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. 2022 Apr 28:12:855101.
doi: 10.3389/fonc.2022.855101. eCollection 2022.

Association Between Diabetes Risk Reduction Diet and Lung Cancer Risk in 98,159 Participants: Results From a Prospective Study

Yin Zhang  1   2   3 , Guochao Zhong  4 , Min Zhu  1   2   3 , Ling Chen  1   2   3 , Huajing Wan  1   2   3 , Fengming Luo  1   2   3
Affiliations

Association Between Diabetes Risk Reduction Diet and Lung Cancer Risk in 98,159 Participants: Results From a Prospective Study

Yin Zhang et al. Front Oncol. .

Abstract

Purpose: To evaluate the association between diabetes risk reduction diet (DRRD) score and the risk of lung cancer in a large population.

Methods: Data of participants in this study were collected from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated in the Cox proportional hazards regression model for the association of DRRD score and lung cancer incidence in all included participants. Prespecified subgroup analyses were performed to evaluate whether the observed association was modified by age, sex, BMI, race/ethnicity, family history of lung cancer, smoking status and history of diabetes.

Results: A total of 98,159 participants were included in this study. The mean (SD) age of the study participants cohort at baseline was 65.5 (5.73) years old. The mean (SD) follow-up time was 8.83 (1.96) years. The mean (SD) score of DRRD was 26.82 (5.19), and ranged from 20.47 (2.3) to 33.65 (2.42) from the lowest quartile to the highest quartile of the DRRD score, inferring the possibility of highest through the lowest risk of type 2 diabetes. The calculated HRs showed there was a trend that higher quartile indicated lower risk of lung cancer after adjusted for covariates (HRQ4vsQ1: 0.85; 95% CI:0.73,0.98; p for trend =0.036). The inverse trend between higher DRRD score and the risk of squamous cell carcinoma was more evident (HRQ4vsQ1: 0.50; 95% CI:0.34,0.73; p for trend =0.002). The inverse association between DRRD score and the incidence of lung cancer was more pronounced in participants who had a clear family history of lung cancer (p for interaction=0.016).

Conclusion: A protective association between DRRD score and risk of lung cancer is obtained. People are encouraged to adhere to higher DRRD score in their daily diet. Further studies should be conducted to confirm the result and explore the mechanism.

Keywords: diabetes risk reduction diet score; dose - response; lung cancer; prevention; prostate lung colorectal and ovarian cancer screening trial.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of the selected individuals.
Figure 2
Figure 2
Dose-response relationship between DRRD score and risk of lung cancer adjusted for age (continuous), sex (male or female), BMI (continuous), total energy intake (continuous), family history of lung cancer (yes, no, or possible), marital status (married or not married), race/ethnicity (white or non-white), smoking status (never, former smoker, current smoker), pack-years of cigarettes (continuous), alcohol intake (never, former, current, or unknown), history of diabetes (yes or no) (p for nonlinear= 0.667).
Figure 3
Figure 3
Subgroup analyses evaluating the association between DRRD score and incidence of lung cancer modified by age (>65 vs. ≤65 years old), sex (male vs. female), BMI (>25 vs. 25-30 vs. ≥30 kg/m2), race/ethnicity (white vs. non-white), family history of lung cancer (yes vs. no/possible), smoking status (non-smokers vs. smokers), and history of diabetes (yes vs. no).
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