Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, U1018 Inserm, Institut Gustave Roussy, Espace Maurice Tubiana, University Paris-Saclay, 114 Rue Edouard Vaillant, 94805, Villejuif Cedex, France.
Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA.
Eur J Nutr. 2023 Aug;62(5):1977-1989. doi: 10.1007/s00394-023-03108-w. Epub 2023 Mar 4.
Inflammation is implicated in breast cancer development, and diet is one of the modifiable risk factors involved in the regulation of chronic inflammation. Previous studies on the association between breast cancer risk and Dietary Inflammatory Indexes (DII) derived from food frequency questionnaires and data on inflammatory potential of dietary components have reported inconsistent results.
To investigate the association between the DII and the risk of breast cancer using data from a large population-based cohort study.
A total of 67,879 women from the E3N cohort were followed from 1993 to 2014. A total of 5686 breast cancer cases were diagnosed during the follow-up. The food frequency questionnaire administered at baseline in 1993 was used to calculate an adapted DII. Cox proportional hazard models using age as the time scale were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). Spline regression was used to determine any dose-response relationship. We also evaluated effect modification by menopausal status, body mass index, smoking status and alcohol consumption.
The median DII score of the study population was slightly pro-inflammatory (DII = + 0.39); ranged from - 4.68 in the lowest quintile to + 4.29 in the highest quintile. The HR increased linearly with the DII (HR per 1SD = 1.04 [95% CI: 1.01, 1.07]), and reached 1.13 [95% CI: 1.04, 1.23] in the 5th quintile group as compared to the first. A positive linear dose-response relationship was also observed when modeling DII with spline functions. Slightly higher HRs were observed in non-smokers (HR 1.06 [95% CI: 1.02, 1.10]; p trend = 0.001) and in low-alcohol consumers (≤ 1 glass/day) (HR 1.05 [95% CI: 1.01, 1.08]; p trend = 0.002).
Our results suggest a positive association between DII and breast cancer risk. Consequently, the promotion of anti-inflammatory diet may contribute to breast cancer prevention.
炎症与乳腺癌的发生有关，而饮食是调节慢性炎症的可改变风险因素之一。此前，基于食物频率问卷和饮食成分炎症潜力的数据，研究了膳食炎症指数（DII）与乳腺癌风险之间的关系，结果并不一致。
利用来自大型人群队列研究的数据，调查 DII 与乳腺癌风险之间的关系。
E3N 队列共有 67879 名女性，随访时间从 1993 年至 2014 年。随访期间共诊断出 5686 例乳腺癌病例。1993 年基线时的食物频率问卷用于计算改良的 DII。采用年龄作为时间尺度的 Cox 比例风险模型估计风险比（HR）和 95%置信区间（CI）。采用样条回归来确定任何剂量-反应关系。我们还评估了绝经状态、体重指数、吸烟状况和饮酒状况的效应修饰作用。
研究人群的中位数 DII 评分略呈促炎状态（DII=+0.39）；范围从最低五分位数的-4.68 到最高五分位数的+4.29。DII 每增加 1SD，HR 呈线性增加（HR per 1SD=1.04 [95% CI：1.01, 1.07]），与第一五分位数组相比，第五五分位数组的 HR 为 1.13 [95% CI：1.04, 1.23]。当使用样条函数对 DII 进行建模时，也观察到了正的线性剂量-反应关系。在非吸烟者（HR 1.06 [95% CI：1.02, 1.10]；p 趋势=0.001）和低酒精消费者（≤1 杯/天）（HR 1.05 [95% CI：1.01, 1.08]；p 趋势=0.002）中，HR 略高。
我们的结果表明 DII 与乳腺癌风险之间存在正相关。因此，促进抗炎饮食可能有助于预防乳腺癌。
