Zhang Yin, Zhong Guochao, Zhu Min, Chen Ling, Wan Huajing, Luo Fengming
Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China.
Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China.
Front Oncol. 2022 Apr 28;12:855101. doi: 10.3389/fonc.2022.855101. eCollection 2022.
To evaluate the association between diabetes risk reduction diet (DRRD) score and the risk of lung cancer in a large population.
Data of participants in this study were collected from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated in the Cox proportional hazards regression model for the association of DRRD score and lung cancer incidence in all included participants. Prespecified subgroup analyses were performed to evaluate whether the observed association was modified by age, sex, BMI, race/ethnicity, family history of lung cancer, smoking status and history of diabetes.
A total of 98,159 participants were included in this study. The mean (SD) age of the study participants cohort at baseline was 65.5 (5.73) years old. The mean (SD) follow-up time was 8.83 (1.96) years. The mean (SD) score of DRRD was 26.82 (5.19), and ranged from 20.47 (2.3) to 33.65 (2.42) from the lowest quartile to the highest quartile of the DRRD score, inferring the possibility of highest through the lowest risk of type 2 diabetes. The calculated HRs showed there was a trend that higher quartile indicated lower risk of lung cancer after adjusted for covariates (HR: 0.85; 95% CI:0.73,0.98; p for trend =0.036). The inverse trend between higher DRRD score and the risk of squamous cell carcinoma was more evident (HR: 0.50; 95% CI:0.34,0.73; p for trend =0.002). The inverse association between DRRD score and the incidence of lung cancer was more pronounced in participants who had a clear family history of lung cancer (p for interaction=0.016).
A protective association between DRRD score and risk of lung cancer is obtained. People are encouraged to adhere to higher DRRD score in their daily diet. Further studies should be conducted to confirm the result and explore the mechanism.
评估糖尿病风险降低饮食（DRRD）评分与大量人群患肺癌风险之间的关联。
本研究参与者的数据来自前列腺、肺、结肠直肠和卵巢（PLCO）癌症筛查试验。在Cox比例风险回归模型中计算所有纳入参与者的DRRD评分与肺癌发病率关联的风险比（HRs）和95%置信区间（CIs）。进行预设亚组分析以评估观察到的关联是否因年龄、性别、体重指数、种族/民族、肺癌家族史、吸烟状况和糖尿病史而改变。
本研究共纳入98159名参与者。研究参与者队列在基线时的平均（标准差）年龄为65.5（5.73）岁。平均（标准差）随访时间为8.83（1.96）年。DRRD的平均（标准差）评分为26.82（5.19），从DRRD评分的最低四分位数到最高四分位数范围为20.47（2.3）至33.65（2.42），推断出患2型糖尿病风险从最高到最低的可能性。计算出的HRs显示，在调整协变量后，四分位数越高表明肺癌风险越低存在一种趋势（HR：0.85；95%CI：0.73，0.98；趋势p值 = 0.036）。较高的DRRD评分与鳞状细胞癌风险之间的反向趋势更明显（HR：0.50；95%CI：0.34，0.73；趋势p值 = 0.002）。DRRD评分与肺癌发病率之间的反向关联在有明确肺癌家族史的参与者中更为明显（交互作用p值 = 0.016）。
获得了DRRD评分与肺癌风险之间的保护性关联。鼓励人们在日常饮食中坚持更高的DRRD评分。应进行进一步研究以证实该结果并探索其机制。
