Dietary Patterns of Insulinemia, Inflammation and Glycemia and Pancreatic Cancer Risk: Findings from the Women's Health Initiative
Menée aux Etats-Unis par questionnaire auprès de 129 241 femmes (âge : 50-79 ans), cette étude de cohorte analyse le lien entre des régimes alimentaires associés à un hyperinsulinisme et à une inflammation systémique, la présence d'un diabète de type 2 et le risque de cancer du pancréas (durée médiane de suivi : 19,9 ans ; 850 cas)
Background: Pancreatic cancer risk is increasing in countries with high consumption of Western dietary patterns and rising obesity rates. We examined the hypothesis that specific dietary patterns reflecting hyperinsulinemia (empirical dietary index for hyperinsulinemia-EDIH), systemic inflammation (empirical dietary inflammatory pattern-EDIP), and postprandial glycemia (glycemic index-GI, glycemic load-GL) are associated with pancreatic cancer risk, including the potential modifying role of type 2 diabetes (T2D) and body mass index (BMI). Methods: We calculated dietary scores from baseline (1993-1998) food frequency questionnaires among 129,241 women, 50-79 years-old in the Women's Health Initiative. We used multivariable-adjusted Cox regression to estimate hazard ratios (HR) and 95% confidence intervals (95%CI) for pancreatic cancer risk. Results: During a median 19.9 years of follow-up, 850 pancreatic cancer cases were diagnosed. We observed no association between dietary scores and pancreatic cancer risk overall. However, risk was elevated among participants with longstanding T2D (present >3 years before pancreatic cancer diagnosis) for EDIH. For each 1 standard deviation increment in dietary score, the HRs (95%CIs) were: EDIH, 1.33(1.06-1.66); EDIP, 1.26(0.98-1.63); GI, 1.26(0.96-1.67); and GL, 1.23(0.96-1.57); though interactions were not significant (all Pinteraction >0.05). Separately, we observed inverse associations between GI, 0.86(0.76-0.96), Pinteraction=0.0068; and GL, 0.83 (0.73-0.93), Pinteraction=0.0075, with pancreatic cancer risk among normal-weight women. Conclusion: We observed no overall association between the dietary patterns evaluated and pancreatic cancer risk, although women with T2D appeared to have greater cancer risk. Impact: The elevated risk for hyperinsulinemic diets among women with longstanding T2D and the inverse association among normal-weight women warrant further examination.