在98459名55岁及以上参与者中，坚持生命线饮食与较低的肺癌风险相关：一项大型前瞻性队列研究。

Adherence to lifelines diet is associated with lower lung cancer risk in 98,459 participants aged 55 years and above: a large prospective cohort study.

作者信息

Shi Yangpiaoyi, Xin Li, Peng Linglong, Xu Zhiquan, Liu Hang, Wei Qi, Tan Wanhao, Wang Yaxu, Xiang Ling, Gu Haitao

机构信息

Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Department of Clinical Nutrition, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

Front Nutr. 2024 Oct 23;11:1463481. doi: 10.3389/fnut.2024.1463481. eCollection 2024.

DOI:10.3389/fnut.2024.1463481

PMID:39507907

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11537889/

Abstract

BACKGROUND

Lifelines Diet Score (LLDS) was developed based on the 2015 Dutch Dietary Guidelines and current international scientific evidence. As a dietary quality assessment tool, the LLDS aims to evaluate the association between the Lifeline diet and the risk of chronic diseases. However, the evidence linking LLDS to lung cancer risk is currently limited.

OBJECTIVE

Our objective was to explore whether adherence to the LLDS is associated with reduced incidence and mortality of lung cancer, including its major histological subtypes: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC).

METHODS

Data for this research were sourced from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Trial. The LLDS for each participant was calculated based on responses to the dietary history questionnaire (DHQ), and subsequently analyzed after being categorized into quintiles. The Cox proportional hazards regression model was utilized to compute the hazard ratios (HRs) and 95% confidence intervals (CIs) for both the incidence and mortality of lung cancer, SCLC and NSCLC. Additionally, stratified analyses were conducted to ascertain possible effect modifiers, and several sensitivity analyses were performed to evaluate the robustness of the findings.

RESULTS

During the mean follow-up periods of 8.8 years for incidence and 15.1 years for mortality, we identified 1,642 new cases and 1,172 related deaths from lung cancer. Participants in the highest quartiles of LLDS compared to those in the lowest exhibited a reduced incidence (HR = 0.80, 95% CI = 0.68-0.94, for trend = 0.003) and mortality (HR = 0.81, 95%CI = 0.67-0.98, for trend = 0.009) of lung cancer. Furthermore, this negative association remained for SCLC incidence (HR = 0.55, 95% CI = 0.35-0.87, for trend = 0.002) and mortality (HR = 0.42, 95% CI = 0.25-0.70, for trend <0.001). The association between LLDS and the incidence and mortality of lung cancer is not influenced by pre-defined potential effect modifiers (all > 0.05). The sensitivity analyses substantiated the robustness of the results.

CONCLUSION

In conclusion, our research indicates that among 98,459 U.S. adults aged 55 and older, adherence to the LLDS is linked to a diminished incidence and mortality of lung cancer.

摘要

背景

生命线饮食评分（LLDS）是根据2015年荷兰饮食指南和当前国际科学证据制定的。作为一种饮食质量评估工具，LLDS旨在评估生命线饮食与慢性病风险之间的关联。然而，目前将LLDS与肺癌风险联系起来的证据有限。

目的

我们的目的是探讨坚持LLDS是否与肺癌（包括其主要组织学亚型：小细胞肺癌（SCLC）和非小细胞肺癌（NSCLC））的发病率和死亡率降低有关。

方法

本研究的数据来源于前列腺、肺、结肠和卵巢（PLCO）试验。根据饮食史问卷（DHQ）的回答计算每个参与者的LLDS，随后将其分为五分位数后进行分析。采用Cox比例风险回归模型计算肺癌、SCLC和NSCLC发病率和死亡率的风险比（HRs）和95%置信区间（CIs）。此外，进行分层分析以确定可能的效应修饰因素，并进行了几项敏感性分析以评估研究结果的稳健性。

结果

在发病率平均随访8.8年和死亡率平均随访15.1年期间，我们确定了1642例肺癌新病例和1172例相关死亡病例。与最低五分位数的参与者相比，LLDS最高四分位数的参与者肺癌发病率（HR = 0.80，95%CI = 0.68 - 0.94，趋势P = 0.003）和死亡率（HR = 0.81，95%CI = 0.67 - 0.98，趋势P = 0.009）降低。此外，这种负相关在SCLC发病率（HR = 0.55，95%CI = 0.35 - 0.87，趋势P = 0.002）和死亡率（HR = 0.42，95%CI = 0.25 - 0.70，趋势P < 0.001）中仍然存在。LLDS与肺癌发病率和死亡率之间的关联不受预先定义的潜在效应修饰因素的影响（所有P > 0.05）。敏感性分析证实了结果的稳健性。