title: Inflammatory potential of diet and risk for hepatocellular cancer in a case-control study from Italy.
abstract: Inflammation and diet have been suggested to be important risk factors for hepatocellular cancer (HCC). This Italian multicentre hospital-based case-control study conducted between 1999 and 2002 and including 185 cases with incident, histologically confirmed HCC, and 404 controls hospitalised for acute non-neoplastic diseases provided an opportunity to investigate the association between HCC and the dietary inflammatory index (DII). The DII was computed on the basis of dietary intake assessed 2 years before the date of interview by a validated sixty-three-item FFQ. Logistic regression models were used to estimate OR adjusted for age, sex, study centre, education, BMI, smoking, physical activity, serum markers of hepatitis B and C infection and energy intake. Energy adjustment for DII was performed using the residual method. Participants in the highest tertile of DII scores (i.e. with a more pro-inflammatory diet) had a higher risk for HCC (ORtertile 3 v, 1 2·43; 95 % CI 1·27, 4·68; P trend=0·03). When stratified by the presence or absence of hepatitis B/C infection and sex, DII was strongly associated with HCC in hepatitis B- and C-negative participants (ORtertile 3 v. 1 4·18; 95 % CI 1·53, 11·39; P trend=0·02) and among males (ORtertile 3 v. 1 3·60; 95 % CI 1·65, 7·87; P trend=0·001). These results indicate that a pro-inflammatory diet is associated with increased risk for HCC, in those without a history of hepatitis B/C infection and among males.
authors.affiliation: 1Cancer Prevention and Control Program,University of South Carolina,Columbia,SC 29208,USA.
authors.forename: Nitin
authors.initials: N
authors.lastname: Shivappa
authors.affiliation: 1Cancer Prevention and Control Program,University of South Carolina,Columbia,SC 29208,USA.
authors.forename: James R
authors.initials: JR
authors.lastname: Hébert
authors.affiliation: 3Epidemiology and Biostatistics Unit,CRO Aviano,National Cancer Institute,33081 Aviano,Italy.
authors.forename: Jerry
authors.initials: J
authors.lastname: Polesel
authors.affiliation: 3Epidemiology and Biostatistics Unit,CRO Aviano,National Cancer Institute,33081 Aviano,Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Zucchetto
authors.affiliation: 4Department of Epidemiology,'Fondazione G. Pascale',Istituto Nazionale Tumori,80133 Naples,Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Crispo
authors.affiliation: 4Department of Epidemiology,'Fondazione G. Pascale',Istituto Nazionale Tumori,80133 Naples,Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Montella
authors.affiliation: 5Infections and Cancer Epidemiology Group,International Agency for Research on Cancer,Lyon 69372,France.
authors.forename: Silvia
authors.initials: S
authors.lastname: Franceschi
authors.affiliation: 6Department of Clinical Sciences and Community Health,Università degli Studi di Milano,via G. Venezian 1,20133 Milan,Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Rossi
authors.affiliation: 6Department of Clinical Sciences and Community Health,Università degli Studi di Milano,via G. Venezian 1,20133 Milan,Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: La Vecchia
authors.affiliation: 3Epidemiology and Biostatistics Unit,CRO Aviano,National Cancer Institute,33081 Aviano,Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Serraino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000209:etiology*; D016022:Case-Control Studies; D004032:Diet / Q000009:adverse effects*; D002149:Energy Intake; D015444:Exercise; D005260:Female; D006509:Hepatitis B / Q000150:complications; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D007249:Inflammation / Q000209:etiology*; D007558:Italy / Q000453:epidemiology; D008113:Liver Neoplasms / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012907:Smoking
keywords: DII dietary inflammatory index; Dietary surveys and nutritional epidemiology; Diets; HCC hepatocellular cancer; Hepatocellular cancer; Inflammation; Italy