TY - JOUR
T1 - Inflammatory potential of the diet and colorectal tumor risk in persons with Lynch syndrome
AU - Brouwer, Jesca G.M.
AU - Makama, Maureen
AU - Van Woudenbergh, Geertruida J.
AU - Vasen, Hans F.A.
AU - Nagengast, Fokko M.
AU - Kleibeuker, Jan H.
AU - Kampman, Ellen
AU - Van Duijnhoven, Fränzel J.B.
N1 - Publisher Copyright:
© 2017 American Society for Nutrition.
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Background: Persons with Lynch syndrome (LS) have high lifetime risk of developing colorectal tumors (CRTs) because of a germline mutation in one of their mismatch repair (MMR) genes. An important process in the development of CRTs is inflammation, which has been shown to be modulated by diet. Objective: We aimed to investigate the association between the inflammatory potential of the diet and the risk of CRTs in persons with LS. Design: We used the dietary intake of 457 persons with LS from a prospective cohort study to calculate the adapted dietary inflammatory index (ADII). The ADII was split into tertiles in which the highest tertile reflects the most proinflammatory potential of the diet. Cox proportional hazard models, with robust sandwich variance estimates to adjust for dependency within families, were used to calculate HRs and 95% CIs of CRTs by ADII tertile. HRs were adjusted for age, smoking status, and education level, and number of colonoscopies as a time-dependent variable. A potential effect measure modification was explored by stratifying the results by mutated MMR gene, sex, and a history of CRTs. We performed sensitivity analyses by repeating the analyses in non-nonsteroidal anti-inflammatory drug (NSAID) users (n = 315). Results: During a median follow-up time of 59 mo, 200 participants (43.8%) developed CRTs. No significant association was shown between highest compared with lowest ADII tertiles (HR for highest compared with lowest tertiles: 1.37; 95% CI: 0.80, 2.34). Stratification by mutated MMR gene, sex, and CRT history did not show significantly differential associations (P-interactions ≥ 0.64). In non-NSAID users, an HR of 1.60 (95% CI: 0.88, 2.93) for highest compared with lowest tertiles was shown. No significant effect modification was shown in this group either (P-interactions ≥ 0.24). Conclusion: A proinflammatory potential of the diet does not seem to be significantly associated with CRT risk in persons with LS.
AB - Background: Persons with Lynch syndrome (LS) have high lifetime risk of developing colorectal tumors (CRTs) because of a germline mutation in one of their mismatch repair (MMR) genes. An important process in the development of CRTs is inflammation, which has been shown to be modulated by diet. Objective: We aimed to investigate the association between the inflammatory potential of the diet and the risk of CRTs in persons with LS. Design: We used the dietary intake of 457 persons with LS from a prospective cohort study to calculate the adapted dietary inflammatory index (ADII). The ADII was split into tertiles in which the highest tertile reflects the most proinflammatory potential of the diet. Cox proportional hazard models, with robust sandwich variance estimates to adjust for dependency within families, were used to calculate HRs and 95% CIs of CRTs by ADII tertile. HRs were adjusted for age, smoking status, and education level, and number of colonoscopies as a time-dependent variable. A potential effect measure modification was explored by stratifying the results by mutated MMR gene, sex, and a history of CRTs. We performed sensitivity analyses by repeating the analyses in non-nonsteroidal anti-inflammatory drug (NSAID) users (n = 315). Results: During a median follow-up time of 59 mo, 200 participants (43.8%) developed CRTs. No significant association was shown between highest compared with lowest ADII tertiles (HR for highest compared with lowest tertiles: 1.37; 95% CI: 0.80, 2.34). Stratification by mutated MMR gene, sex, and CRT history did not show significantly differential associations (P-interactions ≥ 0.64). In non-NSAID users, an HR of 1.60 (95% CI: 0.88, 2.93) for highest compared with lowest tertiles was shown. No significant effect modification was shown in this group either (P-interactions ≥ 0.24). Conclusion: A proinflammatory potential of the diet does not seem to be significantly associated with CRT risk in persons with LS.
KW - Adapted dietary inflammatory index
KW - Colorectal adenoma
KW - Colorectal carcinoma
KW - Colorectal tumor
KW - Dietary inflammatory index
KW - Hereditary nonpolyposis colorectal cancer
KW - Inflammation
KW - Lynch syndrome
KW - Mismatch repair
UR - http://www.scopus.com/inward/record.url?scp=85033217054&partnerID=8YFLogxK
U2 - 10.3945/ajcn.117.152900
DO - 10.3945/ajcn.117.152900
M3 - Article
C2 - 28931533
AN - SCOPUS:85033217054
SN - 0002-9165
VL - 106
SP - 1287
EP - 1294
JO - American Journal of Clinical Nutrition
JF - American Journal of Clinical Nutrition
IS - 5
ER -