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J Gynecol Oncol. 2019 May;30(3):e23. doi: 10.3802/jgo.2019.30.e23.

Dietary inflammatory index and risk of gynecological cancers: a systematic review and meta-analysis of observational studies.

Author information

1
Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China.
2
Department of Medical Statistics, School of Medicine, Jinan University, Guangzhou, China.
3
Department of Nutrition, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
4
Department of Nutrition, School of Medicine, Jinan University, Guangzhou, China.
5
Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China. zengffjnu@126.com.
#
Contributed equally

Abstract

OBJECTIVE:

There has been growing body of literatures showing that chronic inflammation might play an important role in cancer development. This meta-analysis aimed to assess the association between the dietary inflammation index (DII) score and gynecological cancers.

METHODS:

A systematic search of PubMed, EMBASE and Web of Science up until October 20, 2018 was carried out to retrieve all related cohort and case-control studies. The summary risk assessments were pooled using random-effects models. The dose-response relationship was estimated by linear relationship model.

RESULTS:

Twelve case-control studies (10,774 cases/15,958 controls) and six prospective cohort studies (330,363 participants/23,133 incident cases) were included in this meta-analysis. The pooled adjusted relative risk (RR) of gynecological cancers for the highest DII category compared to the lowest category was 1.38, (95% confidence intervals [CIs], 1.21-1.56, p<0.001]. A positive dose-response relationship was also noticed. Stratified by study design indicated that, the pooled RRs was significantly higher for case-control studies than cohort studies (p for interaction<0.001), for studies conducted among participants with body mass index (BMI) ≥25 kg/m² than participants with BMI <25 kg/m² (p for interaction=0.026), among participants with ovarian cancer and endometrial cancer than participants with breast cancer (p for interaction = 0.038). Meta-regression analysis further confirmed that study design significantly contributed to inter-study heterogeneity (p<0.001).

CONCLUSION:

This meta-analysis suggests that elevated DII is independently associated with a higher risk of gynecological cancers, especially patients with ovarian cancer and endometrial cancer and among obese participants.

KEYWORDS:

Dietary Inflammatory Index; Epidemiologic studies; Gynecologic Neoplasms; Meta-Analysis

PMID:
30887752
PMCID:
PMC6424848
[Available on 2019-05-01]
DOI:
10.3802/jgo.2019.30.e23
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