Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia.
Department of Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham, Alabama.
Cancer Epidemiol Biomarkers Prev. 2020 Nov;29(11):2300-2308. doi: 10.1158/1055-9965.EPI-20-0568. Epub 2020 Aug 20.
Colorectal carcinogenesis is mechanistically linked to inflammation and is highly associated with diet and lifestyle factors that may affect chronic inflammation. We previously developed dietary (DIS) and lifestyle (LIS) inflammation scores, comprising inflammation biomarker-weighted components, to characterize the collective contributions of 19 food groups and four lifestyle exposures to systemic inflammation. Both scores were more strongly directly associated with circulating inflammation biomarkers in three validation populations, including a subset of the study population described below, than were the previously reported dietary inflammatory index and empirical dietary inflammatory pattern.
We calculated the DIS and LIS in three pooled case-control studies of incident, sporadic colorectal adenoma ( = 765 cases and 1,986 controls) with extensive dietary and lifestyle data, and investigated their associations with adenoma using multivariable unconditional logistic regression.
For those in the highest (more proinflammatory) relative to the lowest (more anti-inflammatory) quintiles of the DIS and LIS, the multivariable-adjusted ORs were 1.31 [95% confidence interval (CI), 0.98-1.75; = 0.09] and 1.98 (95% CI, 1.48-2.66; < 0.001), respectively. These associations were strongest for adenomas with high-risk characteristics and among men. Those in the highest relative to the lowest joint DIS/LIS quintile had a 2.65-fold higher odds (95% CI, 1.77-3.95) of colorectal adenoma.
These results support that diets and lifestyles with higher balances of pro- to anti-inflammatory exposures may be associated with higher risk for incident, sporadic colorectal adenoma.
Our findings support further investigation of the DIS and LIS in relation to colorectal neoplasms.
结直肠癌的发生机制与炎症有关,与可能影响慢性炎症的饮食和生活方式因素密切相关。我们之前开发了饮食(DIS)和生活方式(LIS)炎症评分,由炎症生物标志物加权组成,用于描述 19 种食物组和 4 种生活方式暴露对全身炎症的综合贡献。在三个验证人群中,包括下面描述的研究人群的一个子集,这两个评分与循环炎症生物标志物的直接相关性都比以前报道的饮食炎症指数和经验性饮食炎症模式更强。
我们在三个关于偶发性散发性结直肠腺瘤( = 765 例病例和 1986 例对照)的病例对照研究中计算了 DIS 和 LIS,这些研究具有广泛的饮食和生活方式数据,并使用多变量非条件逻辑回归调查了它们与腺瘤的关系。
对于 DIS 和 LIS 最高(更促炎)与最低(更抗炎)五分位数的人群,多变量调整后的 OR 分别为 1.31(95%CI,0.98-1.75; = 0.09)和 1.98(95%CI,1.48-2.66; < 0.001)。这些关联在具有高危特征的腺瘤和男性中最强。与 DIS/LIS 最低五分位相比,处于最高五分位的人群患结直肠腺瘤的几率高出 2.65 倍(95%CI,1.77-3.95)。
这些结果支持饮食和生活方式中促炎与抗炎暴露的平衡更高可能与偶发性散发性结直肠腺瘤的风险增加有关。
我们的发现支持进一步研究 DIS 和 LIS 与结直肠肿瘤的关系。