Unit of Medical Statistics and Biometry, Fondazione IRCCS Istituto Nazionale Dei Tumori Di Milano.
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan.
Eur J Cancer Prev. 2022 Jul 1;31(4):339-345. doi: 10.1097/CEJ.0000000000000709. Epub 2021 Aug 16.
Diabetes and insulin levels may increase the risk of postmenopausal breast cancer. In the present investigation, we aimed at evaluating whether adherence to a diabetes risk reduction diet (DRRD) lowers the risk of breast cancer.
We used data from an Italian, multicentric case-control study (1991-1994) including 2569 incident histologically-confirmed breast cancer cases and 2588 hospital controls. A food frequency questionnaire collected subjects' usual diet. We derived a DRRD score on the basis of eight items: intake of cereal fiber, total fruit, coffee, polyunsaturated to saturated fats ratio and nuts (higher scores for higher intakes), and dietary glycemic index, red/processed meat and sugar-sweetened beverages/fruit juices (higher scores for lower intakes). The score theoretically ranged 8-37, with higher values indicating greater DRRD adherence. Odds ratios (ORs) of breast cancer according to the DRRD score were estimated using multiple logistic regression models.
The DRRD score was inversely related to the risk of breast cancer. The ORs were 0.93 [95% confidence interval (CI), 0.89-0.98] for a three-point score increment and 0.76 (95% CI, 0.64-0.89) for the highest versus the lowest quartile (P for trend 0.001). Inverse associations were observed in subgroups of covariates.
Higher DRRD adherence may decrease the risk of breast cancer.
糖尿病和胰岛素水平可能会增加绝经后乳腺癌的风险。本研究旨在评估遵循降低糖尿病风险饮食(DRRD)是否会降低乳腺癌的风险。
我们使用了一项意大利多中心病例对照研究(1991-1994 年)的数据,该研究包括 2569 例经组织学证实的乳腺癌新发病例和 2588 例医院对照。通过食物频率问卷收集了受试者的常规饮食。我们根据八项指标得出了 DRRD 评分:谷物纤维、总水果、咖啡、多不饱和与饱和脂肪比例以及坚果(摄入量越高,得分越高)、饮食血糖指数、红/加工肉和含糖饮料/果汁(摄入量越低,得分越高)。该评分理论上在 8-37 之间,得分越高表示对 DRRD 的遵循程度越高。采用多因素逻辑回归模型估计了乳腺癌与 DRRD 评分的比值比(OR)。
DRRD 评分与乳腺癌风险呈负相关。三分制评分增加一个单位的 OR 为 0.93(95%置信区间,0.89-0.98),最高四分位数与最低四分位数相比的 OR 为 0.76(95%置信区间,0.64-0.89)(趋势检验 P 值<0.001)。在调整了各种协变量的亚组中也观察到了类似的反比关系。
较高的 DRRD 遵循程度可能会降低乳腺癌的风险。