Hemoglobin A1c Levels Modify Associations between Dietary Acid Load and Breast Cancer Recurrence

Metabolic acidosis promotes cancer metastasis. No prospective studies have examined the association between dietary acid load and breast cancer recurrence among breast cancer survivors, who are susceptible to metabolic acidosis. Hyperglycemia promotes cancer progression and acid formation; however,...

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Bibliographic Details
Published in:Nutrients 2020-02, Vol.12 (2), p.578
Main Authors: Wu, Tianying, Hsu, Fang-Chi, Wang, Shunran, Luong, David, Pierce, John P
Format: Article
Language:English
Subjects:
Acid production
Acidosis
Acids
Acids - adverse effects
Biomarkers
Breast cancer
Breast Neoplasms - blood
Cancer Survivors
Cancer therapies
Cohort Studies
Confidence intervals
Diabetes mellitus
Diet
Epidemiology
Female
Fruits
Glucose
Glycated Hemoglobin A - metabolism
Health risks
Hemoglobin
Humans
Hyperglycemia
Kidney - pathology
Levels
Medical prognosis
Metabolic acidosis
Metabolism
Metastases
Mortality
Multivariate Analysis
Neoplasm Recurrence, Local - blood
Nutrition research
Potassium
Proteins
Risk Factors
Software
Survival
Vegetables
Womens health
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Summary:Metabolic acidosis promotes cancer metastasis. No prospective studies have examined the association between dietary acid load and breast cancer recurrence among breast cancer survivors, who are susceptible to metabolic acidosis. Hyperglycemia promotes cancer progression and acid formation; however, researchers have not examined whether hyperglycemia can modify the association between dietary acid load and breast cancer recurrence. We studied 3081 early-stage breast cancer survivors enrolled in the Women's Healthy Eating and Living study who provided dietary information through 24-h recalls at baseline and during follow-up and had measurements of hemoglobin A1c (HbA1c) at baseline. We assessed dietary acid load using two common dietary acid load scores, potential renal acid load (PRAL) score and net endogenous acid production (NEAP) score. After an average of 7.3 years of follow-up, dietary acid load was positively associated with recurrence when baseline HbA1c levels were ≥ 5.6% (median level) and ≥5.7% (pre-diabetic cut-point). In the stratum with HbA1c ≥ 5.6%, comparing the highest to the lowest quartile of dietary acid load, the multivariable-adjusted hazard ratio was 2.15 (95% confidence interval [CI] 1.34-3.48) for PRAL and was 2.31 (95% CI 1.42-3.74) for NEAP. No associations were observed in the stratum with HbA1c levels were
ISSN:2072-6643
2072-6643
DOI:10.3390/nu12020578