Table 3.
Multivariable models estimating associations of post-diagnostic inflammatory, hyperinsulinemia, and insulin resistance diets and lifestyles with the risk of prostate cancer progression and prostate cancer-specific mortality among men diagnosed with non-metastatic prostate cancer
| Prostate Cancer Progressiona,b | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
|
| ||||||||||
| EDIP | EDIH | EDIR | ELIH | ELIR | ||||||
| Events | 175 | 175 | 175 | 175 | 175 | |||||
| N | 1,875 | 1,875 | 1,875 | 1,875 | 1,875 | |||||
|
| ||||||||||
|
| ||||||||||
| Continuous | ||||||||||
|
| ||||||||||
| Per 1-SD unit | 1.27 (1.17, 1.37) | 1.24 (1.05, 1.46) | 1.22 (1.00, 1.48) | 1.34 (1.17, 1.54) | 1.36 (1.12, 1.64) | |||||
|
| ||||||||||
| Quintile | ||||||||||
|
| ||||||||||
| 1st | Ref | Ref | Ref | Ref | ||||||
| 2nd | 2.21 (1.25, 3.89) | 1.27 (0.83, 1.95) | 1.28 (0.63, 2.60) | 1.66 (1.08, 2.54) | 1.62 (1.03, 2.56) | |||||
| 3rd | 2.60 (1.54, 4.39) | 1.29 (0.79, 2.12) | 1.51 (0.74, 3.10) | 1.69 (0.86, 3.35) | 1.27 (0.74, 2.19) | |||||
| 4th | 1.91 (1.14, 3.20) | 1.61 (1.03, 2.51) | 1.32 (0.61, 2.85) | 2.82 (1.93, 4.11) | 1.95 (1.12, 3.37) | |||||
| 5th | 2.61 (1.75, 3.90) | 1.63 (0.93, 2.86) | 1.38 (0.62, 3.11) | 2.81 (1.78, 4.43) | 2.43 (1.45, 4.07) | |||||
| p-trend | <0.01 | 0.05 | 0.45 | <0.01 | <0.01 | |||||
| Prostate Cancer-Specific Mortalitya,c | ||||||||||
|
| ||||||||||
| EDIP | EDIH | EDIR | ELIH | ELIR | ||||||
|
| ||||||||||
| Events | 60 | 60 | 60 | 60 | 60 | |||||
| N | 2,198 | 2,198 | 2,198 | 2,198 | 2,198 | |||||
|
| ||||||||||
|
| ||||||||||
| Continuous | ||||||||||
|
| ||||||||||
| Per 1-SD unit | 1.15 (0.92, 1.44) | 1.22 (0.97, 1.55) | 1.14 (0.84, 1.55) | 1.22 (0.90, 1.66) | 1.16 (0.83, 1.62) | |||||
|
| ||||||||||
| Quintile | ||||||||||
|
| ||||||||||
| 1st | Ref | Ref | Ref | Ref | Ref | |||||
| 2nd | 1.00 (0.34, 2.91) | 1.66 (0.76, 3.62) | 2.28 (0.76, 6.87) | 1.85 (0.78, 4.43) | 1.04 (0.43, 2.47) | |||||
| 3rd | 1.03 (0.39, 2.74) | 1.09 (0.35, 3.40) | 1.92 (0.55, 6.71) | 0.87 (0.29, 2.54) | 0.75 (0.25, 2.23) | |||||
| 4th | 1.77 (0.68, 4.58) | 1.69 (0.65, 4.42) | 2.02 (0.58, 7.06) | 1.95 (0.82, 4.63) | 0.74 (0.24, 2.26) | |||||
| 5th | 1.31 (0.47, 3.67) | 1.58 (0.65, 3.86) | 2.50 (0.83, 7.53) | 2.20 (0.76, 6.34) | 1.37 (0.44, 4.29) | |||||
| p-trend | 0.30 | 0.39 | 0.24 | 0.17 | 0.83 | |||||
Abbreviations: BMI – body mass index; CaPSURE – Cancer of the Prostate Strategic Urologic Research Endeavor; EDIH – empirical dietary index for hyperinsulinemia; EDIP – empirical dietary inflammatory pattern; EDIR – empirical dietary index for insulin resistance; ELIH – empirical lifestyle index for hyperinsulinemia; ELIR – empirical lifestyle index for insulin resistance; MET – metabolic equivalent of task; PCSM – prostate cancer specific mortality; PSA – prostate specific antigen; SD – standard deviation
Models were adjusted for age at diagnosis (continuous), time between diagnosis and questionnaire completion date (continuous), and CaPSURE clinical site, race (white, other), T stage at diagnosis (≤T1, T2, T3a), Gleason at diagnosis (<7, 7, >7), PSA at diagnosis (≤6, >6 to 10, >10), primary treatment (radical prostatectomy, radiation, hormonal therapy, watchful waiting/active surveillance, other), family history of prostate cancer in bother or father (yes/no), BMI (continuous), physical activity (total MET-hours/week; continuous), smoking (never, former, current), alcohol (continuous), supplement use (yes/no), and total energy intake
Estimated via parametric (Weibull) survival models to account for interval censoring. A total of 2,056 met inclusion for progression analyses.
Estimated via Cox proportional hazards models. A total of 2,447 men met inclusion for PCSM analyses, as men who were excluded from progression analysis due to having a documented progression event prior to questionnaire were included in this analysis