Mehdi Sadeghian - Department of Nutrition, School of Paramedicine, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
Alireza Sadeghi - Students Scientific Center, Tehran University of Medical Sciences, Tehran, Iran Morteza Nasiri, Department of Operating Room Nursing, School of Paramedicine, Qom University of Medical Sciences, Qom
Jamal Rahmani - Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Omid Sadeghi - Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran

Objective: Data on the association of glycemic index (GI) and glycemic load (GL) with risk of endometrial cancer up to 2012 have been summarized in a meta-analysis.Methods: The online databases were searched for relevant publications up to May 2018. Overall, 8 prospective cohort and 5 case-control studies were included in the systematic review and meta-analysis. Two reviewers independently screened literature according to the inclusion and exclusion criteria. Results: Subgroup analysis revealed a significant positive association between dietary intake of total carbohydrate and risk of endometrial cancer after combining estimates from 3 prospective cohort studies with ≥10 years’ duration of follow-up (Combined effect size: 1.29, 95% CI: 1.09-1.53, P = 0.003) and when 3 prospective cohort studies with sample size of ≥50,000 participants were combined (Combined effect size: 1.24, 95% CI: 1.08-1.43, P = 0.002). In addition, a non-linear dose-response relationship was found in this regard after considering estimates from prospective cohort studies (Pnonlinearity = 0.002). Combining effect sizes from case-control studies showed a significant positive association between GI and risk of endometrial cancer; such that in linear dose-response analysis, a 10 unit increase in GI was associated with 4% greater risk of endometrial cancer. However, this association was not significant in prospective cohort studies (P > 0.50).Conclusions: Although dietary intake of total carbohydrate, GI and GL were not significantly associated with risk of developing endometrial cancer, we did find positive association in some subgroups. We found a significant positive non-linear association of GI and GL with risk of endometrial cancer.

Carbohydrate ; endometrial neoplasms ; glycemic load ; glycemic index ; diet