Association between selected dietary scores and the risk of urothelial cell carcinoma: A prospective cohort study.
Association between selected dietary scores and the risk of urothelial cell carcinoma: A prospective cohort study.
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DOI：
10.1002/ijc.30175
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发表时间：
2016-09-15
影响因子：
6.4
通讯作者：
Giles GG
中科院分区：
文献类型：
--
作者：
Dugué PA;Hodge AM;Brinkman MT;Bassett JK;Shivappa N;Hebert JR;Hopper JL;English DR;Milne RL;Giles GG
调查食物和营养摄入与尿路上皮细胞癌（UCC）风险之间关系的研究产生了混合结果。我们使用了三种常见的饮食评分：地中海饮食评分（MDS）、2010年替代健康饮食指数（AHEI-2010）和饮食炎症指数（DII）来评估饮食与UCC风险之间相关性的证据。在平均21.3年的随访时间内，诊断出379例UCC病例。饮食评分是使用基线时121项食物频率问卷的数据计算的。我们使用考克斯模型计算饮食评分（每一个标准差）和UCC风险之间关联的风险比（HR）。为了反映对健康饮食的总体坚持，通过对三个分数中的每一个的五分位数求和来构建元评分。所有饮食评分均与UCC的总体风险无关。发现更健康的饮食与侵袭性风险呈负相关（MDS：HR=0.86，95% CI：0.74-1.00，metascore：HR=0.84，95% CI：0.71-0.98），但与浅表性疾病无关（亚型之间的异质性分别为p=0.04和p=0.03）。DII和AHEI-2010的结果一致，但较弱。我们发现了一些吸烟影响的证据，特别是对于metascore（当前：HR=0.77，95% CI：0.58-1.01，既往：HR=0.77，95% CI：0.64-0.92，从未：HR=1.01，95% CI：0.81-1.26，异质性p =0.05）。健康的饮食可以预防侵入性的风险，但不是表面的，UCC。促进健康的饮食习惯可能有助于降低侵袭性UCC的风险，特别是对于当前和以前的吸烟者。
Studies investigating the association of food and nutrient consumption with the risk of urothelial cell carcinoma (UCC) have produced mixed results. We used three common dietary scores, the Mediterranean Diet Score (MDS), the Alternate Healthy Eating Index 2010 (AHEI-2010), and the Dietary Inflammatory Index (DII) to assess the evidence of an association between diet and the risk of UCC. Over a median follow-up time of 21.3 years, 379 incident UCC cases were diagnosed. Dietary scores were calculated using data from a 121-item food frequency questionnaire administered at baseline. We used Cox models to compute hazard ratios (HR) for the association between dietary scores (per one standard deviation) and UCC risk. In order to reflect overall adherence to a healthy diet, a metascore was constructed by summing the quintiles of each of the three scores. None of the dietary scores was associated with the risk of UCC overall. A healthier diet was found to be inversely associated with the risk of invasive (MDS: HR=0.86, 95% CI: 0.74–1.00, metascore: HR=0.84, 95% CI: 0.71–0.98), but not superficial disease (heterogeneity between subtypes p=0.04 and p=0.03, respectively). Results were consistent but weaker for DII and AHEI-2010. We found some evidence of effect modification by smoking, in particular for the metascore (Current: HR=0.77, 95% CI: 0.58–1.01, Former: HR=0.77, 95% CI: 0.64–0.92, Never: HR=1.01, 95% CI: 0.81–1.26, p for heterogeneity=0.05). A healthy diet may be protective against the risk of invasive, but not superficial, UCC. Promoting healthy dietary habits may help lower the risk of invasive UCC, especially for current and former smokers.