Association between the dietary inflammatory index and the risk of hepatocellular carcinoma in a cirrhotic population

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS Clinical nutrition Pub Date : 2025-01-01 DOI:10.1016/j.clnu.2024.11.021

Maud Rizk , Cécile Roux-Levy , Brigitte Bernard-Chabert , Jean-Pierre Bronowicki , Carine Richou , François Habersetzer , Jean-Louis Jouve , James R. Hebert , Nitin Shivappa , Marie-Christine Boutron-Ruault , Mona Diab Assaf , Patrick Hillon , Vanessa Cottet

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Abstract

Background & aims

Hepatocellular carcinoma (HCC) is recognized as an inflammation-related cancer. However, the relation between inflammation deriving from the diet and HCC risk among cirrhotic patients has not yet been investigated. This study aimed to examine the association between the dietary inflammatory index (DII®) and HCC risk among cirrhotic patients.

Methods

Clinical and dietary data were collected from the French case–control study CiRCE (Cirrhosis and Risk of hepatocellular Carcinoma in the East), which included 401 cirrhotic patients without HCC (controls) and 181 cirrhotic patients with HCC (cases) recruited between 2008 and 2012 in six French university hospitals. DII scores (36 food items and nutrients) were assessed using a validated self-administered diet history questionnaire. Odds ratios (OR) and 95 % confidence intervals (CI) were estimated with logistic regression models (adjusted for age, gender, time from cirrhosis diagnosis, etiology of cirrhosis, Child-Pugh score, and diabetes).

Results

The DII scores ranged between −4.77 and +7.59 with a mean value of 1.03 ± 2.87 among cases and 0.83 ± 2.87 among controls, indicating that both groups were following a pro-inflammatory diet. After multi-variable adjustment, there was a positive association between HCC risk and the DII score when considered as a continuous variable (OR_continuous = 1.14 [1.02–1.27], p-value = 0.021) or categorized in tertiles (OR_T3vsT1 = 2.33 [1.16–4.67], p-trend = 0.021). Similar results were found when alcohol was omitted from the DII calculation but considered as a co-variate: OR_continuous = 1.15 [1.03–1.28], p-value = 0.013, and OR_T3vsT1 = 2.35 [1.18–4.68], p-trend = 0.015. A positive correlation was observed between the DII scores and two inflammatory biomarkers (CRP, IL-6) among controls.

Conclusion

The present study reported an association between a pro-inflammatory DII score and the risk of HCC in cirrhotic patients. Correlations between the scores and biological parameters support a potential role for inflammation in HCC among cirrhotic. Result should be confirmed in larger prospective studies, and could lead to nutritional prevention in cirrhotic patients.

Clinical Trial Registry

This study was registered in www.clinicaltrials.gov as NCT01798173.

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肝硬化人群饮食炎症指数与肝细胞癌风险之间的关系

背景与目的：肝细胞癌（HCC）是一种公认的炎症相关癌症。然而，在肝硬化患者中，饮食引起的炎症与HCC风险之间的关系尚未被调查。本研究旨在探讨肝硬化患者饮食炎症指数（DII®）与HCC风险之间的关系。方法：临床和饮食数据来自法国病例对照研究CiRCE（肝硬化和东部肝细胞癌风险），其中包括2008年至2012年在法国6所大学医院招募的401名无HCC的肝硬化患者（对照组）和181名肝硬化合并HCC患者（病例）。DII评分（36种食物和营养素）使用经过验证的自我管理饮食史问卷进行评估。使用logistic回归模型（调整年龄、性别、肝硬化诊断时间、肝硬化病因、Child-Pugh评分和糖尿病）估计优势比（OR）和95%置信区间（CI）。结果：DII评分范围为-4.77 ~ +7.59，病例组平均值为1.03±2.87，对照组平均值为0.83±2.87，提示两组均采用促炎饮食。多变量调整后，将DII评分作为连续变量（or连续= 1.14 [1.02-1.27]，p值= 0.021）或分位数分类（ORT3vsT1 = 2.33 [1.16-4.67]， p趋势= 0.021），HCC风险与DII评分呈正相关。当从DII计算中省略酒精但将其作为一个协变量时，也发现了类似的结果：ORcontinuous = 1.15 [1.03-1.28]， p值= 0.013,ORT3vsT1 = 2.35 [1.18-4.68], p-trend = 0.015。在对照组中，DII评分与两种炎症生物标志物（CRP, IL-6）呈正相关。结论：本研究报道了促炎DII评分与肝硬化患者发生HCC风险之间的关联。评分和生物学参数之间的相关性支持炎症在肝硬化HCC中的潜在作用。结果应在更大的前瞻性研究中得到证实，并可能导致肝硬化患者的营养预防。临床试验注册：本研究在www.Clinicaltrials: gov注册为NCT01798173。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical nutrition 医学-营养学

CiteScore

14.10

自引率

6.30%

发文量

356

审稿时长

28 days

期刊介绍： Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing essential scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.