Association of inflammatory and insulinemic potential of diet and lifestyle with risk of hepatocellular carcinoma

Wanshui Yang; Jing Sui; Longgang Zhao; Yanan Ma; Fred K. Tabung; Tracey G. Simon; Dong Hoon Lee; Xufen Zeng; Long H. Nguyen; Jeffrey A. Meyerhardt; Andrew T. Chan; Edward L. Giovannucci; Xuehong Zhang

doi:10.1158/1055-9965.EPI-20-1329

Association of inflammatory and insulinemic potential of diet and lifestyle with risk of hepatocellular carcinoma

Wanshui Yang, Jing Sui, Longgang Zhao, Yanan Ma, Fred K. Tabung, Tracey G. Simon, Dong Hoon Lee, Xufen Zeng, Long H. Nguyen, Jeffrey A. Meyerhardt, Andrew T. Chan, Edward L. Giovannucci, Xuehong Zhang

Department of Sports Industry Studies

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Abstract

Background: We prospectively examined the extent to which greater inflammatory and insulinemic potential of diet and lifestyle are associated with the risk of developing hepatocellular carcinoma (HCC) in two nationwide cohorts. Methods: Five kinds of pattern scores, including the empirical dietary inflammatory pattern (EDIP), empirical dietary index for hyperinsulinemia (EDIH) and insulin resistance (EDIR), empirical lifestyle pattern score for hyperinsulinemia (ELIH) and insulin resistance (ELIR) were calculated. Multivariable hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression. Results: After an average follow-up of 25.6 years among 119,316 participants, 142 incident HCC cases were documented. Higher adherence to EDIP (HR by comparing extreme tertiles: 2.03; 95% CI, 1.31-3.16; Ptrend = 0.001), EDIH (HR, 1.61; 95% CI, 1.06-2.43; Ptrend=0.02), and EDIR (HR, 1.62; 95% CI: 1.08-2.42; Ptrend=0.02) was associated with increased risk of HCC. Likewise, participants with higher scores of ELIH (HR, 1.89; 95% CI, 1.25-2.87; Ptrend = 0.001) and ELIR (HR, 2.05; 95% CI, 1.34-3.14, Ptrend = 0.0004) had higher risk of developing HCC. Additional adjustment for diabetes mellitus and/or body mass index attenuated the magnitude of the associations, indicating that diabetes and/or adiposity may partly mediate the association of these patterns with HCC risk. Conclusions: Our findings suggest that inflammation and insulin resistance/hyperinsulinemia are potential mechanisms linking dietary or lifestyle factors and HCC development. Impact: Inflammation and insulin resistance/hyperinsulinemia may partly mediate the association of diet and other lifestyles with HCC development, and interventions to reduce the adverse effect of pro-inflammatory and hyperinsulinemic diet and lifestyle may reduce HCC risk.

Original language	English
Pages (from-to)	789-796
Number of pages	8
Journal	Cancer Epidemiology Biomarkers and Prevention
Volume	30
Issue number	4
DOIs	https://doi.org/10.1158/1055-9965.EPI-20-1329
Publication status	Published - 2021 Apr

Bibliographical note

Funding Information:
T.G. Simon reports grants from Amgen and other from Aetion outside the submitted work. J.A. Meyerhardt reports personal fees from COTA Healthcare, Ignyta, and Taiho Pharmaceutical outside the submitted work. A.T. Chan reports personal fees from Pfizer Inc., as well as grants and personal fees from Bayer Pharma AG, and personal fees from Boehringer Ingelheim outside the submitted work. No disclosures were reported by the other authors.

Publisher Copyright:
© 2021 American Association for Cancer Research.

All Science Journal Classification (ASJC) codes

Epidemiology
Oncology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1158/1055-9965.EPI-20-1329

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Yang, W., Sui, J., Zhao, L., Ma, Y., Tabung, F. K., Simon, T. G., Lee, D. H., Zeng, X., Nguyen, L. H., Meyerhardt, J. A., Chan, A. T., Giovannucci, E. L., & Zhang, X. (2021). Association of inflammatory and insulinemic potential of diet and lifestyle with risk of hepatocellular carcinoma. Cancer Epidemiology Biomarkers and Prevention, 30(4), 789-796. https://doi.org/10.1158/1055-9965.EPI-20-1329

@article{bf27ceff84e44ce788a458782684a284,

title = "Association of inflammatory and insulinemic potential of diet and lifestyle with risk of hepatocellular carcinoma",

abstract = "Background: We prospectively examined the extent to which greater inflammatory and insulinemic potential of diet and lifestyle are associated with the risk of developing hepatocellular carcinoma (HCC) in two nationwide cohorts. Methods: Five kinds of pattern scores, including the empirical dietary inflammatory pattern (EDIP), empirical dietary index for hyperinsulinemia (EDIH) and insulin resistance (EDIR), empirical lifestyle pattern score for hyperinsulinemia (ELIH) and insulin resistance (ELIR) were calculated. Multivariable hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression. Results: After an average follow-up of 25.6 years among 119,316 participants, 142 incident HCC cases were documented. Higher adherence to EDIP (HR by comparing extreme tertiles: 2.03; 95% CI, 1.31-3.16; Ptrend = 0.001), EDIH (HR, 1.61; 95% CI, 1.06-2.43; Ptrend=0.02), and EDIR (HR, 1.62; 95% CI: 1.08-2.42; Ptrend=0.02) was associated with increased risk of HCC. Likewise, participants with higher scores of ELIH (HR, 1.89; 95% CI, 1.25-2.87; Ptrend = 0.001) and ELIR (HR, 2.05; 95% CI, 1.34-3.14, Ptrend = 0.0004) had higher risk of developing HCC. Additional adjustment for diabetes mellitus and/or body mass index attenuated the magnitude of the associations, indicating that diabetes and/or adiposity may partly mediate the association of these patterns with HCC risk. Conclusions: Our findings suggest that inflammation and insulin resistance/hyperinsulinemia are potential mechanisms linking dietary or lifestyle factors and HCC development. Impact: Inflammation and insulin resistance/hyperinsulinemia may partly mediate the association of diet and other lifestyles with HCC development, and interventions to reduce the adverse effect of pro-inflammatory and hyperinsulinemic diet and lifestyle may reduce HCC risk.",

author = "Wanshui Yang and Jing Sui and Longgang Zhao and Yanan Ma and Tabung, {Fred K.} and Simon, {Tracey G.} and Lee, {Dong Hoon} and Xufen Zeng and Nguyen, {Long H.} and Meyerhardt, {Jeffrey A.} and Chan, {Andrew T.} and Giovannucci, {Edward L.} and Xuehong Zhang",

note = "Funding Information: T.G. Simon reports grants from Amgen and other from Aetion outside the submitted work. J.A. Meyerhardt reports personal fees from COTA Healthcare, Ignyta, and Taiho Pharmaceutical outside the submitted work. A.T. Chan reports personal fees from Pfizer Inc., as well as grants and personal fees from Bayer Pharma AG, and personal fees from Boehringer Ingelheim outside the submitted work. No disclosures were reported by the other authors. Publisher Copyright: {\textcopyright} 2021 American Association for Cancer Research.",

year = "2021",

month = apr,

doi = "10.1158/1055-9965.EPI-20-1329",

language = "English",

volume = "30",

pages = "789--796",

journal = "Cancer Epidemiology Biomarkers and Prevention",

issn = "1055-9965",

publisher = "American Association for Cancer Research Inc.",

number = "4",

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Yang, W, Sui, J, Zhao, L, Ma, Y, Tabung, FK, Simon, TG, Lee, DH, Zeng, X, Nguyen, LH, Meyerhardt, JA, Chan, AT, Giovannucci, EL & Zhang, X 2021, 'Association of inflammatory and insulinemic potential of diet and lifestyle with risk of hepatocellular carcinoma', Cancer Epidemiology Biomarkers and Prevention, vol. 30, no. 4, pp. 789-796. https://doi.org/10.1158/1055-9965.EPI-20-1329

TY - JOUR

T1 - Association of inflammatory and insulinemic potential of diet and lifestyle with risk of hepatocellular carcinoma

AU - Yang, Wanshui

AU - Sui, Jing

AU - Zhao, Longgang

AU - Ma, Yanan

AU - Tabung, Fred K.

AU - Simon, Tracey G.

AU - Lee, Dong Hoon

AU - Zeng, Xufen

AU - Nguyen, Long H.

AU - Meyerhardt, Jeffrey A.

AU - Chan, Andrew T.

AU - Giovannucci, Edward L.

AU - Zhang, Xuehong

N1 - Funding Information: T.G. Simon reports grants from Amgen and other from Aetion outside the submitted work. J.A. Meyerhardt reports personal fees from COTA Healthcare, Ignyta, and Taiho Pharmaceutical outside the submitted work. A.T. Chan reports personal fees from Pfizer Inc., as well as grants and personal fees from Bayer Pharma AG, and personal fees from Boehringer Ingelheim outside the submitted work. No disclosures were reported by the other authors. Publisher Copyright: © 2021 American Association for Cancer Research.

PY - 2021/4

Y1 - 2021/4

N2 - Background: We prospectively examined the extent to which greater inflammatory and insulinemic potential of diet and lifestyle are associated with the risk of developing hepatocellular carcinoma (HCC) in two nationwide cohorts. Methods: Five kinds of pattern scores, including the empirical dietary inflammatory pattern (EDIP), empirical dietary index for hyperinsulinemia (EDIH) and insulin resistance (EDIR), empirical lifestyle pattern score for hyperinsulinemia (ELIH) and insulin resistance (ELIR) were calculated. Multivariable hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression. Results: After an average follow-up of 25.6 years among 119,316 participants, 142 incident HCC cases were documented. Higher adherence to EDIP (HR by comparing extreme tertiles: 2.03; 95% CI, 1.31-3.16; Ptrend = 0.001), EDIH (HR, 1.61; 95% CI, 1.06-2.43; Ptrend=0.02), and EDIR (HR, 1.62; 95% CI: 1.08-2.42; Ptrend=0.02) was associated with increased risk of HCC. Likewise, participants with higher scores of ELIH (HR, 1.89; 95% CI, 1.25-2.87; Ptrend = 0.001) and ELIR (HR, 2.05; 95% CI, 1.34-3.14, Ptrend = 0.0004) had higher risk of developing HCC. Additional adjustment for diabetes mellitus and/or body mass index attenuated the magnitude of the associations, indicating that diabetes and/or adiposity may partly mediate the association of these patterns with HCC risk. Conclusions: Our findings suggest that inflammation and insulin resistance/hyperinsulinemia are potential mechanisms linking dietary or lifestyle factors and HCC development. Impact: Inflammation and insulin resistance/hyperinsulinemia may partly mediate the association of diet and other lifestyles with HCC development, and interventions to reduce the adverse effect of pro-inflammatory and hyperinsulinemic diet and lifestyle may reduce HCC risk.

AB - Background: We prospectively examined the extent to which greater inflammatory and insulinemic potential of diet and lifestyle are associated with the risk of developing hepatocellular carcinoma (HCC) in two nationwide cohorts. Methods: Five kinds of pattern scores, including the empirical dietary inflammatory pattern (EDIP), empirical dietary index for hyperinsulinemia (EDIH) and insulin resistance (EDIR), empirical lifestyle pattern score for hyperinsulinemia (ELIH) and insulin resistance (ELIR) were calculated. Multivariable hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression. Results: After an average follow-up of 25.6 years among 119,316 participants, 142 incident HCC cases were documented. Higher adherence to EDIP (HR by comparing extreme tertiles: 2.03; 95% CI, 1.31-3.16; Ptrend = 0.001), EDIH (HR, 1.61; 95% CI, 1.06-2.43; Ptrend=0.02), and EDIR (HR, 1.62; 95% CI: 1.08-2.42; Ptrend=0.02) was associated with increased risk of HCC. Likewise, participants with higher scores of ELIH (HR, 1.89; 95% CI, 1.25-2.87; Ptrend = 0.001) and ELIR (HR, 2.05; 95% CI, 1.34-3.14, Ptrend = 0.0004) had higher risk of developing HCC. Additional adjustment for diabetes mellitus and/or body mass index attenuated the magnitude of the associations, indicating that diabetes and/or adiposity may partly mediate the association of these patterns with HCC risk. Conclusions: Our findings suggest that inflammation and insulin resistance/hyperinsulinemia are potential mechanisms linking dietary or lifestyle factors and HCC development. Impact: Inflammation and insulin resistance/hyperinsulinemia may partly mediate the association of diet and other lifestyles with HCC development, and interventions to reduce the adverse effect of pro-inflammatory and hyperinsulinemic diet and lifestyle may reduce HCC risk.

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Association of inflammatory and insulinemic potential of diet and lifestyle with risk of hepatocellular carcinoma

Abstract

Bibliographical note

All Science Journal Classification (ASJC) codes

UN SDGs

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