High-Quality Diets Are Associated With Reduced Risk of Hepatocellular Carcinoma and Chronic Liver Disease: The Multiethnic Cohort
High-Quality Diets Are Associated With Reduced Risk of Hepatocellular Carcinoma and Chronic Liver Disease: The Multiethnic Cohort
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DOI：
10.1002/hep4.1313
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发表时间：
2019-03-01
影响因子：
5.1
通讯作者：
Setiawan, Veronica Wendy
中科院分区：
文献类型：
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作者：
Bogumil, David;Park, Song-Yi;Setiawan, Veronica Wendy
肝细胞癌（HCC）和慢性肝病（CLD）是全球发病率和死亡率的主要来源。HCC发病率和CLD死亡率都因种族而异。在不同人群中，关于饮食措施与这些结果之间关系的研究有限。在多民族队列中，我们前瞻性地研究了四种饮食质量指数（DQI）评分（健康饮食指数-2010、替代健康饮食指数-2010、替代地中海饮食[aMED]和阻止高血压的饮食方法）、HCC发病率和CLD死亡率之间的关系。我们分析了169,806名年龄在45至75岁之间的非裔美国人、夏威夷原住民、日裔美国人、拉丁美洲人和白人的数据。DQI评分通过在基线时使用经过验证的食物频率问卷来计算。在平均17年的随访期间，在研究参与者中确定了603例HCC事件和753例CLD死亡。使用Cox回归估计每个DQI的多变量风险比（hr）和95%置信区间（CIs）。较高的aMED评分，反映了良好的健康饮食，与较低的HCC风险相关（五分位数[Q]5 vs Q1 HR， 0.68; 95% CI, 0.51-0.90；趋势，P = 0.02）。在种族/民族特异性分析中，各组之间没有显著的异质性（相互作用，P = 0.32）；然而，这种关联仅在拉丁裔人群中具有统计学意义（Q4 vs Q1 HR, 0.47; 95% CI, 0.29-0.79；趋势，P = 0.006）。所有DQI测量值与CLD死亡率呈负相关，在种族/民族间无显著异质性。结论：较高的aMED评分与较低的HCC风险相关。DQI得分越高，CLD死亡风险越低。这些结果提示，良好的饮食质量可以降低HCC发病率和CLD死亡率。
Hepatocellular carcinoma (HCC) and chronic liver disease (CLD) are major sources of morbidity and mortality globally. Both HCC incidence and CLD mortality are known to vary by race. There is limited research on the association between dietary measures and these outcomes in a diverse population. We prospectively investigated the associations between four diet quality index (DQI) scores (Healthy Eating Index-2010, Alternative Healthy Eating Index-2010, Alternate Mediterranean Diet [aMED], and Dietary Approaches to Stop Hypertension), HCC incidence, and CLD mortality in the Multiethnic Cohort. We analyzed data from 169,806 African Americans, Native Hawaiians, Japanese Americans, Latinos, and whites, aged 45 to 75 years. DQI scores were calculated by using a validated food frequency questionnaire administered at baseline. During an average 17 years of follow-up, 603 incident cases of HCC and 753 CLD deaths were identified among study participants. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) for each DQI were estimated using Cox regression. Higher aMED scores, reflecting favorable adherence to a healthful diet, were associated with a lower risk of HCC (quintile [Q]5 versus Q1 HR, 0.68; 95% CI, 0.51-0.90; trend, P = 0.02). In racial/ethnic-specific analyses, there was no significant heterogeneity across groups (interaction, P = 0.32); however, the association only remained statistically significant among Latinos (Q4 versus Q1 HR, 0.47; 95% CI, 0.29-0.79; trend, P = 0.006). All DQI measures were inversely associated with CLD mortality, with no significant heterogeneity by race/ethnicity. Conclusion: Higher aMED scores were associated with a lower risk of HCC. A higher score of any DQI was associated with a lower risk of CLD mortality. These results suggest that better diet quality may reduce HCC incidence and CLD mortality.