Table 4.
Sensitivity analyses of multivariable-adjusted hazard ratios of E-DII from diet plus supplements in relation to mortality outcomes in the WHI-DM and OS.
| Most anti-inflammatory E-DII Quartile 1 | E-DII Quartile 2 | E-DII Quartile 3 | Most pro-inflammatory E-DII Quartile 4 | P-trenda | |
|---|---|---|---|---|---|
| Excluding DM-intervention arm (N = 2722) | |||||
| Nb | 649 | 646 | 699 | 728 | |
| All-cause mortality | |||||
| No. of deaths | 180 | 221 | 249 | 291 | |
| MV-adjusted HR (95% CI)c | 0.59 (0.48–0.72) | 0.77 (0.64–0.93) | 0.84 (0.70–1.00) | 1.00 (ref) | <0.001 |
| Total cancer mortality | |||||
| No. of deaths | 109 | 128 | 148 | 180 | |
| MV-adjusted HR (95% CI)c | 0.56 (0.43–0.72) | 0.73 (0.58–0.92) | 0.81 (0.65–1.01) | 1.00 (ref) | <0.001 |
| CVD mortality | |||||
| No. of deaths | 21 | 38 | 42 | 40 | |
| MV-adjusted HR (95% CI)c | 0.49 (0.28–0.87) | 0.92 (0.58–1.47) | 0.99 (0.63–1.54) | 1.00 (ref) | 0.13 |
| Mortality from other causesd | |||||
| No. of deaths | 50 | 55 | 59 | 71 | |
| MV-adjusted HR (95% CI)c | 0.76 (0.51–1.13) | 0.82 (0.57–1.18) | 0.86 (0.60–1.22) | 1.00 (ref) | 0.15 |
| Additionally adding CVD status at baseline in the MV-adjusted model (N = 3386)e | |||||
| Nb | 852 | 849 | 842 | 843 | |
| All-cause mortality | |||||
| No. of deaths | 224 | 280 | 296 | 336 | |
| MV-adjusted HR (95% CI)c | 0.59 (0.49–0.71) | 0.78 (0.66–0.92) | 0.85 (0.72–0.99) | 1.00 (ref) | <0.001 |
| Total cancer mortality | |||||
| No. of deaths | 135 | 164 | 181 | 203 | |
| MV-adjusted HR (95% CI)c | 0.58 (0.46–0.74) | 0.76 (0.62–0.95) | 0.88 (0.72–1.08) | 1.00 (ref) | <0.001 |
| CVD mortality | |||||
| No. of deaths | 26 | 45 | 44 | 48 | |
| MV-adjusted HR (95% CI)c | 0.46 (0.28–0.77) | 0.86 (0.57–1.32) | 0.82 (0.54–1.25) | 1.00 (ref) | 0.04 |
| Mortality from other causesd | |||||
| No. of deaths | 63 | 71 | 71 | 85 | |
| MV-adjusted HR (95% CI)c | 0.69 (0.48–0.98) | 0.78 (0.56–1.09) | 0.80 (0.58–1.11) | 1.00 (ref) | 0.03 |
| Excluding participants with FFQs completed within 6 months of cancer diagnosis (N = 2718) | |||||
| Nb | 708 | 694 | 656 | 660 | |
| All-cause mortality | |||||
| No. of deaths | 186 | 235 | 222 | 256 | |
| MV-adjusted HR (95% CI)c | 0.58 (0.47–0.71) | 0.81 (0.67–0.97) | 0.81 (0.67–0.97) | 1.00 (ref) | <0.001 |
| Total cancer mortality | |||||
| No. of deaths | 114 | 135 | 127 | 150 | |
| MV-adjusted HR (95% CI)c | 0.57 (0.44–0.74) | 0.76 (0.59–0.97) | 0.79 (0.62–1.00) | 1.00 (ref) | <0.001 |
| CVD mortality | |||||
| No. of deaths | 23 | 37 | 34 | 41 | |
| MV-adjusted HR (95% CI)c | 0.46 (0.26–0.80) | 0.85 (0.53–1.36) | 0.77 (0.48–1.23) | 1.00 (ref) | 0.08 |
| Mortality from other causesd | |||||
| No. of deaths | 49 | 63 | 61 | 65 | |
| MV-adjusted HR (95% CI)c | 0.69 (0.46–1.03) | 0.93 (0.65–1.35) | 0.92 (0.64–1.31) | 1.00 (ref) | 0.14 |
| Excluding participants with FFQs completed within 1.5 years of cancer diagnosis (N = 1448) | |||||
| Nb | 388 | 370 | 351 | 339 | |
| All-cause mortality | |||||
| No. of deaths | 96 | 116 | 124 | 130 | |
| MV-adjusted HR (95% CI)c | 0.54 (0.40–0.71) | 0.74 (0.56–0.96) | 0.86 (0.67–1.11) | 1.00 (ref) | <0.001 |
| Total cancer mortality | |||||
| No. of deaths | 54 | 64 | 69 | 74 | |
| MV-adjusted HR (95% CI)c | 0.51 (0.35–0.74) | 0.67 (0.47–0.95) | 0.82 (0.58–1.15) | 1.00 (ref) | 0.001 |
| CVD mortality | |||||
| No. of deaths | 10 | 25 | 20 | 19 | |
| MV-adjusted HR (95% CI)c | 0.35 (0.15–0.79) | 1.15 (0.60–2.19) | 0.98 (0.50–1.88) | 1.00 (ref) | 0.14 |
| Mortality from other causesd | |||||
| No. of deaths | 32 | 27 | 35 | 37 | |
| MV-adjusted HR (95% CI)c | 0.67 (0.40–1.14) | 0.67 (0.40–1.15) | 0.97 (0.60–1.57) | 1.00 (ref) | 0.11 |
aLinear trend test represented the P-value for the continuous E-DII variable.
bThe cut-off points for the E-DII quartiles in the two sensitivity analyses in this table were chosen as same as those used in the main association analysis in the original sample of 3434 subjects to be consistent.
cThe multivariable-adjusted (MV) model was adjusted for age at cancer diagnosis, income levels, WHI study arm, race/ethnicity, education levels, years from cancer diagnosis to FFQ, baseline physical activity in MET-h/week, smoking status at baseline, total energy intake per day, BMI, cancer stage and cancer grade with the time-dependent covariate in the model to stratify participants’ status before and after the post-diagnosis FFQ, with exception in the second sensitivity where CVD status was additionally adjusted in the MV model.
dOther causes referred to death causes other than cancer and CVD in this study, which included homicide, accident, suicide, other injury, Alzheimer’s, pneumonia, chronic obstructive pulmonary disease, pulmonary fibrosis, renal failure, sepsis, amyotrophic lateral sclerosis, dementia, pancreatic diseases, Parkinson’s disease, hepatic cirrhosis, known other causes and unknown causes.
eThere was missing CVD status data on 48 subjects, who were excluded from this analysis.