率相关（得分每增加一个单位（范围0 - 12）的OR（95%CI）为0.78（0.66，0.92））。
诊断前膳食碳水化合物的摄入组成和质量会影响早期PCa初次治疗失败的风险。未来纳入碳水化合物代谢分子层面的研究可能会阐明潜在机制。
