Dietary inflammatory index and risk of colorectal adenoma: effect measure modification by race, nonsteroidal anti-inflammatory drugs, cigarette smoking and body mass index?
Menée par questionnaire auprès de 1 313 témoins et de 587 patients atteints d'un adénome colorectal, cette étude analyse l'association entre le potentiel inflammatoire de l'alimentation, évalué à l'aide d'un système de score, et le risque de développer la maladie, puis identifie les facteurs modifiant cette association (origine ethnique, indice de masse corporelle, statut tabagique, utilisation d'anti-inflammatoires non stéroïdiens)
Purpose: To investigate if the association between dietary inflammatory potential and colorectal adenoma (CRA) is modified by race and factors known to modulate inflammation. Methods: We examined effect measure modification of race, nonsteroidal anti-inflammatory drugs (NSAIDs), cigarette smoking and body mass index (BMI) on the diet-CRA association by employing energy-adjusted dietary inflammatory index (E-DII™) to characterize dietary inflammatory potential among 587 cases and 1,313 controls participating in a colonoscopy screening-based cross-sectional study of CRA. Participants completed a food frequency questionnaire from which E-DII score was derived. E-DII score was calculated from 34 food parameters (constituents), utilizing an energy-adjusted global comparative database to compute z scores from which centered proportions were summed to create the score. CRA cases were defined as individuals whose colonoscopy detected at least one pathologically confirmed adenomatous polyp. Unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: A pro-inflammatory diet was not statistically significantly associated with elevated CRA risk (OR 1.07; 95% CI 0.97–1.19; p value = 0.18) in the multivariate regression model. NSAIDs use (ORnever-users 1.19; 95% CI 1.03–1.38; ORever-users 0.96; 95% CI 0.83–1.12; Pinteraction = 0.04) and race (ORAfrican Americans 1.22; 95% CI 1.03–1.44; OREuropean Americans 0.99; 95% CI 0.86–1.14; Pinteraction = 0.14) appeared to modify the association, whereas cigarette smoking and BMI did not (Pinteraction = 0.40 and 0.78, respectively). Conclusion: NSAIDs use and race may modify the diet-CRA association. Further investigation in prospective cohort studies is warranted to confirm these findings.