Diet quality and cardiometabolic health in breast cancer survivors: the Pathways Study.

IF 3 3区医学 Q2 ONCOLOGY Breast Cancer Research and Treatment Pub Date : 2025-05-01 Epub Date: 2025-02-01 DOI:10.1007/s10549-025-07629-2

Isaac J Ergas, Richard K Cheng, Janise M Roh, Jacob K Kresovich, Carlos Iribarren, Mai Nguyen-Huynh, Jamal S Rana, Eileen Rillamas-Sun, Cecile A Laurent, Valerie S Lee, Charles P Quesenberry, Ankeet Bhatt, Song Yao, Lawrence H Kushi, Heather Greenlee, Marilyn L Kwan

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Abstract

Purpose: Breast cancer (BC) survivors experience higher rates of cardiometabolic conditions, partly due to treatment. While healthy eating decreases the risk of these conditions in the general population, its association in BC survivors is unclear.

Methods: We included 3415 participants from the Pathways Study, a prospective cohort of women diagnosed with invasive BC between 2005 and 2013 and followed through 2021. Concordance of food intakes from food frequency questionnaires was estimated for five healthy eating patterns at BC diagnosis: Dietary Approaches to Stop Hypertension (DASH), healthy Plant-based Dietary Index (hPDI), 2020 Healthy Eating Index (HEI), American Cancer Society nutrition guidelines (ACS), and the alternate Mediterranean Diet Index (aMED). Incident hypertension, diabetes, and dyslipidemia were identified through electronic health records. Cumulative incidence rates (CIRs) were estimated accounting for the competing risk of death. Covariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Fine and Gray regression models, stratified by BC treatment status.

Results: Over an average 11.5 years (range = 0.3-16.3) of follow-up, 554 (16.2%) participants developed hypertension, 362 (10.6%) developed diabetes, and 652 (19.1%) developed dyslipidemia. CIRs for any cardiometabolic condition 15 years after BC diagnosis were 39.2% for women in the highest HEI quartile compared to 49.3% in the lowest. After adjustment, women in the highest HEI quartile had lower risks of any cardiometabolic condition (HR = 0.70, 95% CI 0.54-0.91, P_trend = 0.006), including hypertension (HR = 0.71, 95% CI 0.54-0.94, P_trend = 0.007), diabetes (HR = 0.57, 95% CI 0.41-0.79, P_trend < 0.001), and dyslipidemia (HR = 0.77, 95% CI 0.59-0.99, P_trend = 0.04). Similar associations were observed for DASH, hPDI, and ACS with diabetes incidence.

Conclusion: Healthier diets at BC diagnosis, particularly those aligned with the HEI, were associated with lower cardiometabolic risks.

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乳腺癌幸存者的饮食质量和心脏代谢健康：途径研究

目的：乳腺癌（BC）幸存者的心脏代谢疾病发生率较高，部分原因是治疗。虽然健康饮食在一般人群中降低了这些疾病的风险，但其与BC幸存者的关系尚不清楚。方法：我们纳入了来自Pathways研究的3415名参与者，这是一个2005年至2013年诊断为浸润性BC的女性前瞻性队列，随访至2021年。从食物频率问卷中估计了BC诊断时五种健康饮食模式的食物摄入量的一致性：停止高血压的饮食方法（DASH）、健康植物性饮食指数（hPDI）、2020健康饮食指数（HEI）、美国癌症协会营养指南（ACS）和替代地中海饮食指数（aMED）。通过电子健康记录确定高血压、糖尿病和血脂异常的发生率。考虑竞争死亡风险，估计累积发病率（CIRs）。采用Fine和Gray回归模型计算经协变量校正的风险比（hr）和95%置信区间（ci），并按BC治疗状况分层。结果：在平均11.5年（范围= 0.3-16.3）的随访中，554名（16.2%）参与者患高血压，362名（10.6%）参与者患糖尿病，652名（19.1%）参与者患血脂异常。在BC诊断后15年任何心脏代谢疾病的CIRs在HEI最高四分位数的女性中为39.2%，而在最低四分位数的女性中为49.3%。调整后，HEI最高四分位数的女性患任何心脏代谢疾病的风险都较低（HR = 0.70, 95% CI 0.54-0.91， p趋势= 0.006），包括高血压（HR = 0.71, 95% CI 0.54-0.94， p趋势= 0.007），糖尿病（HR = 0.57, 95% CI 0.41-0.79， p趋势趋势= 0.04）。DASH、hPDI和ACS与糖尿病发病率也有类似的关联。结论：诊断为BC的患者饮食更健康，特别是那些符合HEI的患者，与较低的心脏代谢风险相关。

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

Breast Cancer Research and Treatment 医学-肿瘤学

CiteScore

6.80

自引率

2.60%

发文量

342

审稿时长

1 months

期刊介绍： Breast Cancer Research and Treatment provides the surgeon, radiotherapist, medical oncologist, endocrinologist, epidemiologist, immunologist or cell biologist investigating problems in breast cancer a single forum for communication. The journal creates a "market place" for breast cancer topics which cuts across all the usual lines of disciplines, providing a site for presenting pertinent investigations, and for discussing critical questions relevant to the entire field. It seeks to develop a new focus and new perspectives for all those concerned with breast cancer.