Dietary inflammatory and insulinemic potential, risk of hepatocellular carcinoma, and chronic liver disease mortality

Author:

Long Lu12,Liu Xing34,Petrick Jessica5,Liu Wanqing6,Lee Jeffrey K78,Liao Linda9,Lai Michelle J10,Yang Wanshui111,Libermann Towia A12,Roberts Lewis R13,McGlynn Katherine A9,Tabung Fred K314,Zhang Xuehong13

Affiliation:

1. Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School , Boston, MA, USA

2. Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University , Chengdu, P.R. China

3. Department of Nutrition, Harvard T.H. Chan School of Public Health , Boston, MA, USA

4. Department of Epidemiology, School of Public Health, Fudan University , Shanghai, P.R. China

5. Slone Epidemiology Center, Boston University , Boston, MA, USA

6. Department of Pharmaceutical Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University , Detroit, MI, USA

7. Division of Research, Kaiser Permanente Northern California , Oakland, CA, USA

8. Department of Gastroenterology, Kaiser Permanente Northern California , San Francisco, CA, USA

9. Division of Cancer Epidemiology and Genetics, National Cancer Institute , Bethesda, MD, USA

10. Beth Israel Deaconess Medical Center, Harvard Medical School , Boston, MA, USA

11. Department of Nutrition, School of Public Health, Anhui Medical University , Hefei, Anhui, P.R. China

12. Department of Medicine, Beth Israel Deaconess Medical Center, and Harvard Medical School , Boston, MA, USA

13. Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science , Rochester, MN, USA

14. The Ohio State University College of Medicine and Comprehensive Cancer Center , Columbus, OH, USA

Abstract

Abstract Background Diet modulates inflammation and insulin response and may be an important modifiable factor in the primary prevention of hepatocellular carcinoma (HCC) and chronic liver disease (CLD). We developed the empirical dietary inflammatory pattern (EDIP) and empirical dietary index for hyperinsulinemia (EDIH) scores to assess the inflammatory and insulinemic potentials of diet. We prospectively examined the associations of EDIP and EDIH at baseline with the following HCC risk and CLD mortality. Design We followed 485 931 individuals in the National Institutes of Health–American Association of Retired Persons Diet and Health Study since 1995. Cox proportional hazards regression was used to calculate multivariable hazard ratios (HRs) and 95% confidence intervals (CIs). Results We confirmed 635 incident HCC cases and 993 CLD deaths. Participants in the highest compared with those in the lowest EDIP quartile had a 1.35 times higher risk of developing HCC (95% CI = 1.08 to 1.70, Ptrend = .0005) and a 1.70 times higher CLD mortality (95% CI = 1.41 to 2.04, Ptrend < .0001). For the same comparison, participants with the highest EDIH were at increased risk of HCC (HR = 1.53, 95% CI = 1.20 to 1.95, Ptrend = .0004) and CLD mortality (HR = 1.72, 95% CI = 1.42 to 2.01, Ptrend < .0001). Similar positive associations of scores with HCC risk and CLD mortality were observed for both women and men. Moreover, individuals in both the highest EDIP and EDIH tertiles had a 92% increased HCC risk (95% CI = 1.43 to 2.58) and 98% increased CLD mortality (95% CI = 1.27 to 3.08) compared with those in both lowest tertiles. Conclusions Our findings suggest that inflammation and hyperinsulinemia are potential mechanisms linking diet to HCC development and CLD mortality.

Funder

National Institutes of Health

Publisher

Oxford University Press (OUP)

Subject

Cancer Research,Oncology

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