Department of Gastroenterology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.
Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea.
J Gastric Cancer. 2024 Oct;24(4):436-450. doi: 10.5230/jgc.2024.24.e39.
This study aims to explore the relationship between soy food consumption and gastric cancer (GC) risk, accounting for infection status.
We analyzed data from patients with GC and healthy individuals prospectively enrolled by 6 hospitals between 2016 and 2018. Dietary intake was evaluated using questionnaires that categorized seven dietary habits and 19 food groups. Multivariate logistic regression models were applied to examine associations. Model I adjusted for various epidemiological factors, while Model II included further adjustments for infection. Primary exposures examined were consumption frequencies of nonfermented, unsalted soy foods (soybean/tofu) and fermented, salty soy foods (soybean paste stew).
A total of 5,535 participants were included, with 1,629 diagnosed with GC. In Model I, the frequency of soybean/tofu consumption was inversely related to GC risk; adjusted odd ratios (aORs) were 0.62 (95% confidence interval [CI], 0.48-0.8), 0.38 (95% CI, 0.3-0.49), 0.42 (95% CI, 0.33-0.53), and 0.33 (95% CI, 0.27-0.42) for 1 time/week, 2 times/week, 3 times/week, and ≥4 times/week. Consumption of 2 servings/week of soybean paste stew showed the lowest GC association, forming a V-shaped curve. Both low (aOR, 4.03; 95% CI, 3.09-5.26) and high serving frequencies of soybean paste stew (aOR, 2.23; 95% CI, 1.76-2.82) were associated with GC. The association between soy foods and GC in Model II was similar to that in Model I. The soy food-GC associations were consistent across sexes in Model I. Nonetheless, the positive correlation between frequent consumption of soybean paste stew (≥5 times/week) and GC was more pronounced in women (aOR, 7.58; 95% CI, 3.20-17.99) compared to men (aOR, 3.03; 95% CI, 1.61-5.88) in Model II. Subgroup analyses by status and salty diet revealed a consistent inverse relationship between soybean/tofu and GC risk. In contrast, soybean paste stew showed a V-shaped relationship in -positive or salty diet groups and no significant association in the -negative group.
Soybean/tofu intake is consistently associated with a decreased risk of GC. However, the relationship between soybean paste stew consumption and GC risk varies, depending on infection status and dietary salt intake.
ClinicalTrials.gov Identifier: NCT03046745.
本研究旨在探讨大豆食品摄入与胃癌（GC）风险之间的关系，并考虑到 感染状况。
我们前瞻性分析了 2016 年至 2018 年期间 6 家医院入组的 GC 患者和健康个体的数据。使用问卷评估饮食摄入情况，问卷将七种饮食习惯和 19 种食物组进行了分类。采用多变量逻辑回归模型来检验相关性。模型 I 调整了各种流行病学因素，模型 II 进一步调整了 感染。主要暴露因素为非发酵、未加盐的大豆食品（大豆/豆腐）和发酵、加盐的大豆食品（豆瓣酱炖）的食用频率。
共纳入 5535 名参与者，其中 1629 人被诊断为 GC。在模型 I 中，大豆/豆腐的食用频率与 GC 风险呈负相关；调整后的比值比（aOR）分别为 0.62（95%置信区间[CI]，0.48-0.8）、0.38（95%CI，0.3-0.49）、0.42（95%CI，0.33-0.53）和 0.33（95%CI，0.27-0.42），每周食用 1 次、2 次、3 次和≥4 次。每周食用 2 份豆瓣酱炖菜与 GC 的关联最低，呈 V 形曲线。低（aOR，4.03；95%CI，3.09-5.26）和高（aOR，2.23；95%CI，1.76-2.82）豆瓣酱炖菜食用频率均与 GC 相关。模型 II 中大豆食品与 GC 的关联与模型 I 相似。在模型 I 中，大豆食品与 GC 的关联在性别间一致。然而，在模型 II 中，与男性（aOR，3.03；95%CI，1.61-5.88）相比，女性（aOR，7.58；95%CI，3.20-17.99）频繁食用豆瓣酱炖菜（≥5 次/周）与 GC 的正相关更为明显。根据 状态和咸食的亚组分析显示，大豆/豆腐与 GC 风险之间存在一致的负相关关系。相比之下，豆瓣酱炖菜在 阳性或咸食组呈 V 形关系，在 阴性组则无显著关联。
大豆/豆腐的摄入与 GC 风险呈负相关。然而，豆瓣酱炖菜的食用与 GC 风险之间的关系因 感染状态和饮食盐摄入而异。
ClinicalTrials.gov 标识符：NCT03046745。
