Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
Department of Public Health Management, School of Public Health, Kabul University of Medical Sciences, Kabul, Afghanistan.
Nutr Cancer. 2022;74(7):2489-2498. doi: 10.1080/01635581.2021.2014906. Epub 2021 Dec 13.
Insulin has a critical role in the pathogenesis of several cancers. We are aware of no study that examined the association between dietary insulin index (DII) and dietary insulin load (DIL) and gastric cancer.
This study aimed to investigate the relationship between dietary insulin index and DIL and odds of gastric cancer in Afghanistan.
In this hospital-based case-control study, we recruited 90 patients with newly-diagnosed gastric cancer and 180 healthy controls in Kabul, Afghanistan. Cases were chosen based on convenience-sampling method from the patients with pathologically confirmed gastric cancer aged between 20 and 75 years that had been referred to Jamhuriat Hospital, Kabul, Afghanistan. We applied a pre-tested food frequency questionnaire for dietary assessment of study participants. DIL and DII were calculated based on earlier publications. Multivariable logistic regression models were applied to examine the association between DII and DIL and gastric cancer.
Mean BMI of study participants was 23.55 ± 3.06 kg/m, of them 73% were males. After adjustment for potential confounders, participants in the top tertile of DII had 3.96 times greater odds for gastric cancer compared with those in the first tertile (95% CI: 1.23, 12.69; P-trend = 0.03). After adjustment for potential confounders, people in the highest tertile of DIL were 3.41 times more likely to have gastric cancer compared with those in the lowest tertile (95% CI: 1.28, 9.09; P-trend = 0.01). These associations remained significant even after further controlling for BMI, family history of cancer, H. pylori infection and salt intake.
A significant positive association was seen between dietary insulin index and insulin load and odds of gastric cancer in Afghan adults. Prospective cohort studies are required to confirm our findings.
胰岛素在多种癌症的发病机制中起着关键作用。我们尚未发现研究探讨饮食胰岛素指数（DII）和饮食胰岛素负荷（DIL）与胃癌之间的关系。
本研究旨在探讨阿富汗饮食胰岛素指数和 DIL 与胃癌发生风险之间的关系。
本项基于医院的病例对照研究在阿富汗喀布尔招募了 90 名新诊断为胃癌的患者和 180 名健康对照者。通过便利抽样方法，从年龄在 20 至 75 岁之间、曾被转诊至阿富汗喀布尔的贾姆希德医院且经病理证实患有胃癌的患者中选择病例。我们采用了经过预测试的食物频率问卷来评估研究参与者的饮食情况。根据先前的出版物计算 DIL 和 DII。采用多变量逻辑回归模型来检验 DII 和 DIL 与胃癌之间的关联。
研究参与者的平均 BMI 为 23.55±3.06kg/m2，其中 73%为男性。调整潜在混杂因素后，DII 处于最高三分位的参与者患胃癌的几率比处于最低三分位的参与者高 3.96 倍（95%CI：1.23，12.69；P 趋势=0.03）。调整潜在混杂因素后，DIL 处于最高三分位的参与者患胃癌的几率比处于最低三分位的参与者高 3.41 倍（95%CI：1.28，9.09；P 趋势=0.01）。即使进一步控制 BMI、癌症家族史、幽门螺杆菌感染和盐摄入量，这些关联仍然具有统计学意义。
在阿富汗成年人中，饮食胰岛素指数和胰岛素负荷与胃癌发生几率呈显著正相关。需要前瞻性队列研究来证实我们的发现。
