饮食和生活方式的胰岛素生成潜能与男性和女性消化系统癌症风险的关联。
Association of the Insulinemic Potential of Diet and Lifestyle With Risk of Digestive System Cancers in Men and Women.
作者信息
Wang Weike, Fung Teresa T, Wang Molin, Smith-Warner Stephanie A, Giovannucci Edward L, Tabung Fred K
出版信息
JNCI Cancer Spectr. 2018 Nov;2(4):pky080. doi: 10.1093/jncics/pky080. Epub 2019 Jan 30.
BACKGROUND
We examined the role of the insulinemic potential of diet and lifestyle in the development of cancers of the digestive system, using two plasma C-peptide-based indices: the empirical dietary index for hyperinsulinemia (EDIH) and empirical lifestyle index for hyperinsulinemia (ELIH).
METHODS
We used Cox regression to analyze data on 45 816 men (Health Professionals Follow-up Study, 1986-2012) and 74 191 women (Nurses' Health Study, 1984-2012) to examine associations between EDIH and ELIH scores and digestive system cancers. We computed the diet-only score (EDIH) from food-frequency questionnaires administered every 4 years. The lifestyle score (ELIH) included diet, body mass index, and physical activity. Outcomes included incident cancer of the digestive system (mouth, throat, esophagus, stomach, small intestine, and colorectum) and its accessory organs (pancreas, gallbladder, and liver). values were two-sided.
RESULTS
We found direct associations between higher insulinemic potential of diet or lifestyle and risk of developing digestive system cancers in both men and women. The pooled multivariable hazard ratios (HRs) for participants comparing the highest to lowest EDIH quintile were: HR = 1.27, 95% confidence interval (CI) = 1.15 to 1.40, < .001 for digestive system cancers; HR = 1.30, 95% CI = 1.17 to 1.45, < .001 for digestive tract cancers (excluding accessory organs); and HR = 1.15, 95% CI = 0.93 to 1.41, = .48 for digestive accessory organ cancers. The same associations were stronger with the lifestyle score: HR = 1.47, 95% CI = 1.23 to 1.76, < .001 for digestive system cancers; HR = 1.49, 95% CI = 1.14 to 1.95, = .001 for digestive tract cancers; and HR = 1.43, 95% CI = 1.17 to 1.73, < .001 for digestive accessory organ cancers.
CONCLUSIONS
The findings suggest that interventions to reduce the insulinemic potential of diet and lifestyle may be a means of preventing digestive system cancer.
背景
我们使用两个基于血浆C肽的指标，即高胰岛素血症经验饮食指数（EDIH）和高胰岛素血症经验生活方式指数（ELIH），来研究饮食和生活方式的胰岛素生成潜力在消化系统癌症发生中的作用。
方法
我们使用Cox回归分析了45816名男性（健康专业人员随访研究，1986 - 2012年）和74191名女性（护士健康研究，1984 - 2012年）的数据，以检验EDIH和ELIH得分与消化系统癌症之间的关联。我们根据每4年进行一次的食物频率问卷计算仅饮食得分（EDIH）。生活方式得分（ELIH）包括饮食、体重指数和身体活动。结局包括消化系统（口腔、咽喉、食管、胃、小肠和结肠直肠）及其附属器官（胰腺、胆囊和肝脏）的新发癌症。P值为双侧。
结果
我们发现，饮食或生活方式的胰岛素生成潜力较高与男性和女性患消化系统癌症的风险之间存在直接关联。将最高与最低EDIH五分位数的参与者进行比较的汇总多变量风险比（HR）为：消化系统癌症的HR = 1.27，95%置信区间（CI）= 1.15至1.40，P <.001；消化道癌症（不包括附属器官）的HR = 1.30，95% CI = 1.17至1.45，P <.001；消化附属器官癌症的HR = 1.15，95% CI = 0.93至1.41，P =.48。生活方式得分的相同关联更强：消化系统癌症的HR = 1.47，95% CI = 1.23至1.76，P <.001；消化道癌症的HR = 1.49，95% CI = 1.14至1.95，P =.001；消化附属器官癌症的HR = 1.43，95% CI = 1.17至1.73，P <.001。
结论
研究结果表明，采取干预措施降低饮食和生活方式的胰岛素生成潜力可能是预防消化系统癌症的一种方法。
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