Torres-Laiton Luisa, Luján-Barroso Leila, Nadal-Zaragoza Núria, Castro-Espin Carlota, Jakszyn Paula, Panico Camilla, Le Cornet Charlotte, Dahm Christina C, Petrova Dafina, Rodríguez-Palacios Daniel Ángel, Jannasch Franziska, Masala Giovanna, Dossus Laure, Padroni Lisa, Guevara Marcela, Schulze Matthias B, Fortner Renée T, Tumino Rosario, Crous-Bou Marta
Unit of Nutrition and Cancer, Catalan Institute of Oncology-Bellvitge Biomedical Research Institute (ICO-IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
Department of Nutrition, Food Science and Gastronomy, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain.
Nutrients. 2025 May 12;17(10):1645. doi: 10.3390/nu17101645.
BACKGROUND/OBJECTIVES: Endometrial cancer (EC)'s major risk factors include obesity and diabetes, both strongly related with lifestyle choices and dietary factors. Our study aimed to evaluate the relationship between diabetes-related dietary patterns, EC risk, and survival in a population of middle-aged European women.
A total of 285,418 female participants from the European Prospective Investigation into Cancer and Nutrition (EPIC) study were included in the analysis. After a mean time of 10.6 years of follow-up, 1955 incident EC cases were registered; of those, 133 women died from EC. The Empirical Dietary Index for Insulin Resistance (EDIR), the Empirical Dietary Index for Hyperinsulinemia (EDIH), and the Diabetes Risk Reduction Diet (DRRD), were estimated from dietary information collected at baseline from EPIC participants. Cox proportional hazards regression models were used to evaluate the association between the dietary patterns and EC risk, using hazard ratios (HR), 95% confidence intervals (CI), and adjusting for relevant confounders. Cox and Fine-Gray models were used to assess the association with overall and EC-specific mortality, respectively.
Higher adherence to EDIR was associated with an increased risk of EC, multivariable HR for T3vsT1 were 1.17 (95% CI = 1.04 to1.31). However, when BMI was included in the models, these associations became weaker and no longer statistically significant. No associations were observed in relation to adherence to EDIH, DRRD, and EC risk. No associations were found in relation to diabetes-related dietary patterns and mortality.
This study highlights the potential role of diabetes related dietary patterns and EC etiology and prevention. Further studies are warranted to better understand the role of etiology-derived dietary patterns and disease prevention and prognosis.
背景/目的：子宫内膜癌（EC）的主要风险因素包括肥胖和糖尿病，二者均与生活方式选择和饮食因素密切相关。我们的研究旨在评估中年欧洲女性群体中与糖尿病相关的饮食模式、EC风险及生存率之间的关系。
欧洲癌症与营养前瞻性调查（EPIC）研究中的285418名女性参与者纳入分析。经过平均10.6年的随访，登记了1955例EC新发病例；其中，133名女性死于EC。根据EPIC参与者基线时收集的饮食信息估算胰岛素抵抗经验饮食指数（EDIR）、高胰岛素血症经验饮食指数（EDIH）和糖尿病风险降低饮食（DRRD）。采用Cox比例风险回归模型，利用风险比（HR）、95%置信区间（CI）并校正相关混杂因素，评估饮食模式与EC风险之间的关联。分别采用Cox模型和Fine-Gray模型评估与总死亡率和EC特异性死亡率的关联。
更高的EDIR依从性与EC风险增加相关，T3组与T1组的多变量HR为1.17（95%CI = 1.04至1.31）。然而，当将BMI纳入模型时，这些关联变弱且不再具有统计学意义。未观察到与EDIH、DRRD依从性和EC风险相关的关联。未发现与糖尿病相关饮食模式和死亡率的关联。
本研究突出了与糖尿病相关的饮食模式在EC病因学和预防中的潜在作用。有必要进一步开展研究，以更好地了解源自病因学的饮食模式在疾病预防和预后中的作用。
