Liu Jia-Xin, Bao Rui-Han, Luan Meng, Liu Chuan, Wu Lang, Liu Fang-Hua, Li Yi-Zi, Xu He-Li, Wei Yi-Fan, Xiao Qian, Huang Dong-Hui, Li Xiao-Ying, Bao Qi, Wang Jia-Yi, Chen Yu-Han, Liu Jia-Ming, Gao Song, Wang Xiao-Ying, Zhang De-Yu, Gong Ting-Ting, Wu Qi-Jun
Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China.
School of Undergraduate, China Medical University, Shenyang, China; Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
J Acad Nutr Diet. 2025 Feb 19. doi: 10.1016/j.jand.2025.02.008.
Dietary factors impact systemic inflammation, which not only correlates with poorer outcomes in patients with ovarian cancer (OC), but also promotes cancer development through increased cell division, genetic alterations, and malignant transformation of epithelial cells at inflammatory sites. However, evidence between dietary inflammatory patterns and OC survival remains sparse.
The aim of this study was to examine associations between pre- and post-diagnosis dietary inflammatory patterns, including their changes, and overall survival (OS).
This study analyzed data from the hospital-based prospective, longitudinal cohort study: the Ovarian Cancer Follow-Up Study. Dietary intake information was collected at baseline (pre-diagnosis) and 12 months after diagnosis (post-diagnosis) using a 111-item food frequency questionnaire. Three inflammatory dietary scores were analyzed: dietary inflammatory index (DII), inflammatory score of the diet (ISD), and empirical dietary inflammatory pattern. The dietary inflammatory scores were calculated for each person and categorized in tertiles.
PARTICIPANTS/SETTING: Participants included 560 patients aged 18 through 79 years, who were newly diagnosed with OC, recruited at the Shengjing Hospital of China Medical University between 2015 and 2022.
OS time was defined as the interval between the histologic diagnosis of OC and the date of death from any cause or the date of last follow-up (February 16, 2023) for patients who were still alive.
Differences in general and clinical characteristics according to the tertile of inflammatory dietary pattern scores were assessed using χ test for categorical variables and Student t test or Kruskal-Wallis test for continuous variables. Cox proportion hazard models were used to calculate hazard ratios (HRs) and 95% CIs for the associations of the pre- and post-diagnosis inflammatory dietary patterns with OS.
High pre-diagnosis DII, ISD, and empirical dietary inflammatory pattern scores were associated with worse OS (HR 1.84; 95% CI 1.12 to 3.01; HR 1.70; 95% CI 1.04 to 2.79; and HR 1.64; 95% CI 1.14 to 2.35, respectively). High post-diagnosis DII and ISD scores were related to worse OS (HR 2.71; 95% CI 1.15 to 6.40 and HR 2.84; 95% CI 1.25 to 6.49). Compared with those who maintained stable scores (change ± 20%), patients whose DII or ISD scores increased (>20%) from pre- to post-diagnosis had worse OS (DII: HR 2.00; 95% CI 1.30 to 3.08; ISD: HR 1.56; 95% CI 1.10 to 2.21), whereas patients whose empirical dietary inflammatory pattern score decreased (>20%) had better OS (HR 0.67; 95% CI 0.45 to 0.99). Moreover, compared with persistently low scores, patients who changed from low pre-diagnosis to high post-diagnosis scores had worse OS (DII: HR 2.47; 95% CI 1.54 to 3.94; ISD: HR 2.88; 95% CI 1.81-4.57).
Pre- and post-diagnosis adherence to inflammatory dietary patterns was associated with poor OC survival.
饮食因素会影响全身炎症反应，这不仅与卵巢癌（OC）患者较差的预后相关，还通过增加细胞分裂、基因改变以及炎症部位上皮细胞的恶性转化来促进癌症发展。然而，饮食炎症模式与OC生存率之间的证据仍然稀少。
本研究旨在探讨诊断前后的饮食炎症模式（包括其变化）与总生存期（OS）之间的关联。
本研究分析了基于医院的前瞻性纵向队列研究——卵巢癌随访研究的数据。使用111项食物频率问卷在基线（诊断前）和诊断后12个月（诊断后）收集饮食摄入信息。分析了三种炎症饮食评分：饮食炎症指数（DII）、饮食炎症评分（ISD）和经验性饮食炎症模式。计算每个人的饮食炎症评分，并将其分为三分位数。
参与者/设置：参与者包括560名年龄在18至79岁之间的新诊断为OC的患者，于2015年至2022年在中国医科大学附属盛京医院招募。
OS时间定义为OC组织学诊断与任何原因导致的死亡日期或仍存活患者的最后随访日期（2023年2月16日）之间的间隔。
根据炎症饮食模式评分的三分位数，使用卡方检验评估分类变量的一般和临床特征差异，使用学生t检验或Kruskal-Wallis检验评估连续变量的差异。使用Cox比例风险模型计算诊断前后炎症饮食模式与OS关联的风险比（HR）和95%置信区间（CI）。
诊断前高DII、ISD和经验性饮食炎症模式评分与较差的OS相关（HR分别为1.84；95%CI为1.12至3.01；HR为1.70；95%CI为1.04至2.79；以及HR为1.64；95%CI为1.14至2.35）。诊断后高DII和ISD评分与较差的OS相关（HR分别为2.71；95%CI为1.15至6.40和HR为2.84；95%CI为1.25至6.49）。与评分保持稳定（变化±20%）的患者相比，诊断前后DII或ISD评分增加（>20%）的患者OS较差（DII：HR为2.00；95%CI为1.30至3.08；ISD：HR为1.56；95%CI为1.10至2.21），而经验性饮食炎症模式评分降低（>20%）的患者OS较好（HR为0.67；95%CI为0.45至0.99）。此外，与持续低评分相比，从诊断前低评分变为诊断后高评分的患者OS较差（DII：HR为2.47；95%CI为1.54至3.94；ISD：HR为2.88；95%CI为1.81至4.57）。
诊断前后坚持炎症饮食模式与OC患者较差的生存率相关。
