蛋白质及碳水化合物摄入量与结直肠癌关系的meta分析

Protein/carbohydrate intake and risk of colorectal cancer:a meta-analysis of observational studies

摘要:

目的  探讨蛋白质及碳水化合物的摄入量对结直肠癌发病率的影响，并对性别和结肠直肠进行亚组分析。方法  在Pubmed、Embase和Cochrane Library数据库里通过检索式检索，选取1991年1月1日-2015年12月31日的蛋白质及碳水化合物摄入量与结直肠癌关系的英文文献，筛选文献并对纳入文献进行质量评分和数据提取，使用Stata 12.0统计软件进行meta分析。结果  最终共纳入22个研究，16 012例患者。蛋白质摄入与结直肠癌发生率无关（■：1.03，95%CI：0.85，1.25）；碳水化合物摄入与结直肠癌发生率无关（■：1.15，95%CI：0.99，1.33）。仅分析其中的病例对照研究，碳水化合物摄入可以增加结直肠癌的发生率（■：1.35，95%CI：1.07，1.69）。亚组分析显示男性的碳水化合物摄入可以增加结直肠癌的发生率（■：1.21，95%CI：1.01，1.45）。然而，碳水化合物相关研究则发现了明显的发表偏倚Begg（P =0.000）或Egger’s（P =0.001）。结论  笔者的结论并没有足够的证据说明在目前的研究中蛋白质/碳水化合物摄入与结直肠癌存在关联性，对于该争议还需要进一步随机对照实验及机制研究来考量。

Abstract:

Objective To explore the association between protein/carbohydrate intake and the risk of colorectal cancer. To explore the effects of sex and tumor site on the risk of colorectal cancer. Methods We conducted a meta-analysis of studies published in the database of pubmed, embase and cochrane library between January 1, 1991 and December 31, 2015 to assess the association between protein/carbohydrate consumption and the risk of colorectal cancer via Stata 12.0. Results A total of 22 studies and 16,012 cases were included in the meta-analysis. The summary relative risk (RR) indicated no significant association between protein (■ : 1.03, 95%CI : 0.85, 1.25) and carbohydrate (■ : 1.15, 95%CI: 0.99, 1.33) intake and the risk of colorectal cancer. A significant positive association with the risk of colorectal cancer was observed in the case-control stdies of carbohydrate intake (■ : 1.35, 95%CI: 1.07, 1.69) and in male subgroup of carbohydrate intake (■ : 1.21, 95%CI: 1.01, 1.45). However, publication bias was evident with either Egger's test (P = 0.001) or Begg's test (P = 0.000) in studies of carbohydrate. Conclusions There is not enough evidence to confirm the association between protein/carbohydrate intake and the risk of colorectal cancer in our research. Further studies, especially, randomized, double-blind and placebo-controlled studies, should be performed to explore the new views mentioned in our article.