宏量营养素质量及其与能量摄入的相互作用与卵巢癌患者生存的关系：一项前瞻性队列研究的结果。

The association of macronutrient quality and its interactions with energy intake with survival among patients with ovarian cancer: results from a prospective cohort study.

机构信息

Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning Province, Shenyang, China.

Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.

出版信息

Am J Clin Nutr. 2023 Jun;117(6):1362-1371. doi: 10.1016/j.ajcnut.2023.03.023. Epub 2023 Mar 29.

DOI:10.1016/j.ajcnut.2023.03.023

PMID:37001589

Abstract

BACKGROUND

Emerging evidence supports shifting the focus from the quantity of macronutrients to quality to obtain greater benefits for the prognosis of ovarian cancer (OC). Additionally, despite the high relevance between macronutrient quality and quantity, the interaction of these parameters on OC survival remains unknown.

OBJECTIVE

A multidimensional macronutrient quality index (MQI) was applied to investigate the association between overall macronutrient quality and the survival of patients with OC.

METHODS

A prospective cohort study was conducted with 701 females diagnosed with OC who were enrolled from 2015 to 2020. Dietary intake information was obtained from a validated food frequency questionnaire. The MQI was calculated based on 3 quality indices: carbohydrate quality index (CQI), fat quality index (FQI), and protein quality index (PQI). Cox proportional hazards regression was conducted to calculate HRs and 95% CIs. Furthermore, we evaluated whether energy intake status (total energy intake and energy balance) modified the association between MQI and OC survival.

RESULTS

During a median follow-up period of 38 (interquartile: 35-40) mo, 130 deaths occurred. The prediagnosis high MQI scores were associated with substantially improved survival among females with OC (HR = 0.50, 95% CI: 0.33, 0.77). For sub-indices of the MQI, higher CQI (HR = 0.60, 95% CI: 0.36, 0.99), higher FQI (HR = 0.55, 95% CI: 0.34, 0.87), and higher PQI (HR = 0.58, 95% CI: 0.35, 0.94) scores were all associated with better survival. Notably, significant interactions were observed for the MQI score with total energy intake and energy balance as well as the quantity and quality of carbohydrates on survival.

CONCLUSIONS

Intake of high-quality macronutrients before diagnosis was associated with improved survival among females with OC, especially for those with energy imbalance.

摘要

背景

越来越多的证据表明，为了改善卵巢癌（OC）的预后，我们应该关注宏量营养素的质量而非数量。此外，尽管宏量营养素的质量和数量密切相关，但这些参数对 OC 患者生存的相互作用仍不清楚。

目的

应用多维宏量营养素质量指数（MQI）来研究 OC 患者整体宏量营养素质量与生存之间的关系。

方法

这是一项前瞻性队列研究，共纳入了 701 名 2015 年至 2020 年期间被诊断为 OC 的女性患者。通过一份经过验证的食物频率问卷获取饮食摄入信息。根据 3 个质量指数（CQI、FQI 和 PQI）计算 MQI。使用 Cox 比例风险回归计算 HR 和 95%CI。此外，我们还评估了能量摄入状态（总能量摄入和能量平衡）是否会改变 MQI 与 OC 生存之间的关系。

结果

在中位随访 38（四分位距：35-40）个月期间，有 130 人死亡。OC 女性的 MQI 评分较高与生存显著改善相关（HR = 0.50，95%CI：0.33，0.77）。MQI 的子指数中，较高的 CQI（HR = 0.60，95%CI：0.36，0.99）、较高的 FQI（HR = 0.55，95%CI：0.34，0.87）和较高的 PQI（HR = 0.58，95%CI：0.35，0.94）评分均与生存改善相关。值得注意的是，MQI 评分与总能量摄入和能量平衡以及碳水化合物的数量和质量与生存之间存在显著的交互作用。