上海市中老年女性膳食血糖负荷来源及与子宫内膜癌的关联研究  

Source of daily dietary glycemic load and its association with endometrial cancer in elderly women in urban Shanghai

作　　者：高静 王杰[2] 谭玉婷[3] 方婕[3] 刘大可[3] 王静[3] 韩丽华[3] 徐红丽[1] 李泓澜 项永兵[3] GAO Jing;WANG Jie;TAN Yuting;FANG Jie;LIU Dake;WANG Jing;HAN Lihua;XU Hongli;LI Honglan;XIANG Yongbing(Tong University School of Medicine,Shanghai 200025;School of Public Health,Shanghai Jiao Tong University,Shanghai 200025;State Key Laboratory of Oncogenes and Related Genes&Department of Epidemiology,Shanghai Cancer Institute,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200032)

机构地区：[1]上海交通大学医学院临床研究中心,上海200025 [2]上海交通大学公共卫生学皖,上海200025 [3]上海交通大学医学院附属仁济医院上海市肿瘤研究所,癌基因及相关基因国家重点实验室和流行病学研究室,上海200032

出　　处：《肿瘤》2020年第12期855-863,共9页Tumor

基　　金：上海市卫生和计划生育委员会科研课题计划面上项目(编号:201540225)。

摘　　要：目的:分析上海市中老年女性膳食血糖负荷来源及其与子宫内膜癌发病风险之间的关系。方法:利用上海市女性健康队列的研究数据,对膳食血糖指数、血糖负荷与子宫内膜癌的关系进行分析。饮食摄入量通过食物频率问卷进行评估。采用COX比例风险模型计算风险比(hazard ratio,HR)和95%置信区间(confidence interval,CI)。血糖指数、血糖负荷和总碳水化合物的摄入量采用残差法进行调整。结果:共纳入符合条件的女性研究对象69086名。截至2014年底,上海市女性队列平均随访时间为15.6年,共有272例子宫内膜癌确诊。在调整潜在的混杂因素后,未发现饮食中碳水化合物的摄入量、血糖指数或血糖负荷与总人群子宫内膜癌的风险相关(P>0.05)。但亚组分析显示,在绝经前女性中,较高的血糖指数和血糖负荷均可增加子宫内膜癌的风险。与最低四分位组相比,血糖指数的最高四分位数HR为2.80(95%CI:1.27~6.21),血糖负荷的HR为2.98(95%CI:1.36~6.54),总碳水化合物的HR为2.18(95%CI:1.04~4.58),且趋势检验均具有统计学意义(P<0.05)。结论:上海市中老年女性日常血糖负荷主要来源为米饭和面食;较高的血糖负荷可能会增加绝经前女性罹患子宫内膜癌的风险。Objective:To investigate the source of daily glycemic load and its association with the risk of endometrial cancer in elderly women in urban Shanghai.Methods:This study was conducted within the Shanghai women’s health study.Dietary intakes were assessed with a food frequency questionnaire.COX proportional hazards models were applied to calculate hazard ratio(HR)and 95%confidence interval(CI).Glycemic index,glycemic load,and total carbohydrates were adjusted for total energy intake using the residuals method.Results:Among 69086 women included for analysis,272 incident endometrial cancer cases were diagnosed during the follow up.There was no overall association between dietary carbohydrate intake,glycemic index,or glycemic load and incidence of endometrial cancer after adjusting for potential confounders.However,the stratified analysis indicated that both glycemic index and glycemic load were associated with the increased risk of endometrial cancer in premenopausal women.The HRs for the highest versus the lowest quartile were 2.80(95%CI:1.27-6.21)for glycemic index,2.98(95%CI:1.36-6.54)for glycemic load and 2.18(95%CI:1.04-4.58)for total carbohydrates.Trend analysis were all statistically significant.Conclusion:The major contributors of glycemic index are rice and wheaten food in elderly women.High intake of daily dietary glycemic load is associated with the increased risk of endometrial cancer among premenopausal women.

关 键 词：子宫内膜肿瘤 队列研究 血糖指数 血糖负荷 膳食碳水化合物 

分 类 号：R737.33[医药卫生—肿瘤]