| Objective:Evidence on the association between pre-diagnosis dietary protein intake and ovarian cancer(OC)survival is limited.This study intends to use the Ovarian Cancer Follow-Up Study(OOPS)was to explore the diagnosis before total dietary protein and different sources of dietary protein(meat,eggs,milk,grains,fruits and vegetables,fish,legumes,nuts,etc.)the link between the intake and OC patients died,to reduce the OC will provide a scientific basis for patient mortality.Methods:The prospective cohort study included patients aged 18-75 years with OC who were admitted and treated at Shengjing Hospital,China Medical University from2015 to 2020.Outcomes were obtained through active follow-up and medical records until March 31,2021.In this study,non-parametric test and chi-square test were used to compare the differences in baseline characteristics among OC patients with different dietary protein intake.Using Cox proportional risk regression model respectively explore the total protein the different sources of dietary protein(meat,eggs,milk,grains,fruits and vegetables,fish,legumes,nuts,etc.)and OC mortality,the dose response relationship was assessed using restricted cubic spline model.Subgroup analysis and interaction analysis were performed according to age at diagnosis,menopausal status,FIGO tage,residual lesions,histological type,and BMI.Meanwhile,sensitivity analysis was conducted using residual method model.Results:A total of 703 patients with ovarian cancer are included in this study,as of March 31st,2021,with 130 deaths among the follow-up cases.The study showed that compared to the lowest quartile of protein intake,the highest quartile of total dietary protein intake,protein intake from egg sources,protein intake from fish sources,and protein intake from fruits and vegetables corresponded to HR and 95%CI of 0.49(0.31-0.78),0.53(0.32-0.87),0.62(0.40-0.98),and 0.49(0.31-0.78),respectively.The HR and 95%CI for protein intake from dairy sources were 2.09(1.28-3.40),with trend P values all<0.05.Subgroup analysis results showed that in subgroups of patients with a diagnosis age of>50 years,BMI≥24kg/m~2,menopause,serous and non-serous ovarian cancer,early disease stage(FIGO stage I-II),and no residual lesions after surgery,high dietary protein intake from all sources was associated with a lower risk of total mortality,with HR and 95%CI of 0.41(0.23-0.75),0.22(0.07-0.68),0.40(0.23-0.70),0.54(0.31-0.94),and 0.39(0.15-0.99),0.24(0.10-0.58),0.48(0.27-0.86),respectively.In the subgroups of patients with a diagnosis age of≤50 years,BMI<24kg/m~2,menopause,non-serous ovarian cancer,and no residual lesions after surgery,high dietary protein intake from dairy sources was associated with an increased risk of total mortality,with HR and 95%CI of 3.43(1.29-9.10),1.98(1.10-3.56),2.14(1.21-3.80),3.94(1.52-10.24),and 2.08(1.15-3.77).Sensitivity analysis using the residual method to adjust for dietary intake factors showed results that were basically consistent with the core analysis results,but no association was found between total dietary protein intake or protein intake from dairy sources and total mortality in ovarian cancer patients.In addition,this study found an interaction between menopausal status and dietary protein intake from egg sources.There was also an interaction between BMI,menopausal status,histological subtype,and residual lesion status and dietary protein intake from dairy sources.Conclusion:Pre-diagnosis of dietary protein intake,especially eggs are sources of dietary protein intake and dietary protein intake of fruits and vegetables sources increase may be associated with OC patients always lower risk of death.The findings need to be further confirmed. |
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