title: Dietary glycemic index, glycemic load and ovarian cancer risk: a case-control study in Italy.
abstract: BACKGROUND
  Dietary carbohydrates vary in their ability to raise blood glucose and insulin levels, which, in turn, influence levels of sex hormones and insulin-like growth factors. We analyzed the effect of type and amount of carbohydrates on ovarian cancer risk, using the glycemic index (GI) and the glycemic load (GL) measurement in a large case-control study conducted in Italy.
  
  
  METHODS
  Cases included 1031 women with incident, histologically confirmed epithelial ovarian cancer, from four Italian regions. Controls included 2411 women admitted to the same hospital networks for acute, non-neoplastic conditions. Average daily GI and GL were calculated from a validated food frequency questionnaire. Odds ratios (OR) and the corresponding 95% confidence intervals (CI) were computed using multiple logistic regression.
  
  
  RESULTS
  Ovarian cancer was directly associated with dietary GI (OR for highest versus lowest quartile = 1.7, 95% CI 1.3-2.1) and GL (OR = 1.7, 95% CI 1.3-2.1). The associations were observed in pre- and postmenopausal women, and they remained consistent across strata of major covariates identified.
  
  
  CONCLUSIONS
  This study supports the hypothesis of a direct association between GI and GL and ovarian cancer risk and, consequently, of a possible role of hyperinsulinemia/insulin resistance in ovarian cancer development.
authors.affiliation: Servizio di Epidemiologia, Centro di Riferimento Oncologico, Istituto Nazionale Tumori, Aviano, Italy.
authors.forename: L S A
authors.initials: LS
authors.lastname: Augustin
authors.forename: J
authors.initials: J
authors.lastname: Polesel
authors.forename: C
authors.initials: C
authors.lastname: Bosetti
authors.forename: C W C
authors.initials: CW
authors.lastname: Kendall
authors.forename: C
authors.initials: C
authors.lastname: La Vecchia
authors.forename: M
authors.initials: M
authors.lastname: Parpinel
authors.forename: E
authors.initials: E
authors.lastname: Conti
authors.forename: M
authors.initials: M
authors.lastname: Montella
authors.forename: S
authors.initials: S
authors.lastname: Franceschi
authors.forename: D J A
authors.initials: DJ
authors.lastname: Jenkins
authors.forename: L
authors.initials: L
authors.lastname: Dal Maso
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D016022:Case-Control Studies; D004040:Dietary Carbohydrates / Q000009:adverse effects*; D005260:Female; D038321:Glycemic Index; D006801:Humans; D006946:Hyperinsulinism / Q000150:complications; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D007558:Italy / Q000453:epidemiology; D008593:Menopause; D008875:Middle Aged; D016017:Odds Ratio; D010051:Ovarian Neoplasms / Q000097:blood / Q000209:etiology*; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates; D007328:Insulin