1Department of General Surgery,Ningbo Medical Center Lihuili Hospital,Ningbo,315000, People's Republic of China.
2Department of Gastroenterology,Ningbo First Hospital,Ningbo,315000, People's Republic of China.
Br J Nutr. 2019 May;121(10):1081-1096. doi: 10.1017/S0007114519000424. Epub 2019 Mar 6.
Several studies analysed the associations between dietary carbohydrate intake, glycaemic index (GI) and glycaemic load (GL) and digestive system cancers; however, the results remain controversial. This study was to perform a meta-analysis evaluating the quantitative and dose-response associations between carbohydrate intake, GI and GL, and risk of digestive system cancers. We searched medical and biological databases up to June 2018 and identified twenty-six cohort studies and eighteen case-control studies. Meta-analytic fixed or random effects models were applied to process data. We also performed dose-response analysis, meta-regression and subgroup analyses. We found that high levels of GI were significantly associated with the risk of digestive system cancers at the highest compared with the lowest categories from cohort studies (summary relative risk (RR)=1·10, 95 % CI 1·05, 1·15). Similar effects were observed from case-control studies of the comparison between the extreme categories, but the difference did not reach statistical significance (summary OR=1·28, 95 % CI 0·97, 1·69). We also observed significant dose-response association between GI and digestive system cancers, with every 10-unit increase in GI (summary RR=1·003; 95 % CI 1·000, 1·012 for cohort studies; summary OR=1·09; 95 % CI 1·06, 1·11 for case-control studies). In addition, both cohort studies and case-control studies indicated that neither dietary carbohydrate intake nor GL bore any statistical relationship to digestive system cancers from the results of the highest compared with the lowest categories analyses and dose-response analyses. The results suggest a moderate association between high-GI diets and the risk of digestive system cancers.
一些研究分析了饮食碳水化合物摄入量、血糖生成指数（GI）和血糖负荷（GL）与消化系统癌症之间的关联，但结果仍存在争议。本研究旨在进行荟萃分析，评估碳水化合物摄入量、GI 和 GL 与消化系统癌症风险之间的定量和剂量反应关联。我们检索了截至 2018 年 6 月的医学和生物数据库，共确定了 26 项队列研究和 18 项病例对照研究。采用固定或随机效应模型进行荟萃分析处理数据。我们还进行了剂量反应分析、荟萃回归和亚组分析。我们发现，从队列研究来看，与最低类别相比，最高 GI 类别与消化系统癌症风险显著相关（汇总相对风险（RR）=1.10，95%CI 1.05，1.15）。从病例对照研究来看，在极端类别之间进行比较时也观察到了类似的影响，但差异无统计学意义（汇总 OR=1.28，95%CI 0.97，1.69）。我们还观察到 GI 与消化系统癌症之间存在显著的剂量反应关联，GI 每增加 10 个单位（汇总 RR=1.003；95%CI 1.000，1.012 用于队列研究；汇总 OR=1.09；95%CI 1.06，1.11 用于病例对照研究）。此外，队列研究和病例对照研究均表明，从最高类别与最低类别分析和剂量反应分析的结果来看，饮食碳水化合物摄入量或 GL 与消化系统癌症均无统计学关联。结果表明，高 GI 饮食与消化系统癌症风险之间存在中度关联。
