Associations of Dietary Glycemic Index, Glycemic Load and Carbohydrate with the Risk of Cervical Intraepithelial Neoplasia and Cervical Cancer: A Case-Control Study.

Sundara Raj Sreeja,Mi Kyung Kim,Sang Soo Seo

doi:10.3390/nu12123742

Abstract

Background: The association of dietary glycemic index (GI) and glycemic load (GL) with the risk of cervical cancer has never been investigated. Thus, we aimed to find evidence of any association of GI and GL with the risk of cervical intraepithelial neoplasia (CIN) and cervical cancer. Methods: In this hospital-based case-control study, we included 1340 women (670 controls and 262, 187 and 221 patients with CIN1, CIN2/3, and cervical cancer, respectively) from the Korean human papillomavirus cohort study. Completed demographic questionnaires and semi-quantitative food-frequency questionnaires were collected. The association of dietary GI and GL with CIN and cervical cancer was estimated using a logistic regression model. Results: The multivariate odds ratios (OR) of the highest compared with the lowest quintile of GL for CIN1 were 2.8 (95% confidence interval (CI) = 1.33–5.88). Dietary GI and GL were not associated with CIN2/3 and cervical cancer. Stratified analyses by body mass index (BMI) indicated a positive association between GI and GL and CIN 1 risk among women with a BMI (in kg/m2) <23 (OR = 2.94; 95% CI = 1.32–6.53; p for trend = 0.031 for GI and OR = 3.15; 95% CI = 1.53–6.52; p for trend = 0.013 for GL), but not among those with a BMI of ≥23. A stratification analysis by menopausal status showed that the highest quintile of GI and GL was significantly associated with the risk of CIN1 (OR = 2.91; 95% CI = 1.43–5.96; p for trend = 0.005) (OR = 2.96; 95% CI = 1.53–5.69; p for trend = 0.023) among premenopausal women. Also, in HPV positive women, dietary GL showed significant CIN1 risk (OR = 2.61; 95% CI = 1.09–6.24; p for trend = 0.087). Conclusion: Our case-control study supports the hypothesized associations of dietary GI and GL with increased risk of CIN1. Thus, the consumption of low GI and GL foods plays a significant role in the prevention of cervical carcinogenesis.

Highlights

Dietary consumption of excessive glycemic index (GI) and glycemic load (GL) foods may play an inevitable part in the emergence of cancers [1]
Our case-control study supports the hypothesized associations of dietary GI and GL with increased risk of CIN1
Stratification analysis indicated that the positive association of dietary GI and GL with the risk of CIN1 was predominant among women with a body mass index (BMI)

Summary

Introduction

Dietary consumption of excessive glycemic index (GI) and glycemic load (GL) foods may play an inevitable part in the emergence of cancers [1]. Dietary GI indicates the blood glucose-raising potential of carbohydrate foods [2]. This index represents the increased area under the blood glucose response curve after a 50 g consumption of available carbohydrate from a test food relative to standard food (usually bread or glucose) [3]. Foods with high GI may reduce insulin production and inflammatory responses [9]. The association of dietary glycemic index (GI) and glycemic load (GL) with the risk of cervical cancer has never been investigated. We aimed to find evidence of any association of GI and GL with the risk of cervical intraepithelial neoplasia (CIN) and cervical cancer

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Discussion

Conclusion