肥胖与大肠腺瘤相关性的Meta分析

Meta-analysis on association between obesity and colorectal adenomas

摘要:

目的  综合分析与评价肥胖与大肠腺瘤发病的相关性。方法  系统检索中国知网学术期刊全文数据库（CNKI）、万方数据知识服务平台、中国生物医学文献数据库、维普中文科技期刊数据库、PubMed、EMBase、Cochrane Library等数据库。采用Newcastle-Ottawa Scale （NOS）文献质量评价量表对纳入文献质量进行评价。使用Stata 12.0软件进行Meta分析。结果  最终纳入研究28篇。Meta分析■=1.38（95%CI：1.30，1.47，P =
0.000)，提示肥胖人群大肠腺瘤的发病风险较正常人群增加38%。I2 =43%（P =0.009）提示该Meta分析存在中等程度的异质性。剂量关系分析结果也显示高BMI会增加大肠腺瘤的患病风险。敏感性分析显示该Meta分析有较强的稳定性。性别和人种亚组分析表明性别和人种对大肠腺瘤的发病无显著影响。Egger’s和Begg’s检测结果显示该Meta分析不存在发表偏倚。结论  肥胖会增加大肠腺瘤的发病风险，建议在进行大肠腺瘤筛查时将肥胖作为风险因素。

Abstract:

Objective To analyze and evaluate the association between obesity and colorectal adenomas. Methods A systematic search for related studies from CNKI, WanFang Data, SinoMed, CqVip, PubMed, EMBase and Cochrane Library was performed following the searching strategies. The quality of the included studies was assessed using Newcastle-Ottawa Scale (NOS), and a meta-analysis was conducted using Stata 12.0 software. Results Twenty-eight studies were included. The combined ■ was 1.38 (95%CI: 1.30-1.47, P = 0.000), which indicated that obese people was 38% higher in the prevalence of colorectal adenomas. I2 = 43% (P = 0.009) showed that this meta-analysis had a moderate degree of heterogeneity. Dose-response relationship analysis also showed that high BMI could increase the prevalence of colorectal adenoma. No significant diffe-
rences were found during the sensitivity analysis, which meant that this analysis performed a good stability. Subgroup analysis showed that neither gender nor race had significant influence on the occurrence of colorectal adenomas. Significant publication bias was not observed according to Egger's and Begg's results. Conclusions Obesity increases the prevalence of colorectal adenomas, which suggests that obesity should be considered as a risk factor in colorectal adenoma screening.