饮食质量指数和肝癌风险：来自新加坡华人健康研究的结果

StephenW

Quality Diet Indexes and Risk of Hepatocellular Carcinoma: Findings from the Singapore Chinese Health Study
Hung N Luu  1   2 , Nithya Neelakantan  3 , Ting-Ting Geng  3 , Renwei Wang  1 , George Goh Boon Bee  4   5 , Jose C Clemente  6 , Aizhen Jin  4 , Rob M van Dam  3   7   8 , Wei Jia  9 , Jaideep Behari  10   11 , Woon-Puay Koh  3   4 , Jian-Min Yuan  1   2
Affiliations
Affiliations

    1
    Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA.
    2
    Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
    3
    Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
    4
    Health Services and Systems Research, Duke-NUS Medical School Singapore, Singapore.
    5
    Department of Gastroenterology & Hepatology, Singapore General Hospital, Singapore.
    6
    Department of Genetics and Genomic Sciences, and Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, Icahn Institute for Genomics & Multiscale Biology, New York, NY, USA.
    7
    Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.
    8
    Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA.
    9
    University of Hawaii Cancer Center, Honolulu, Hawaii, USA.
    10
    Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
    11
    Pittsburgh Liver Research Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

    PMID: 33129230 DOI: 10.1002/ijc.33367

Abstract

There is limited research on the effect of dietary quality on hepatocellular carcinoma (HCC) risk in populations with relatively high risk of HCC. Using data from Singapore Chinese Health Study, a prospective cohort study, of 63,257 Chinese aged 45-74, we assessed four diet-quality index (DQI) scores: the Alternative Health Eating Index-2010 (AHEI-2010), Alternate Mediterranean Diet (aMED), Dietary Approaches to Stop Hypertension (DASH) and Heathy Diet Indicator (HDI). We identified 561 incident HCC cases among the cohort participants after a mean of 17.6 years of follow-up. Cox proportional hazard regression model was used to estimate hazard ratio (HR) and 95% confidence interval (CI) for HCC in relation to these DQI scores. Unconditional logistic regression method was used to evaluate the associations between DQIs and HCC risk among a subset of individuals who tested negative for hepatitis B surface antigen (HBsAg). High scores of AHEI-2010, aMED and DASH, representing higher dietary quality, were associated with lower risk of HCC (all Ptrend <0.05). Compared with the lowest quartile, HRs (95% CIs) of HCC for the highest quartile of AHEI-2010, aMED, and DASH were 0.69 (0.53-0.89), 0.70 (0.52-0.95), and 0.67 (0.51-0.87), respectively. No significant association between HDI and HCC risk was observed. Among HBsAg-negative individuals, similar inverse associations were observed, and the strongest inverse association was for aMED (HRQ4vsQ1 =0.46, 95% CI: 0.23-0.94, Ptrend =0.10). These findings support the notion that adherence to a healthier diet may lower the risk of HCC, suggesting that dietary modification may be an effective approach for primary prevention of HCC.

Keywords: Diet quality index (DQI) scores; hepatocellular carcinoma; risk factor.

This article is protected by copyright. All rights reserved.

StephenW

饮食质量指数和肝癌风险：来自新加坡华人健康研究的结果
Hung N Luu 1 2，Nithya Neelakantan 3，Ging-Ting Ting 3，Wenwei Wang 1，George Goh Boon Bee 4 5，Jose Clemente 6，Aizhen Jin 4，Rob M van Dam 3 7 8，Wei Jia 9，Jaideep Behari 10 11，Woon-Puay Koh 3 4，袁建民1 2
隶属关系
隶属关系

    1个
    美国宾夕法尼亚州匹兹堡大学匹兹堡大学UPMC希尔曼癌症中心癌症控制和人口科学处。
    2
    美国宾夕法尼亚州匹兹堡，匹兹堡大学公共卫生研究生院流行病学系。
    3
    新加坡国立大学Saw Swee Hock公共卫生学院。
    4
    新加坡杜克国大医学院卫生服务与系统研究，新加坡。
    5
    新加坡新加坡总医院消化内科和肝病科。
    6
    美国纽约州伊坎市基因组与多尺度生物学研究所，伊坎西奈山伊坎医学院遗传与基因组科学系和精密免疫学研究所。
    7
    新加坡国立大学Yong Loo Lin医学院和新加坡国立大学卫生系统。
    8
    美国马萨诸塞州波士顿，哈佛大学陈陈公共卫生学院营养系。
    9
    美国夏威夷檀香山夏威夷大学癌症中心。
    10
    美国宾夕法尼亚州匹兹堡匹兹堡大学医学中心医学系胃肠病学，肝病学和营养学系。
    11
    美国宾夕法尼亚州匹兹堡匹兹堡大学医学中心匹兹堡肝脏研究中心。

    PMID：33129230 DOI：10.1002 / ijc.33367

抽象

饮食质量对具有较高肝癌风险的人群中肝细胞癌（HCC）风险的影响的研究有限。根据前瞻性队列研究新加坡中国健康研究的数据，该研究针对63,257名45-74岁的中国人，我们评估了四个饮食质量指数（DQI）评分：替代性健康饮食指数-2010（AHEI-2010），替代性地中海饮食（ aMED），停止高血压的饮食方法（DASH）和健康饮食指标（HDI）。经过平均17.6年的随访，我们在队列参与者中确定了561例HCC事件。使用Cox比例风险回归模型来估计与这些DQI得分相关的HCC风险比（HR）和95％置信区间（CI）。使用无条件逻辑回归方法评估乙型肝炎表面抗原（HBsAg）阴性的个体子集中DQI与HCC风险之间的关联。 AHEI-2010，aMED和DASH的高分代表较高的饮食质量与较低的HCC风险相关（所有Ptrend <0.05）。与最低四分位数相比，AHEI-2010，aMED和DASH最高四分位数的HCC HR（95％CI）分别为0.69（0.53-0.89），0.70（0.52-0.95）和0.67（0.51-0.87），分别。在HDI和HCC风险之间未发现明显关联。在HBsAg阴性个体中，观察到相似的反向关联，而最强的反向关联是针对aMED（HRQ4vsQ1 = 0.46，95％CI：0.23-0.94，Ptrend = 0.10）。这些发现支持这样的观点，即坚持更健康的饮食可以降低HCC的风险，这表明饮食习惯的改变可能是预防HCC的有效方法。

关键词：饮食质量指数（DQI）评分；肝细胞癌；风险因素。

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