Shen Qiu-Ming, Tuo Jia-Yi, Li Zhuo-Ying, Fang Jie, Tan Yu-Ting, Zhang Wei, Li Hong-Lan, Xiang Yong-Bing
State Key Laboratory of Systems Medicine for Cancer & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 25, Lane 2200, Xie Tu Road, Shanghai, 200032, People's Republic of China.
School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, People's Republic of China.
Eur J Nutr. 2024 Jun;63(4):1113-1124. doi: 10.1007/s00394-024-03347-5. Epub 2024 Feb 12.
The associations between dietary patterns and liver cancer risk have received much attention, but evidence among the Chinese population is scarce. This study aims to update the results of two cohort studies and provide the sex-specific associations in the Chinese population.
This study was based on two cohorts from the Shanghai Men's Health Study (SMHS) and the Shanghai Women's Health Study (SWHS). Diet information was collected by validated food frequency questionnaires. Dietary patterns were derived by factor analysis. Cox regression model was utilized to estimate the hazard ratio (HR) and 95% confidence interval (CI) for associations between dietary patterns and liver cancer risk.
During median follow-up years of 11.2 (male) and 17.1 (female) years, 427 males and 252 females were identified as incident primary liver cancer cases. In males, vegetable-based dietary pattern was inversely associated with liver cancer (HR: 0.67, 95%CI 0.51-0.88, P < 0.001). Interaction analysis indicated that in males lower vegetable-based dietary pattern score and older age/medical history of chronic hepatitis combined increase the hazard of liver cancer more than the sum of them, with a 114% and 1061% higher risk, respectively. In females, the fruit-based dietary pattern was associated with a reduced risk of liver cancer (HR: 0.63, 95%CI 0.42-0.95, P = 0.03). In both males and females, null associations were observed between the meat-based dietary pattern and the risk of liver cancer.
A vegetable-based dietary pattern in males and a fruit-based dietary pattern in females tended to have a protective role on liver cancer risk. This study provided updated information that might be applied to guide public health action for the primary prevention of liver cancer.
饮食模式与肝癌风险之间的关联已受到广泛关注，但中国人群中的相关证据较少。本研究旨在更新两项队列研究的结果，并提供中国人群中按性别划分的关联情况。
本研究基于上海男性健康研究（SMHS）和上海女性健康研究（SWHS）的两个队列。通过经过验证的食物频率问卷收集饮食信息。通过因子分析得出饮食模式。采用Cox回归模型估计饮食模式与肝癌风险之间关联的风险比（HR）和95%置信区间（CI）。
在男性中位随访11.2年、女性中位随访17.1年期间，分别有427名男性和252名女性被确诊为原发性肝癌病例。在男性中，以蔬菜为主的饮食模式与肝癌呈负相关（HR：0.67，95%CI 0.51 - 0.88，P < 0.001）。交互分析表明，在男性中，较低的以蔬菜为主的饮食模式得分与较高年龄/慢性肝炎病史相结合，比两者单独作用时更能增加患肝癌的风险，风险分别高出114%和1061%。在女性中，以水果为主的饮食模式与肝癌风险降低相关（HR：0.63，95%CI 0.42 - 0.95，P = 0.03）。在男性和女性中，均未观察到以肉类为主的饮食模式与肝癌风险之间存在关联。
男性以蔬菜为主的饮食模式和女性以水果为主的饮食模式往往对肝癌风险具有保护作用。本研究提供了可用于指导肝癌一级预防公共卫生行动的最新信息。
