University at Buffalo, School of Public Health and Health Professions, Department of Epidemiology and Environmental Health, Buffalo, New York, USA.
Roswell Park Comprehensive Cancer Center, Department of Cancer Prevention and Control, Buffalo, New York, USA.
J Nutr. 2021 Jun 1;151(6):1597-1608. doi: 10.1093/jn/nxab011.
Ovarian cancer is the fifth most common cause of cancer death among women in the US, yet few modifiable risk factors have been established. Diets high in glycemic index (GI) and glycemic load (GL) have been linked to several cancers, but epidemiologic studies of ovarian cancer have yielded inconsistent results.
In this study, we aimed to examine associations between GI or GL and ovarian cancer.
We used prospective data from the Prostate, Lung, Colorectal, and Ovarian cohort. GI and GL were calculated from validated FFQs. Participants were women who were aged 60 to 74 y, did not have a history of cancer, and had both ovaries. Cox proportional hazard models were used to calculate HRs and 95% CIs for risk of ovarian cancer associated with quartiles of GI and GL. Analyses were performed separately for those who completed the dietary questionnaire at baseline (DQX) or later in the study (DHQ).
From the DQX sample set, 181 cases were identified among 24,633 women with median follow-up of 12.1 y; there were 211 cases among 42,410 women in the DHQ set, with median follow-up of 8.9 y. After adjusting for age at dietary questionnaire completion, year of randomization, year of questionnaire, study center, and oral contraceptive use, the risk of ovarian cancer decreased by 43% (HR: 0.57; 95% CI: 0.37, 0.88) among those in the highest compared with those in the lowest quartile of GL (DQX). Those in the highest compared with those in the lowest quartile of GI (DHQ), had a 38% lower risk (HR: 0.62; 95% CI: 0.42, 1.00).
We observed lower risk of ovarian cancer associated with higher GI and GL. Results should be interpreted with caution as they may have been influenced by limitations including lack of variability in dietary intake. Additional studies are needed to better understand what is driving these associations.
卵巢癌是美国女性癌症死亡的第五大常见原因，但尚未确定几个可改变的危险因素。高血糖指数（GI）和血糖负荷（GL）的饮食与多种癌症有关，但卵巢癌的流行病学研究结果不一致。
本研究旨在研究 GI 或 GL 与卵巢癌之间的关联。
我们使用前列腺癌、肺癌、结直肠癌和卵巢癌队列的前瞻性数据。GI 和 GL 是从经过验证的 FFQ 中计算得出的。参与者为年龄在 60 至 74 岁之间、没有癌症病史且双侧卵巢完整的女性。使用 Cox 比例风险模型计算与 GI 和 GL 四分位的卵巢癌风险相关的 HR 和 95%CI。分别分析了在基线（DQX）或研究后期（DHQ）完成饮食问卷的参与者。
在 DQX 样本集中，在 24633 名女性中发现了 181 例病例，中位随访时间为 12.1 年；在 DHQ 样本集中，在 42410 名女性中发现了 211 例病例，中位随访时间为 8.9 年。调整饮食问卷完成时的年龄、随机化年份、问卷年份、研究中心和口服避孕药使用情况后，与 GL 最低四分位相比，GL 最高四分位的卵巢癌风险降低 43%（HR：0.57；95%CI：0.37，0.88）（DQX）。与 GI 最低四分位相比，GI 最高四分位的风险降低了 38%（HR：0.62；95%CI：0.42，1.00）（DHQ）。
我们观察到 GI 和 GL 较高与卵巢癌风险较低相关。结果应谨慎解释，因为它们可能受到限制，包括饮食摄入缺乏变异性的影响。需要进一步研究以更好地了解驱动这些关联的因素。
