CARBOHYDRATE QUANTITY AND QUALITY AFFECT THE RISK OF ENDOMETRIAL CANCER: A SYSTEMATIC REVIEW AND DOSE-RESPONSE META-ANALYSIS

Background and Aim: Data on the association of glycemic index (GI) and glycemic load (GL) with endometrial cancer were summarized in a 2012 meta-analysis; however, to our knowledge, no study has examined the dose-response relationships in this regard and also the association between dietary total carbohydrate intake and endometrial cancerMethods: The online databases were searched for relevant publications up to May 2018, using relevant keywords. In total, 8 prospective and 5 case-control studies were included in the systematic review and meta-analysis that included 734,765 individuals and 8,466 cases of endometrial cancer.Results: We found a significant positive association between total carbohydrate intake and endometrial cancer in prospective studies with 10 years’ duration of follow-up (Combined RR: 1.29, 95% CI: 1.09-1.53, P=0.003) and in those with sample size of 50,000 participants (Combined RR: 1.24, 95% CI: 1.08-1.43, P=0.002). In addition, a non-linear dose-response relation was found in this regard after considering estimates from prospective studies (Pnonlinearity =0.002). Combining effect sizes from case-control studies showed a significant positive association between GI and endometrial cancer (Combined RR: 1.41, 95% CI: 1.16-1.73, P=0.001); such that in linear dose-response analysis, a-10 unit increase in GI was associated with 4% greater risk of endometrial cancer (Combined RR: 1.04, 95% CI: 1.02-1.05, P<0.001). In terms of GL, a significant positive association was seen with endometrial cancer in prospective studies. In addition, a non-linear dose-response association was seen in this regard (Pnonlinearity <0.001). Conclusion: In conclusion, dietary total carbohydrates, GI, GL were positively associated with endometrial cancer.

کلیدواژه ها:

carbohydrate ، endometrial neoplasms ، glycemic load ، glycemic index ، diet