Hyperinsulinemic and Pro-Inflammatory Dietary Patterns and Metabolomic Profiles Are Associated with Increased Risk of Total and Site-Specific Cancers among Postmenopausal Women
Abstract
:Simple Summary
Abstract
1. Introduction
2. Methods
2.1. Study Population
2.2. Dietary Assessment and Calculation of Dietary Indices
2.3. Ascertainment of Incident Cancer
2.4. Metabolomics Profiling and Derivation of Metabolomics Profile Scores for the Dietary Patterns
2.5. Statistical Analysis
3. Results
3.1. Participant Characteristics (Table 1)
Empirical Dietary Index for Hyperinsulinemic (EDIH) Score a,b | Empirical Dietary Inflammatory Pattern (EDIP) Score a,b | Health Eating Index 2015 (HEI-2015) a,b | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Characteristic | Quintile 1 | Quintile 2 | Quintile 3 | Quintile 4 | Quintile 5 | Quintile 1 | Quintile 2 | Quintile 3 | Quintile 4 | Quintile 5 | Quintile 1 | Quintile 2 | Quintile 3 | Quintile 4 | Quintile 5 |
n | 22,493 | 22,494 | 22,494 | 22,494 | 22,493 | 22,493 | 22,494 | 22,494 | 22,494 | 22,493 | 22,493 | 22,493 | 22,494 | 22,493 | 22,493 |
Race/ethnicity | |||||||||||||||
American Indian or Alaskan Native | 0.3 | 0.3 | 0.5 | 0.5 | 0.5 | 0.4 | 0.3 | 0.4 | 0.5 | 0.6 | 0.6 | 0.4 | 0.4 | 0.3 | 0.3 |
Asian or Pacific Islander | 2.2 | 2.8 | 3.2 | 3.1 | 2.7 | 1.3 | 1.9 | 2.3 | 3.5 | 5.1 | 2.7 | 3.1 | 2.9 | 2.9 | 2.5 |
Black | 4.0 | 5.1 | 7.1 | 9.5 | 13 | 3.2 | 4.2 | 6.2 | 9.5 | 16 | 11 | 8.9 | 7.4 | 6.0 | 5.5 |
Hispanic/Latino | 2.5 | 2.9 | 3.4 | 4.1 | 5.0 | 1.5 | 1.8 | 2.6 | 3.9 | 8.3 | 5.4 | 4.5 | 3.5 | 2.6 | 1.8 |
Other | 1.4 | 1.5 | 1.3 | 1.4 | 1.5 | 1.2 | 1.2 | 1.4 | 1.6 | 1.8 | 1.6 | 1.5 | 1.4 | 1.3 | 1.3 |
White | 89 | 87 | 84 | 81 | 77 | 92 | 91 | 87 | 81 | 68 | 78 | 81 | 84 | 87 | 88 |
Age, years | 63 ± 7 | 64 ± 7 | 64 ± 7 | 63 ± 7 | 62 ± 7 | 63 ± 7 | 63 ± 7 | 64 ± 7 | 64 ± 7 | 62 ± 7 | 62 ± 7 | 63 ± 7 | 63 ± 7 | 64 ± 7 | 64 ± 7 |
BMI, kg/m2 | 26 ± 5 | 26 ± 5 | 27 ± 5 | 28 ± 6 | 30 ± 6 | 27 ± 5 | 27 ± 5 | 27 ± 5 | 28 ± 6 | 29 ± 6 | 29 ± 6 | 28 ± 6 | 27 ± 6 | 27 ± 5 | 26 ± 5 |
Under/Normal weight (15 ≤ BMI < 25) | 49 | 44 | 39 | 34 | 24 | 44 | 42 | 39 | 36 | 29 | 29 | 33 | 37 | 42 | 49 |
Overweight (25 ≤ BMI < 30) | 33 | 35 | 35 | 35 | 32 | 35 | 35 | 35 | 34 | 32 | 33 | 34 | 35 | 35 | 33 |
Obese (BMI ≥ 30) | 18 | 21 | 25 | 31 | 43 | 21 | 23 | 26 | 29 | 39 | 38 | 32 | 27 | 23 | 18 |
Physical activity, MET-hours/week | 17 ± 16 | 15± 14 | 13 ± 13 | 11 ± 12 | 9 ± 11 | 16 ± 15 | 14 ± 14 | 13 ± 13 | 12 ± 13 | 10 ± 12 | 8 ± 11 | 11 ± 12 | 13 ± 14 | 15 ± 14 | 17 ± 15 |
Pack years of smoking | 11 ± 18 | 9 ± 17 | 9 ± 17 | 9 ± 18 | 11 ± 19 | 13 ± 20 | 10 ±18 | 9 ± 17 | 8 ± 17 | 8 ± 17 | 12 ± 21 | 10 ± 19 | 9 ± 18 | 9 ± 16 | 8 ±16 |
Current smoking | 6 | 5 | 6 | 7 | 9 | 8 | 6 | 6 | 6 | 7 | 13 | 8 | 6 | 4 | 3 |
Aspirin/NSAIDs use | 14 | 14 | 13 | 13 | 13 | 14 | 14 | 14 | 13 | 12 | 13 | 13 | 14 | 13 | 14 |
Statin use | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 3 | 2 |
Hypercholestrolemia | 12 | 14 | 15 | 15 | 15 | 12 | 13 | 15 | 15 | 16 | 12 | 14 | 14 | 15 | 16 |
Educational level | |||||||||||||||
<high school | 3 | 4 | 5 | 6 | 8 | 3 | 3 | 4 | 6 | 10 | 9 | 6 | 5 | 4 | 2 |
High school/GED | 45 | 51 | 55 | 59 | 62 | 50 | 52 | 54 | 57 | 58 | 62 | 58 | 54 | 51 | 46 |
≥4 years of college | 51 | 45 | 39 | 35 | 29 | 46 | 43 | 41 | 36 | 31 | 28 | 35 | 41 | 44 | 51 |
Total alcohol intake, alcohol servings/week c | 4.8 ± 7.5 | 2.4 ± 4.2 | 1.9 ± 3.7 | 1.6 ± 3.6 | 1.5 ± 3.6 | 5.3 ± 7.8 | 2.8 ± 4.4 | 1.9 ± 3.6 | 1.3 ± 3.0 | 0.8 ± 2.6 | 1.7 ± 4.0 | 2.2 ± 4.6 | 2.6 ± 5.0 | 2.8 ± 5.2 | 3.0 ± 5.5 |
Macronutrients, %kcal/d | |||||||||||||||
Carbohydrates | 54 ± 10 | 54 ± 9 | 52 ± 8 | 49 ± 8 | 45 ± 9 | 50 ± 10 | 51 ± 9 | 51 ± 9 | 51 ± 9 | 50 ± 9 | 46 ± 9 | 48 ± 9 | 51 ± 9 | 53 ± 9 | 56 ± 8 |
Total fat | 28 ± 8 | 29 ± 8 | 31 ± 8 | 34 ± 7 | 38 ± 7 | 30 ± 9 | 31 ± 8 | 32 ± 8 | 33 ± 8 | 34 ± 8 | 38 ± 7 | 35 ± 7 | 32 ± 7 | 29 ± 7 | 26 ± 7 |
Saturated fat | 9 ± 3 | 10 ± 3 | 10 ± 3 | 11 ± 3 | 13 ± 3 | 10 ± 3 | 11 ± 3 | 10 ± 3 | 11 ± 3 | 11 ± 3 | 14 ± 3 | 12 ± 3 | 11 ± 3 | 9 ± 2 | 8 ± 2 |
Unsaturated fat | 16 ± 5 | 17 ± 5 | 18 ± 5 | 20 ± 5 | 22 ± 5 | 18 ± 5 | 18 ± 5 | 19 ± 5 | 19 ± 5 | 20 ± 5 | 22 ± 5 | 20 ± 5 | 19 ± 5 | 17 ± 5 | 16 ± 5 |
Total protein | 16 ± 3 | 17 ± 3 | 17 ± 3 | 17 ± 3 | 17 ± 4 | 17 ± 3 | 17 ± 3 | 17 ± 3 | 17 ± 3 | 17 ± 4 | 16 ± 3 | 17 ± 3 | 17 ± 3 | 17 ± 3 | 18 ± 3 |
Animal/plant protein ratio | 2 ± 1 | 2 ± 1 | 2 ± 1 | 3 ± 1 | 3 ± 2 | 2 ± 1 | 2 ± 1 | 2 ± 1 | 3 ± 1 | 3 ± 1 | 3 ± 2 | 3 ± 1 | 3 ± 1 | 2 ± 1 | 2 ± 1 |
Micronutrients, per 1000 kcal | |||||||||||||||
Calcium, mg/d | 577 ± 217 | 560 ± 211 | 528 ± 203 | 484 ± 184 | 410 ± 156 | 533 ± 205 | 531 ± 198 | 525 ± 201 | 511 ± 207 | 459 ± 201 | 419 ± 167 | 470 ± 183 | 508 ± 196 | 549 ± 204 | 614 ± 213 |
Potassium, mg/d | 1860 ± 427 | 1816 ± 412 | 1728 ± 388 | 1599 ± 353 | 1384 ± 319 | 1882 ± 416 | 1781 ± 383 | 1709 ± 376 | 1616 ± 377 | 1397 ± 371 | 1296 ± 295 | 1523 ± 309 | 1688 ± 335 | 1848 ± 360 | 2030 ± 360 |
Vitamin D, mcg/d | 3 ± 2 | 3 ± 2 | 3 ± 2 | 3 ± 2 | 2 ± 1 | 3 ± 2 | 3 ± 2 | 3 ± 2 | 3 ± 2 | 3 ± 2 | 2 ± 1 | 2 ± 1 | 3 ± 2 | 3 ± 2 | 3 ± 2 |
Magnesium, mg/d | 180 ± 35 | 175 ± 35 | 167 ± 33 | 154 ± 30 | 134 ± 28 | 177 ± 34 | 170 ± 33 | 164 ± 34 | 158 ± 34 | 141 ± 35 | 126 ± 24 | 147 ± 25 | 162 ± 26 | 177 ± 28 | 197 ± 30 |
Iron, mg/d | 8 ± 2 | 8 ± 3 | 8 ± 3 | 8 ± 2 | 7 ± 2 | 8 ± 2 | 8 ± 2 | 8 ± 3 | 8 ± 3 | 8 ± 3 | 7 ± 2 | 8 ± 2 | 8 ± 3 | 8 ± 3 | 9 ± 3 |
Folate, mcg/d | 184 ± 64 | 183 ± 65 | 175 ± 64 | 161 ± 59 | 136 ± 50 | 184 ± 62 | 177 ± 61 | 171 ± 62 | 164 ± 63 | 142 ± 61 | 129 ± 52 | 152 ± 55 | 169 ± 59 | 185 ± 62 | 202 ± 62 |
Vitamin A, mcg RAE/d | 483 ± 194 | 493 ± 199 | 486 ± 198 | 467 ± 197 | 423 ± 196 | 490 ± 205 | 485 ± 189 | 480 ± 188 | 470 ± 192 | 426 ± 210 | 385 ± 182 | 438 ± 188 | 469 ± 196 | 506 ± 192 | 553 ± 193 |
Vitamin C, mg/d | 74 ± 40 | 76 ± 41 | 72 ± 39 | 63 ± 35 | 49 ± 28 | 70 ± 38 | 71 ± 38 | 70 ± 39 | 67 ± 38 | 54 ± 34 | 41 ± 26 | 57 ± 31 | 69 ± 36 | 79 ± 38 | 88 ± 38 |
Vitamin E, IU/d | 6 ± 3 | 6 ± 4 | 6 ± 4 | 6 ± 3 | 5 ± 3 | 6 ± 3 | 6 ± 3 | 6 ± 4 | 6 ± 4 | 5 ± 3 | 5 ± 3 | 6 ± 3 | 6 ± 4 | 6 ± 4 | 7 ± 4 |
3.2. Food and Nutrient Profiles of the Dietary Patterns (Supplementary Tables S1 and S4)
3.3. Metabolomics Profile Scores of the Dietary Patterns (Figure 1)
3.4. EDIH and Cancer Risk (Table 2, Figure 2)
Dietary Pattern | Cancer Risk Type | Quintile 1 | Quintile 2 | Quintile 3 | Quintile 4 | Quintile 5 | Q5-Q1 (Absolute Risk Difference); c P-Trend. d | FDR-Adjusted p-Value |
---|---|---|---|---|---|---|---|---|
Total cancer (except non-melanoma skin cancer) | ||||||||
EDIH e | Absolute risk/cases | 969/3934 | 962/3861 | 993/3772 | 1015/3594 | 1021/3607 | 52 | |
EDIH | Relative risk | 1 (reference) | 1.04 (1.00, 1.09) | 1.06 (1.01, 1.11) | 1.04 (1.00, 1.10) | 1.10 (1.04, 1.15) | 0.0008 | 0.0122 |
EDIP e | Absolute risk/cases | 979/4131 | 970/4027 | 992/3703 | 1000/3608 | 1020/3299 | 41 | |
EDIP | Relative risk | 1 (reference) | 1.06 (1.01, 1.11) | 1.02 (0.97, 1.08) | 1.07 (1.01, 1.13) | 1.08 (1.02, 1.15) | 0.0163 | 0.0808 |
HEI-2015 | Absolute risk/cases | 1030/3697 | 1005/3740 | 967/3786 | 977/3750 | 981/3795 | −49 | |
HEI-2015 e | Relative risk | 1 (reference) | 0.98 (0.93, 1.02) | 0.97 (0.92, 1.01) | 0.94 (0.89, 0.98) | 0.93 (0.89, 0.98) | 0.0008 | 0.0122 |
Colorectal cancer | ||||||||
EDIH | Absolute risk/cases | 80/3795 | 80/309 | 89/372 | 85/306 | 91/320 | 11 | |
EDIH | Relative risk | 1 (reference) | 1.06 (0.90, 1.25) | 1.31 (1.11, 1.54) | 1.08 (0.91, 1.28) | 1.19 (1.00, 1.43) | 0.0658 | 0.2084 |
EDIP | Absolute risk/cases | 84/315 | 82/333 | 82/338 | 86/319 | 91/303 | 7 | |
EDIP | Relative risk | 1 (reference) | 1.14 (0.96, 1.35) | 1.19 (0.99, 1.43) | 1.19 (0.98, 1.45) | 1.23 (0.99, 1.52) | 0.0595 | 0.1966 |
HEI-2015 | Absolute riskc/cases | 96/342 | 86/337 | 86/316 | 76/297 | 82/316 | −14 | |
HEI-2015 | Relative risk | 1 (reference) | 0.96 (0.82, 1.12) | 0.90 (0.77, 1.06) | 0.83 (0.70, 0.97) | 0.86 (0.72, 1.01) | 0.0158 | 0.0808 |
Colon cancer | ||||||||
EDIH | Absolute risk/cases | 67/250 | 66/264 | 74/312 | 72/254 | 76/266 | 9 | |
EDIH | Relative risk | 1 (reference) | 1.09 (0.91, 1.31) | 1.33 (1.11, 1.60) | 1.09 (0.90, 1.32) | 1.22 (1.00, 1.48) | 0.0755 | 0.2295 |
EDIP | Absolute risk/cases | 69/260 | 68/286 | 72/279 | 69/266 | 78/255 | 9 | |
EDIP | Relative risk | 1 (reference) | 1.18 (0.98, 1.43) | 1.20 (0.98, 1.46) | 1.22 (0.98, 1.51) | 1.28 (1.02, 1.62) | 0.0483 | 0.1835 |
HEI-2015 | Absolute risk/cases | 80/285 | 71/284 | 73/264 | 64/249 | 67/264 | −13 | |
HEI-2015 | Relative risk | 1 (reference) | 0.97 (0.82, 1.14) | 0.90 (0.76, 1.07) | 0.81 (0.68, 0.97) | 0.83 (0.69, 1.00) | 0.0102 | 0.0808 |
Proximal colon cancer | ||||||||
EDIH | Absolute risk/cases | 39/141 | 38/160 | 46/204 | 50/155 | 45/168 | 6 | |
EDIH | Relative risk | 1 (reference) | 1.16 (0.92, 1.47) | 1.55 (1.23, 1.95) | 1.19 (0.93, 1.52) | 1.41 (1.10, 1.81) | 0.0134 | 0.0808 |
EDIP | Absolute risk/cases | 42/147 | 41/185 | 47/178 | 44/160 | 44/158 | 2 | |
EDIP | Relative risk | 1 (reference) | 1.36 (1.07, 1.73) | 1.34 (1.03, 1.73) | 1.29 (0.98, 1.71) | 1.42 (1.05, 1.92) | 0.0587 | 0.1966 |
HEI-2015 | Absolute risk/cases | 47/173 | 46/176 | 44/169 | 41/151 | 40/159 | −7 | |
HEI-2015 | Relative risk | 1 (reference) | 0.96 (0.78, 1.19) | 0.92 (0.74, 1.14) | 0.78 (0.62, 0.98) | 0.80 (0.64, 1.01) | 0.0156 | 0.0808 |
Distal colon and rectal cancer | ||||||||
EDIH | Absolute risk/cases | 33/127 | 34/116 | 30/132 | 31/119 | 36/133 | 3 | |
EDIH | Relative risk | 1 (reference) | 0.91 (0.70, 1.19) | 0.97 (0.74, 1.27) | 0.95 (0.72, 1.25) | 1.09 (0.82, 1.44) | 0.4874 | 0.6174 |
EDIP | Absolute risk/cases | 33/141 | 34/109 | 27/119 | 32/131 | 39/127 | 6 | |
EDIP | Relative risk | 1 (reference) | 0.80 (0.60, 1.05) | 0.87 (0.65, 1.16) | 1.02 (0.75, 1.39) | 1.03 (0.74, 1.44) | 0.5117 | 0.6375 |
HEI-2015 | Absolute risk/cases | 39/136 | 30/138 | 33/114 | 31/117 | 31/122 | −8 | |
HEI-2015 | Relative risk | 1 (reference) | 1.02 (0.80, 1.31) | 0.88 (0.68, 1.14) | 0.86 (0.66, 1.12) | 0.92 (0.70, 1.20) | 0.2774 | 0.4679 |
Intestinal polyps | ||||||||
EDIH | Absolute risk/cases | 551/1991 | 571/2030 | 594/2134 | 635/2211 | 649/2308 | 98 | |
EDIH | Relative risk | 1 (reference) | 1.05 (0.99, 1.12) | 1.14 (1.07, 1.22) | 1.18 (1.11, 1.27) | 1.23 (1.15, 1.32) | <0.0001 | 0.0038 |
EDIP | Absolute risk/cases | 566/2143 | 604/2144 | 574/2113 | 616/2081 | 639/2193 | 73 | |
EDIP | Relative risk | 1 (reference) | 1.05 (0.98, 1.12) | 1.07 (1.00, 1.15) | 1.08 (1.01, 1.17) | 1.16 (1.07, 1.26) | 0.0004 | 0.0101 |
HEI-2015 | Absolute risk/cases | 651/2307 | 626/2223 | 586/2172 | 585/2075 | 553/1896 | −98 | |
HEI-2015 | Relative risk | 1 (reference) | 0.97 (0.91, 1.03) | 0.95 (0.89, 1.00) | 0.89 (0.84, 0.95) | 0.84 (0.78, 0.89) | <0.0001 | 0.0038 |
Invasive Breast cancer | ||||||||
EDIH | Absolute risk/cases | 275/899 | 259/921 | 272/827 | 276/843 | 294/903 | 19 | |
EDIH | Relative risk | 1 (reference) | 1.09 (0.99, 1.20) | 1.02 (0.92, 1.12) | 1.06 (0.96, 1.18) | 1.19 (1.07, 1.32) | 0.0032 | 0.0405 |
EDIP | Absolute risk/cases | 264/926 | 266/936 | 285/874 | 285/866 | 275/791 | 11 | |
EDIP | Relative risk | 1 (reference) | 1.09 (0.99, 1.20) | 1.07 (0.96, 1.19) | 1.13 (1.01, 1.27) | 1.12 (1.00, 1.27) | 0.0561 | 0.1966 |
HEI-2015 | Absolute risk/cases | 281/872 | 274/867 | 262/847 | 278/869 | 280/938 | −1 | |
HEI-2015 | Relative risk | 1 (reference) | 0.95 (0.86, 1.04) | 0.90 (0.82, 1.00) | 0.92 (0.83, 1.01) | 0.99 (0.90, 1.09) | 0.6135 | 0.6842 |
ER+ | ||||||||
EDIH | Absolute risk/cases | 226/745 | 207/747 | 217/685 | 231/688 | 232/714 | 6 | |
EDIH | Relative risk | 1 (reference) | 1.08 (0.97, 1.20) | 1.04 (0.93, 1.16) | 1.07 (0.96, 1.20) | 1.16 (1.04, 1.30) | 0.017 | 0.0808 |
EDIP | Absolute risk/cases | 217/769 | 213/768 | 232/726 | 228/704 | 222/612 | 5 | |
EDIP | Relative risk | 1 (reference) | 1.09 (0.98, 1.22) | 1.09 (0.97, 1.23) | 1.13 (1.00, 1.29) | 1.08 (0.94, 1.24) | 0.1966 | 0.3735 |
HEI-2015 | Absolute risk/cases | 223/694 | 220/692 | 213/695 | 228/720 | 229/778 | 6 | |
HEI-2015 | Relative risk | 1 (reference) | 0.95 (0.85, 1.05) | 0.93 (0.84, 1.04) | 0.95 (0.86, 1.06) | 1.03 (0.92, 1.14) | 0.6815 | 0.7117 |
ER- | ||||||||
EDIH | Absolute risk/cases | 29/100 | 37/123 | 36/105 | 29/100 | 38/127 | 9 | |
EDIH | Relative risk | 1 (reference) | 1.22 (0.93, 1.60) | 1.05 (0.79, 1.40) | 1.01 (0.75, 1.36) | 1.31 (0.98, 1.76) | 0.1847 | 0.3640 |
EDIP | Absolute risk/cases | 31/108 | 35/104 | 35/106 | 37/124 | 31/113 | 0 | |
EDIP | Relative risk | 1 (reference) | 0.98 (0.73, 1.31) | 1.02 (0.75, 1.39) | 1.23 (0.89, 1.70) | 1.19 (0.84, 1.68) | 0.1796 | 0.3640 |
HEI-2015 | Absolute risk/cases | 38/123 | 31/110 | 31/107 | 33/104 | 35/111 | −3 | |
HEI-2015 | Relative risk | 1 (reference) | 0.87 (0.67, 1.12) | 0.83 (0.64, 1.08) | 0.79 (0.61, 1.04) | 0.85 (0.65, 1.12) | 0.1725 | 0.3640 |
PR+ | ||||||||
EDIH | Absolute risk/cases | 183/626 | 177/636 | 188/588 | 195/575 | 194/604 | 11 | |
EDIH | Relative risk | 1 (reference) | 1.10 (0.99, 1.24) | 1.08 (0.96, 1.21) | 1.09 (0.96, 1.23) | 1.20 (1.06, 1.36) | 0.0085 | 0.0808 |
EDIP | Absolute risk/cases | 184/648 | 177/649 | 197/635 | 195/597 | 184/500 | 0 | |
EDIP | Relative risk | 1 (reference) | 1.12 (0.99, 1.26) | 1.17 (1.03, 1.33) | 1.18 (1.03, 1.36) | 1.09 (0.94, 1.27) | 0.1438 | 0.3277 |
HEI-2015 | Absolute risk/cases | 190/597 | 187/580 | 181/593 | 191/615 | 189/644 | −1 | |
HEI-2015 | Relative risk | 1 (reference) | 0.92 (0.82, 1.04) | 0.92 (0.82, 1.03) | 0.94 (0.84, 1.06) | 0.98 (0.87, 1.10) | 0757 | 0.8946 |
PR- | ||||||||
EDIH | Absolute risk/cases | 66/206 | 62/222 | 62/195 | 60/204 | 70/225 | 4 | |
EDIH | Relative risk | 1 (reference) | 1.08 (0.89, 1.31) | 0.96 (0.78, 1.19) | 1.02 (0.83, 1.26) | 1.16 (0.94, 1.43) | 0.2408 | 0.4679 |
EDIP | Absolute risk/cases | 61/220 | 65/214 | 65/182 | 66/222 | 63/214 | 2 | |
EDIP | Relative risk | 1 (reference) | 0.96 (0.79, 1.18) | 0.83 (0.66, 1.03) | 1.04 (0.83, 1.31) | 1.06 (0.83, 1.36) | 0.5338 | 0.6579 |
HEI-2015 | Absolute risk/cases | 68/212 | 59/212 | 60/204 | 65/199 | 69/225 | 1 | |
HEI-2015 | Relative risk | 1 (reference) | 0.96 (0.79, 1.16) | 0.91 (0.74, 1.10) | 0.88 (0.72, 1.07) | 0.99 (0.81, 1.21) | 0.6136 | 0.7117 |
HER2+ | ||||||||
EDIH | Absolute risk/cases | 27/86 | 24/85 | 26/86 | 28/85 | 30/100 | 3 | |
EDIH | Relative risk | 1 (reference) | 0.99 (0.73, 1.35) | 1.03 (0.75, 1.41) | 1.02 (0.74, 1.42) | 1.24 (0.90, 1.71) | 0.1823 | 0.3640 |
EDIP | Absolute risk/cases | 25/81 | 26/97 | 27/91 | 31/86 | 26/87 | 1 | |
EDIP | Relative risk | 1 (reference) | 1.25 (0.91, 1.72) | 1.21 (0.86, 1.71) | 1.20 (0.83, 1.74) | 1.29 (0.86, 1.92) | 0.3012 | 0.4766 |
HEI-2015 | Absolute risk/cases | 28/97 | 26/84 | 25/84 | 28/90 | 28/87 | 0 | |
HEI-2015 | Relative risk | 1 (reference) | 0.84 (0.63, 1.13) | 0.84 (0.63, 1.14) | 0.91 (0.68, 1.22) | 0.89 (0.66, 1.22) | 0.5863 | 0.6749 |
HER2- | ||||||||
EDIH | Absolute risk/cases | 208/698 | 198/708 | 205/639 | 207/647 | 216/660 | 8 | |
EDIH | Relative risk | 1 (reference) | 1.09 (0.98, 1.22) | 1.03 (0.92, 1.16) | 1.08 (0.96, 1.21) | 1.15 (1.02, 1.29) | 0.0424 | 0.1696 |
EDIP | Absolute risk/cases | 203/726 | 200/722 | 214/665 | 210/660 | 207/579 | 4 | |
EDIP | Relative risk | 1 (reference) | 1.09 (0.98, 1.22) | 1.06 (0.94, 1.20) | 1.13 (0.99, 1.29) | 1.09 (0.95, 1.26) | 0.1868 | 0.3640 |
HEI-2015 | Absolute risk/cases | 212/654 | 202/652 | 198/662 | 208/657 | 214/727 | 2 | |
HEI-2015 | Relative risk | 1 (reference) | 0.95 (0.85, 1.06) | 0.94 (0.84, 1.05) | 0.92 (0.82, 1.03) | 1.01 (0.90, 1.13) | 0.9486 | 0.9486 |
ER- PR- HER2+ | ||||||||
EDIH | Absolute risk/cases | 7/25 | 8/23 | 8/25 | 7/25 | 7/22 | 0 | |
EDIH | Relative risk | 1 (reference) | 0.92 (0.51, 1.65) | 1.01 (0.56, 1.82) | 1.01 (0.55, 1.84) | 0.89 (0.47, 1.68) | 0.8008 | 0.8008 |
EDIP | Absolute risk/cases | 6/19 | 8/31 | 8/21 | 9/25 | 5/24 | −1 | |
EDIP | Relative risk | 1 (reference) | 1.88 (1.00, 3.51) | 1.35 (0.66, 2.77) | 1.71 (0.81, 3.58) | 1.73 (0.78, 3.83) | 0.2972 | 0.4766 |
HEI-2015 | Absolute risk/cases | 9/30 | 5/22 | 7/23 | 7/23 | 8/22 | −1 | |
HEI-2015 | Relative risk | 1 (reference) | 0.72 (0.42, 1.26) | 0.75 (0.43, 1.31) | 0.76 (0.44, 1.34) | 0.76 (0.42, 1.36) | 0.3750 | 0.5182 |
Luminal A | ||||||||
EDIH | Absolute risk/cases | 189/640 | 173/625 | 183/575 | 188/582 | 190/576 | 1 | |
EDIH | Relative risk | 1 (reference) | 1.06 (0.95, 1.19) | 1.03 (0.91, 1.16) | 1.08 (0.95, 1.22) | 1.11 (0.98, 1.26) | 0.1054 | 0.2762 |
EDIP | Absolute risk/cases | 182/660 | 178/655 | 190/599 | 185/577 | 188/507 | 6 | |
EDIP | Relative risk | 1 (reference) | 1.10 (0.98, 1.24) | 1.07 (0.94, 1.22) | 1.11 (0.97, 1.28) | 1.08 (0.93, 1.25) | 0.3097 | 0.4766 |
HEI-2015 | Absolute risk/cases | 187/579 | 181/582 | 179/593 | 186/593 | 190/651 | 3 | |
HEI-2015 | Relative risk | 1 (reference) | 0.95 (0.85, 1.07) | 0.95 (0.84, 1.06) | 0.93 (0.83, 1.05) | 1.02 (0.90, 1.14) | 0.9289 | 0.9289 |
Luminal B | ||||||||
EDIH | Absolute risk/cases | 19/59 | 16/61 | 18/60 | 20/59 | 22/76 | 3 | |
EDIH | Relative risk | 1 (reference) | 1.05 (0.72, 1.51) | 1.06 (0.72, 1.54) | 1.05 (0.71, 1.55) | 1.40 (0.96, 2.04) | 0.0885 | 0.2491 |
EDIP | Absolute risk/cases | 19/61 | 17/65 | 20/69 | 21/59 | 19/61 | 0 | |
EDIP | Relative risk | 1 (reference) | 1.07 (0.73, 1.56) | 1.15 (0.77, 1.71) | 1.02 (0.66, 1.58) | 1.11 (0.70, 1.77) | 0.7315 | 0.7315 |
HEI-2015 | Absolute risk/cases | 19/65 | 19/59 | 18/60 | 20/67 | 20/64 | 1 | |
HEI-2015 | Relative risk | 1 (reference) | 0.88 (0.62, 1.26) | 0.90 (0.63, 1.29) | 1.01 (0.71, 1.44) | 0.98 (0.68, 1.41) | 0.9019 | 0.9019 |
Triple negative | ||||||||
EDIH | Absolute risk/cases | 18/57 | 24/83 | 21/61 | 17/63 | 25/84 | 7 | |
EDIH | Relative risk | 1 (reference) | 1.43 (1.01, 2.01) | 1.05 (0.72, 1.54) | 1.09 (0.74, 1.60) | 1.49 (1.02, 2.16) | 0.1386 | 0.3277 |
EDIP | Absolute risk/cases | 19/66 | 21/65 | 22/65 | 24/81 | 18/71 | −1 | |
EDIP | Relative risk | 1 (reference) | 0.97 (0.67, 1.40) | 0.98 (0.66, 1.45) | 1.24 (0.82, 1.85) | 1.13 (0.73, 1.76) | 0.3704 | 0.5182 |
HEI-2015 | Absolute risk/cases | 24/75 | 21/70 | 19/69 | 19/61 | 23/73 | −1 | |
HEI-2015 | Relative risk | 1 (reference) | 0.91 (0.66, 1.27) | 0.89 (0.64, 1.24) | 0.78 (0.55, 1.10) | 0.93 (0.66, 1.31) | 0.4526 | 0.5950 |
Invasive ductal carcinoma | ||||||||
EDIH | Absolute risk/cases | 144/463 | 140/482 | 143/474 | 153/478 | 158/500 | 14 | |
EDIH | Relative risk | 1 (reference) | 1.07 (0.94, 1.22) | 1.08 (0.94, 1.24) | 1.11 (0.97, 1.28) | 1.20 (1.04, 1.38) | 0.0119 | 0.0808 |
EDIP | Absolute risk/cases | 146/489 | 143/512 | 152/465 | 153/492 | 146/439 | 0 | |
EDIP | Relative risk | 1 (reference) | 1.08 (0.94, 1.23) | 1.00 (0.87, 1.16) | 1.11 (0.95, 1.30) | 1.06 (0.89, 1.25) | 0.4745 | 0.6112 |
HEI-2015 | Absolute risk/cases | 149/459 | 140/485 | 142/450 | 154/506 | 154/497 | 6 | |
HEI-2015 | Relative risk | 1 (reference) | 1.02 (0.89, 1.16) | 0.93 (0.82, 1.06) | 1.05 (0.92, 1.19) | 1.04 (0.91, 1.19) | 0.5326 | 0.6529 |
Invasive lobular carcinoma | ||||||||
EDIH | Absolute risk/cases | 25/87 | 20/81 | 23/65 | 21/68 | 28/81 | 3 | |
EDIH | Relative risk | 1 (reference) | 1.04 (0.76, 1.42) | 0.88 (0.63, 1.24) | 0.97 (0.69, 1.37) | 1.23 (0.87, 1.72) | 0.3275 | 0.4787 |
EDIP | Absolute risk/cases | 22/96 | 23/62 | 24/89 | 23/64 | 24/71 | 2 | |
EDIP | Relative risk | 1 (reference) | 0.70 (0.49, 0.98) | 1.05 (0.76, 1.47) | 0.81 (0.55, 1.18) | 1.00 (0.67, 1.48) | 0.8900 | 0.8900 |
HEI-2015 | Absolute risk/cases | 24/80 | 24/57 | 20/77 | 24/82 | 23/86 | −1 | |
HEI-2015 | Relative risk | 1 (reference) | 0.66 (0.47, 0.93) | 0.87 (0.63, 1.19) | 0.89 (0.65, 1.23) | 0.91 (0.66, 1.26) | 0.9513 | 0.9513 |
Localized | ||||||||
EDIH | Absolute risk/cases | 186/622 | 179/633 | 185/580 | 190/582 | 200/615 | 14 | |
EDIH | Relative risk | 1 (reference) | 1.08 (0.97, 1.21) | 1.03 (0.92, 1.16) | 1.07 (0.94, 1.21) | 1.18 (1.04, 1.34) | 0.0193 | 0.0863 |
EDIP | Absolute risk/cases | 176/630 | 190/658 | 193/597 | 196/606 | 185/541 | 9 | |
EDIP | Relative risk | 1 (reference) | 1.13 (1.01, 1.28) | 1.08 (0.95, 1.23) | 1.17 (1.02, 1.34) | 1.14 (0.98, 1.32) | 0.0836 | 0.2444 |
HEI-2015 | Absolute risk/cases | 189/584 | 192/595 | 179/597 | 188/598 | 192/658 | 3 | |
HEI-2015 | Relative risk | 1 (reference) | 0.97 (0.86, 1.09) | 0.95 (0.84, 1.07) | 0.94 (0.83, 1.06) | 1.03 (0.91, 1.16) | 0.8605 | 0.8605 |
Regional/distant | ||||||||
EDIH | Absolute risk/cases | 67/219 | 62/230 | 67/199 | 66/215 | 70/229 | 3 | |
EDIH | Relative risk | 1 (reference) | 1.09 (0.90, 1.32) | 0.98 (0.80, 1.21) | 1.09 (0.89, 1.34) | 1.20 (0.98, 1.48) | 0.1030 | 0.2762 |
EDIP | Absolute risk/cases | 69/234 | 59/220 | 71/224 | 67/219 | 67/195 | −2 | |
EDIP | Relative risk | 1 (reference) | 1.00 (0.82, 1.22) | 1.07 (0.86, 1.32) | 1.11 (0.88, 1.39) | 1.07 (0.83, 1.37) | 0.4475 | 0.5950 |
HEI-2015 | Absolute risk/cases | 71/226 | 60/216 | 66/201 | 67/220 | 69/229 | −2 | |
HEI-2015 | Relative risk | 1 (reference) | 0.92 (0.77, 1.12) | 0.85 (0.70, 1.03) | 0.92 (0.76, 1.12) | 0.97 (0.80, 1.18) | 0.7019 | 0.7117 |
Endometrial cancer | ||||||||
EDIH | Absolute risk/cases | 46/74 | 47/88 | 53/79 | 52/73 | 62/89 | 16 | |
EDIH | Relative risk | 1 (reference) | 1.30 (0.94, 1.79) | 1.24 (0.89, 1.74) | 1.24 (0.88, 1.76) | 1.63 (1.16, 2.30) | 0.0110 | 0.0808 |
EDIP | Absolute risk/cases | 50/81 | 49/93 | 49/67 | 55/84 | 58/78 | 8 | |
EDIP | Relative risk | 1 (reference) | 1.21 (0.88, 1.68) | 0.94 (0.65, 1.36) | 1.27 (0.87, 1.85) | 1.39 (0.92, 2.09) | 0.1466 | 0.3277 |
HEI-2015 | Absolute risk/cases | 56/67 | 52/84 | 57/98 | 42/81 | 53/73 | −3 | |
HEI-2015 | Relative risk | 1 (reference) | 1.16 (0.84, 1.60) | 1.27 (0.93, 1.74) | 1.01 (0.72, 1.41) | 0.88 (0.62, 1.24) | 0.3151 | 0.4766 |
Endometroid | ||||||||
EDIH | Absolute risk/cases | 32/49 | 22/50 | 35/53 | 38/52 | 42/62 | 10 | |
EDIH | Relative risk | 1 (reference) | 1.14 (0.76, 1.71) | 1.30 (0.86, 1.96) | 1.38 (0.90, 2.10) | 1.74 (1.15, 2.64) | 0.0058 | 0.0630 |
EDIP | Absolute risk/cases | 28/54 | 32/59 | 32/42 | 33/55 | 44/56 | 16 | |
EDIP | Relative risk | 1 (reference) | 1.19 (0.80, 1.77) | 0.90 (0.57, 1.43) | 1.28 (0.80, 2.03) | 1.52 (0.93, 2.50) | 0.117 | 0.2964 |
HEI-2015 | Absolute risk/cases | 36/48 | 29/53 | 45/66 | 34/54 | 25/45 | −11 | |
HEI-2015 | Relative risk | 1 (reference) | 1.03 (0.69, 1.52) | 1.21 (0.83, 1.77) | 0.94 (0.63, 1.41) | 0.77 (0.50, 1.18) | 0.2181 | 0.4043 |
Non-endometroid | ||||||||
EDIH | Absolute risk/cases | 15/25 | 19/39 | 19/25 | 17/21 | 16/27 | 1 | |
EDIH | Relative risk | 1 (reference) | 1.57 (0.94, 2.64) | 1.07 (0.60, 1.92) | 0.97 (0.52, 1.80) | 1.36 (0.75, 2.48) | 0.7359 | 0.7359 |
EDIP | Absolute risk/cases | 20/27 | 13/33 | 19/26 | 18/29 | 16/22 | −4 | |
EDIP | Relative risk | 1 (reference) | 1.21 (0.70, 2.09) | 1.01 (0.54, 1.88) | 1.18 (0.62, 2.27) | 1.03 (0.50, 2.13) | 0.9443 | 0.9443 |
HEI-2015 | Absolute risk/cases | 15/19 | 20/31 | 15/31 | 15/27 | 21/29 | 6 | |
HEI-2015 | Relative risk | 1 (reference) | 1.52 (0.86, 2.70) | 1.43 (0.80, 2.55) | 1.21 (0.66, 2.20) | 1.25 (0.68, 2.28) | 0.7907 | 0.7907 |
Ovarian cancer | ||||||||
EDIH | Absolute rate/cases | 35/60 | 34/52 | 25/54 | 36/41 | 37/53 | 2 | |
EDIH | Relative risk | 1 (reference) | 0.95 (0.65, 1.39) | 1.04 (0.70, 1.53) | 0.85 (0.55, 1.30) | 1.16 (0.77, 1.75) | 0.5950 | 0.6749 |
EDIP | Absolute rate/cases | 37/64 | 31/63 | 32/44 | 33/46 | 34/43 | −3 | |
EDIP | Relative risk | 1 (reference) | 1.02 (0.70, 1.49) | 0.76 (0.49, 1.18) | 0.85 (0.54, 1.36) | 0.89 (0.54, 1.47) | 0.4541 | 0.5950 |
HEI-2015 | Absolute risk/cases | 33/47 | 28/45 | 36/42 | 34/69 | 37/57 | 4 | |
HEI-2015 | Relative risk | 1 (reference) | 0.93 (0.62, 1.40) | 0.84 (0.55, 1.29) | 1.37 (0.93, 2.01) | 1.09 (0.73, 1.64) | 0.2412 | 0.4365 |
Serous | ||||||||
EDIH | Absolute risk/cases | 14/27 | 16/25 | 9/23 | 17/15 | 17/24 | 3 | |
EDIH | Relative risk | 1 (reference) | 1.06 (0.60, 1.85) | 1.06 (0.59, 1.91) | 0.75 (0.38, 1.47) | 1.26 (0.68, 2.32) | 0.7023 | 0.7117 |
EDIP | Absolute risk/cases | 18/28 | 12/35 | 14/20 | 15/10 | 14/21 | −4 | |
EDIP | Relative risk | 1 (reference) | 1.38 (0.80,2.39) | 0.88 (0.46, 1.71) | 0.48 (0.21, 1.11) | 1.41 (0.54, 2.42) | 0.5589 | 0.6637 |
HEI-2015 | Absolute risk/cases | 16/23 | 11/19 | 15/21 | 16/28 | 14/23 | −2 | |
HEI-2015 | Relative risk | 1 (reference) | 0.80 (0.44, 1.48) | 0.86 (0.47, 1.57) | 1.13 (0.64, 2.00) | 0.90 (0.49, 1.66) | 0.9040 | 0.9040 |
Non-Serous | ||||||||
EDIH | Absolute risk/cases | 20/33 | 18/27 | 16/31 | 18/26 | 20/29 | 0 | |
EDIH | Relative risk/cases | 1 (reference) | 0.86 (0.51, 1.44) | 1.01 (0.60, 1.70) | 0.92 (0.53, 1.60) | 1.10 (0.63, 1.91) | 0.6922 | 0.7117 |
EDIP | Absolute risk/cases | 19/36 | 18/28 | 18/24 | 18/36 | 20/22 | 1 | |
EDIP | Relative risk | 1 (reference) | 0.75 (0.44, 1.28) | 0.66 (0.37, 1.91) | 1.04 (0.58, 1.87) | 0.70 (0.36, 1.39) | 0.5761 | 0.6736 |
HEI-2015 | Absolute risk/cases | 16/23 | 15/27 | 20/21 | 19/41 | 22/34 | −6 | |
HEI-2015 | Relative risk | 1 (reference) | 1.14 (0.65, 1.99) | 0.87 (0.48, 1.58) | 1.66 (0.98, 2.80) | 1.32 (0.76, 2.31) | 0.1355 | 0.3277 |
Lung cancer | ||||||||
EDIH | Absolute risk/cases | 116/482 | 108/408 | 107/410 | 113/417 | 119/399 | 3 | |
EDIH | Relative risk | 1 (reference) | 0.94 (0.82, 1.08) | 0.97 (0.84, 1.11) | 1.01 (0.88, 1.16) | 0.89 (0.77, 1.03) | 0.2609 | 0.4507 |
EDIP | Absolute risk/cases | 110/547 | 109/464 | 114/397 | 117/377 | 113/331 | 3 | |
EDIP | Relative risk | 1 (reference) | 1.05 (0.92, 1.20) | 0.97 (0.84, 1.13) | 1.03 (0.88, 1.21) | 1.02 (0.85, 1.21) | 0.9331 | 0.9331 |
HEI-2015 | Absolute risk/cases | 130/520 | 112/439 | 110/415 | 113/387 | 99/354 | −31 | |
HEI-2015 | Relative risk | 1 (reference) | 0.97 (0.86, 1.11) | 0.99 (0.87, 1.13) | 0.97 (0.84, 1.11) | 0.91 (0.78, 1.05) | 0.2555 | 0.4507 |
Small cell | ||||||||
EDIH | Absolute risk/cases | 7/25 | 8/32 | 7/26 | 6/29 | 9/26 | 2 | |
EDIH | Relative risk | 1 (reference) | 1.43 (0.83, 2.45) | 1.02 (0.57, 1.83) | 1.15 (0.64, 2.04) | 0.81 (0.44, 1.48) | 0.3198 | 0.4766 |
EDIP | Absolute risk/cases | 8/31 | 5/38 | 6/23 | 10/28 | 8/18 | 0 | |
EDIP | Relative risk | 1 (reference) | 1.55 (0.92, 2.61) | 0.93 (0.50, 1.72) | 1.28 (0.68, 2.42) | 0.83 (0.40, 1.74) | 0.6212 | 0.6842 |
HEI-2015 | Absolute risk/cases | 7/33 | 7/27 | 7/32 | 8/23 | 7/23 | 0 | |
HEI-2015 | Relative risk | 1 (reference) | 1.21 (0.72, 2.04) | 1.81 (1.09, 3.02) | 1.51 (0.86, 2.65) | 1.79 (1.00, 3.23) | 0.028 | 0.1182 |
Non-small cell | ||||||||
EDIH | Absolute risk/cases | 57/249 | 59/183 | 51/204 | 55/225 | 59/198 | 2 | |
EDIH | Relative risk | 1 (reference) | 0.81 (0.67, 0.99) | 0.94 (0.77, 1.14) | 1.06 (0.88, 1.30) | 0.89 (0.72, 1.09) | 0.7986 | 0.7986 |
EDIP | Absolute risk/cases | 57/275 | 50/218 | 61/205 | 59/192 | 54/169 | −3 | |
EDIP | Relative risk | 1 (reference) | 0.98 (0.80, 1.18) | 1.00 (0.81, 1.23) | 1.04 (0.83, 1.31) | 1.04 (0.81, 1.34) | 0.6585 | 0.7117 |
HEI-2015 | Absolute risk/cases | 64/251 | 56/219 | 53/207 | 57/197 | 51/184 | −13 | |
HEI-2015 | Relative risk | 1 (reference) | 0.98 (0.81, 1.18) | 0.97 (0.80, 1.17) | 0.95 (0.78, 1.16) | 0.90 (0.73, 1.11) | 0.3434 | 0.4924 |
3.5. EDIP and Cancer Risk (Table 2, Figure 2)
3.6. HEI-2015 and Cancer Risk (Table 2, Figure 2)
3.7. Sensitivity Analyses and Subgroup Analyses (Supplementary Tables S5–S8)
4. Discussion
4.1. Principal Findings, Strengths and Weaknesses in Relation to Other Studies
4.2. Strengths and Weaknesses of the Study
4.3. Possible Implications and Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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T1 | T2 | T3 | P for Linear Trend c | 1 sd Increment | P for Continuous Dietary Score e | |
---|---|---|---|---|---|---|
Overall cancer/cases | ||||||
EDIH metabolomics score | 165 | 133 | 143 | |||
MV-adjusted | 1 | 0.80 (0.63, 1.01) | 0.93 (0.72, 1.20) | 0.5171 | 0.99 (0.78, 1.26) | 0.9115 |
EDIP metabolomics score | 179 | 140 | 122 | |||
MV-adjusted | 1 | 0.83 (0.66, 1.04) | 0.81 (0.62, 1.05) | 0.0893 | 0.76 (0.58, 1.00) | 0.0531 |
HEI metabolomics score | 161 | 130 | 150 | |||
MV-adjusted | 1 | 0.82 (0.64, 1.05) | 0.94 (0.73, 1.22) | 0.6573 | 0.86 (0.68, 1.09) | 0.2083 |
Colorectal cancer/cases | ||||||
EDIH metabolomics score | 25 | 16 | 18 | |||
MV-adjusted | 1 | 0.34 (0.14, 0.85) | 0.52 (0.21, 1.28) | 0.1259 | 0.67 (0.27, 1.63) | 0.3777 |
EDIP metabolomics score | 28 | 13 | 18 | |||
MV-adjusted | 1 | 0.38 (0.15, 0.96) | 0.63 (0.25, 1.61) | 0.3514 | 0.57 (0.20, 1.60) | 0.2845 |
HEI metabolomics score | 21 | 13 | 25 | |||
MV-adjusted | 1 | 0.28 (0.10, 0.77) | 1.56 (0.66, 3.71) | 0.2690 | 1.33 (0.58, 3.07) | 0.5007 |
Colon cancer/cases | ||||||
EDIH metabolomics score | 19 | 10 | 17 | |||
MV-adjusted | 1 | 0.38 (0.14, 1.03) | 0.74 (0.29, 1.89) | 0.5184 | 1.04 (0.39, 2.73) | 0.9413 |
EDIP metabolomics score | 21 | 9 | 16 | |||
MV-adjusted | 1 | 0.41 (0.14, 1.22) | 0.73 (0.26, 2.04) | 0.6204 | 0.61 (0.20 1.92) | 0.3987 |
HEI metabolomics score | 19 | 10 | 17 | |||
MV-adjusted | 1 | 0.27 (0.09, 0.77) | 0.94 (0.37, 2.40) | 0.9655 | 0.78 (0.31, 1.96) | 0.5954 |
Intestinal Polyps/cases | ||||||
EDIH metabolomics score | 67 | 77 | 100 | |||
MV-adjusted | 1 | 0.96 (0.63, 1.44) | 1.13 (0.72, 1.76) | 0.5515 | 1.29 (0.84, 1.98) | 0.2458 |
EDIP metabolomics score | 61 | 75 | 108 | |||
MV-adjusted | 1 | 1.17 (0.75, 1.84) | 1.46 (0.91, 2.34) | 0.1136 | 1.51 (0.93, 2.46) | 0.0989 |
HEI metabolomics score | 95 | 80 | 69 | |||
MV-adjusted | 1 | 0.89 (0.60, 1.33) | 0.72 (0.47, 1.11) | 0.1421 | 0.76 (0.51, 1.13) | 0.1701 |
Invasive breast cancer/cases | ||||||
EDIH metabolomics score | 44 | 33 | 41 | |||
MV-adjusted | 1 | 0.74 (0.46, 1.18) | 1.00 (0.62, 1.62) | 0.9814 | 1.39 (0.87, 2.20) | 0.1649 |
EDIP metabolomics score | 41 | 37 | 40 | |||
MV-adjusted | 1 | 0.95 (0.60, 1.52) | 1.16 (0.71, 1.89) | 0.5685 | 1.01 (0.60, 1.71) | 0.9649 |
HEI metabolomics score | 38 | 39 | 41 | |||
MV-adjusted | 1 | 1.02 (0.64, 1.64) | 1.03 (0.62, 1.69) | 0.9158 | 1.00 (0.65, 1.56) | 0.9812 |
Endometrial cancer/cases | ||||||
EDIH metabolomics score | 5 | 5 | 12 | |||
MV-adjusted | 1 | 0.44 (0.10, 1.87) | 1.78 (0.51, 6.27) | 0.2407 | 3.58 (0.96, 13.29) | 0.0566 |
EDIP metabolomics score | 6 | 5 | 11 | |||
MV-adjusted | 1 | 0.70 (0.18, 2.68) | 1.25 (0.36, 4.35) | 0.6640 | 2.67 (0.63, 11.28) | 0.1805 |
HEI metabolomics score | 7 | 10 | 5 | |||
MV-adjusted | 1 | 1.23 (0.39, 3.93) | 0.54 (0.13, 2.25) | 0.3963 | 0.41 (0.12, 1.43) | 0.1627 |
Lung cancer/cases | ||||||
EDIH metabolomics score | 23 | 28 | 24 | |||
MV-adjusted | 1 | 1.25 (0.69, 2.27) | 1.10 (0.56, 2.14) | 0.7803 | 0.88 (0.47, 1.65) | 0.6964 |
EDIP metabolomics score | 33 | 39 | 13 | |||
MV-adjusted | 1 | 0.96 (0.56, 1.65) | 0.52 (0.25, 1.12) | 0.1340 | 0.57 (0.28, 1.14) | 0.1115 |
HEI metabolomics score | 41 | 18 | 16 | |||
MV-adjusted | 1 | 0.49 (0.26, 0.92) | 0.49 (0.24, 1.01) | 0.0289 | 0.46 (0.24, 0.90) | 0.0227 |
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Jin, Q.; Shi, N.; Lee, D.H.; Rexrode, K.M.; Manson, J.E.; Balasubramanian, R.; Zhang, X.; Neuhouser, M.L.; Lopez-Pentecost, M.; Thomson, C.A.; et al. Hyperinsulinemic and Pro-Inflammatory Dietary Patterns and Metabolomic Profiles Are Associated with Increased Risk of Total and Site-Specific Cancers among Postmenopausal Women. Cancers 2023, 15, 1756. https://doi.org/10.3390/cancers15061756
Jin Q, Shi N, Lee DH, Rexrode KM, Manson JE, Balasubramanian R, Zhang X, Neuhouser ML, Lopez-Pentecost M, Thomson CA, et al. Hyperinsulinemic and Pro-Inflammatory Dietary Patterns and Metabolomic Profiles Are Associated with Increased Risk of Total and Site-Specific Cancers among Postmenopausal Women. Cancers. 2023; 15(6):1756. https://doi.org/10.3390/cancers15061756
Chicago/Turabian StyleJin, Qi, Ni Shi, Dong Hoon Lee, Kathryn M. Rexrode, JoAnn E. Manson, Raji Balasubramanian, Xuehong Zhang, Marian L. Neuhouser, Melissa Lopez-Pentecost, Cynthia A. Thomson, and et al. 2023. "Hyperinsulinemic and Pro-Inflammatory Dietary Patterns and Metabolomic Profiles Are Associated with Increased Risk of Total and Site-Specific Cancers among Postmenopausal Women" Cancers 15, no. 6: 1756. https://doi.org/10.3390/cancers15061756