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Glycemic index, glycemic load and endometrial cancer risk: results from the Australian National Endometrial Cancer study and an updated systematic review and meta-analysis.

Abstract

PURPOSE

The relationship between habitual consumption of foods with a high glycemic index (GI) and/or a diet with a high glycemic load (GL) and risk of endometrial cancer is uncertain, and relatively few studies have investigated these associations. The objectives of this study were to examine the association between GI/GL and risk of endometrial cancer using data from an Australian population-based case-control study and systematically review all the available evidence to quantify the magnitude of the association using meta-analysis.

METHODS

The case-control study included 1,290 women aged 18-79 years with newly diagnosed, histologically confirmed endometrial cancer and 1,436 population controls. Controls were selected to match the expected Australian state of residence and age distribution (in 5-year bands) of cases. For the systematic review, relevant studies were identified by searching PubMed and Embase databases through to July 2011. Random-effects models were used to calculate the summary risk estimates, overall and dose-response.

RESULTS

In our case-control study, we observed a modest positive association between high dietary GI (OR 1.43, 95 % CI 1.11-1.83) and risk of endometrial cancer, but no association with high dietary GL (OR 1.15, 95 % CI 0.90-1.48). For the meta-analysis, we collated information from six cohort and two case-control studies, involving a total of 5,569 cases. The pooled OR for the highest versus the lowest intake category of GI was 1.15 (0.95-1.40); however, there was significant heterogeneity (p 0.004) by study design (RR 1.00 [95 % CI 0.87-1.14] for cohort studies and 1.56 [95 % CI 1.21-2.02] for case-control studies). There was no association in the dose-response meta-analysis of GI (RR per 5 unit/day increment of GI 1.00, 95 % CI 0.97-1.03). GL was positively associated with endometrial cancer. The pooled RR for the highest versus the lowest GL intake was 1.21 (95 % CI 1.09-1.33) and 1.06 (95 % CI 1.01-1.11) per 50 unit/day increment of GL in the dose-response meta-analysis.

CONCLUSION

The pooled results from observational studies, including our case-control results, provide evidence of a modest positive association between high GL, but not GI, and endometrial cancer risk.

Links

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  • Authors+Show Affiliations

    ,

    Gynaecological Cancers, Population Health Research Department, Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Brisbane, QLD, Australia. Christina.Nagle@qimr.edu.au

    , , , , ,

    Source

    European journal of nutrition 52:2 2013 Mar pg 705-15

    MeSH

    Adolescent
    Adult
    Aged
    Australia
    Blood Glucose
    Case-Control Studies
    Databases, Factual
    Diet
    Dietary Carbohydrates
    Endometrial Neoplasms
    Female
    Glycemic Index
    Humans
    Middle Aged
    Risk Factors
    Young Adult

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    22648201

    Citation

    Nagle, Christina M., et al. "Glycemic Index, Glycemic Load and Endometrial Cancer Risk: Results From the Australian National Endometrial Cancer Study and an Updated Systematic Review and Meta-analysis." European Journal of Nutrition, vol. 52, no. 2, 2013, pp. 705-15.
    Nagle CM, Olsen CM, Ibiebele TI, et al. Glycemic index, glycemic load and endometrial cancer risk: results from the Australian National Endometrial Cancer study and an updated systematic review and meta-analysis. Eur J Nutr. 2013;52(2):705-15.
    Nagle, C. M., Olsen, C. M., Ibiebele, T. I., Spurdle, A. B., & Webb, P. M. (2013). Glycemic index, glycemic load and endometrial cancer risk: results from the Australian National Endometrial Cancer study and an updated systematic review and meta-analysis. European Journal of Nutrition, 52(2), pp. 705-15. doi:10.1007/s00394-012-0376-7.
    Nagle CM, et al. Glycemic Index, Glycemic Load and Endometrial Cancer Risk: Results From the Australian National Endometrial Cancer Study and an Updated Systematic Review and Meta-analysis. Eur J Nutr. 2013;52(2):705-15. PubMed PMID: 22648201.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Glycemic index, glycemic load and endometrial cancer risk: results from the Australian National Endometrial Cancer study and an updated systematic review and meta-analysis. AU - Nagle,Christina M, AU - Olsen,Catherine M, AU - Ibiebele,Torukiri I, AU - Spurdle,Amanda B, AU - Webb,Penelope M, AU - ,, AU - ,, Y1 - 2012/05/22/ PY - 2011/11/20/received PY - 2012/05/03/accepted PY - 2012/6/1/entrez PY - 2012/6/1/pubmed PY - 2013/8/16/medline SP - 705 EP - 15 JF - European journal of nutrition JO - Eur J Nutr VL - 52 IS - 2 N2 - PURPOSE: The relationship between habitual consumption of foods with a high glycemic index (GI) and/or a diet with a high glycemic load (GL) and risk of endometrial cancer is uncertain, and relatively few studies have investigated these associations. The objectives of this study were to examine the association between GI/GL and risk of endometrial cancer using data from an Australian population-based case-control study and systematically review all the available evidence to quantify the magnitude of the association using meta-analysis. METHODS: The case-control study included 1,290 women aged 18-79 years with newly diagnosed, histologically confirmed endometrial cancer and 1,436 population controls. Controls were selected to match the expected Australian state of residence and age distribution (in 5-year bands) of cases. For the systematic review, relevant studies were identified by searching PubMed and Embase databases through to July 2011. Random-effects models were used to calculate the summary risk estimates, overall and dose-response. RESULTS: In our case-control study, we observed a modest positive association between high dietary GI (OR 1.43, 95 % CI 1.11-1.83) and risk of endometrial cancer, but no association with high dietary GL (OR 1.15, 95 % CI 0.90-1.48). For the meta-analysis, we collated information from six cohort and two case-control studies, involving a total of 5,569 cases. The pooled OR for the highest versus the lowest intake category of GI was 1.15 (0.95-1.40); however, there was significant heterogeneity (p 0.004) by study design (RR 1.00 [95 % CI 0.87-1.14] for cohort studies and 1.56 [95 % CI 1.21-2.02] for case-control studies). There was no association in the dose-response meta-analysis of GI (RR per 5 unit/day increment of GI 1.00, 95 % CI 0.97-1.03). GL was positively associated with endometrial cancer. The pooled RR for the highest versus the lowest GL intake was 1.21 (95 % CI 1.09-1.33) and 1.06 (95 % CI 1.01-1.11) per 50 unit/day increment of GL in the dose-response meta-analysis. CONCLUSION: The pooled results from observational studies, including our case-control results, provide evidence of a modest positive association between high GL, but not GI, and endometrial cancer risk. SN - 1436-6215 UR - https://www.unboundmedicine.com/medline/citation/22648201/full_citation L2 - https://dx.doi.org/10.1007/s00394-012-0376-7 DB - PRIME DP - Unbound Medicine ER -