肥胖与原发性肝癌队列研究的Meta分析

A Meta-analysis of Cohort Studies on the Association Between Obesity and the Risk of Primary Liver Cancer

[目的]探讨肥胖与原发性肝癌发病风险的关系。[方法]利用中国学术期刊全文数据库、万方全文数据库及Medline数据库,检索1989年1月到2009年12月国内外公开发表的关于肥胖与肝癌关系的队列研究文献,利用文献提供的调整后RR值及95%可信区间(95%CI),通过固定效应模型或随机效应模型进行综合分析。[结果]纳入Meta分析的文献共13篇,随访队列总样本大小为7069228,累计肝癌发病1671例。与正常体重的人相比,经Meta分析综合后肥胖的RR值为1.72(95%CI:1.36～2.18),提示肥胖与肝癌的发生有比较密切的关系。经亚组分析,男、女性肥胖的合并RR值及其95%CI分别为1.92(1.59～2.31)和1.67(1.36～2.05);一般人群队列和医院来源病人队列的肥胖合并RR值分别为1.49(95%CI:1.15～1.93)和2.17(95%CI:1.76～2.66)。[结论]肥胖与原发性肝癌之间有一定的关系,可能是肝癌的独立危险因素之一。

[ Purpose] To investigate the association between obesity and the risk of primary liver cancer. [ Methods] A Meta-analysis was conducted to estimate the pooled relative risks （RRs） to evaluate the relationship between obesity and the risk of primary liver cancer from cohort studies, which were identified by searching in MEDLINE, Chinese CNKI and Wanfang databases from January 1989 to December 2009. Adjusted relative risks and their corresponding 95% confidence intervals were calculated by using the fixed-effect and the random-effect model in the analysis. [Results] A total of 7 069 228 study subjects from 13 prospective cohorts and 1 671 incident cases of liver cancer were included in the Meta-analysis. From all the chosened cohort studies, the pooled RR of primary liver cancer was 1.72 （95%Cl：1.36-2.18） for persons with obesity, while it compared to the subjects with normal weight. The results showed a significant association between obesity and the risk of primary liver cancer based on these prospective studies. The data analysis by gender indicated that the pooled RRs for obesity were 1.92 （95%Cl：1.59-2.31） in males and 1.67（95%Cl：1.36-2.05） in females respectively. The pooled RRs was1.49（95%Cl：1.15- 1.93） from the population-based cohorts, and 2.17 （95%Cl：1.76-2.66） from the hospital-based cohorts. [Conclusion] Obesity is associated with primary liver cancer and might be an independent risk factor of it.