叶酸摄入与胰腺癌发生风险的meta分析

Folate intake and risk of pancreatic cancer:a meta-analysis

目的探讨叶酸摄入与胰腺癌发生风险的关系。方法计算机检索Cochrane图书馆、Pubmed、Embase、CBM-disc、CNKI数据库,手工检索相关文献,纳入关于叶酸与胰腺癌发生关系的前瞻性及病例-对照研究。评价质量及提取资料后,采用Stata version 11.0软件对胰腺癌发生风险进行合并。结果共纳入6项队列研究及3项病例-对照研究,2 209例患者。分析提示:从食物中获取叶酸的最高摄入量人群与最低者相比,前组胰腺癌罹患风险统计学上明显降低28%,在以相对危险度(RR)为效应值的队列研究中这种降低趋势更明显[合并RR=0.51,95%CI(0.29,0.89),P=0.017],在病例-对照研究中,合并优势比(OR)=0.79[95%CI(0.66,0.94),P=0.008];总叶酸摄入量(来源于食物及补充的叶酸)最高组人群与最低者相比,胰腺癌罹患风险统计学上明显降低33%,在病例-对照研究中,合并OR=0.53[95%CI(0.30,0.96),P=0.036]。结论本研究结果表明增加总叶酸摄入量(来源于食物及补充的叶酸)及食物来源叶酸摄入量是胰腺的保护因素。

Objective To evaluate the relationship between folate intake and risk of pancreatic cancer.Methods We searched various databases,including Cochrane Cental Register of Clinical Trials,Pubmed,EMBASE,CBMdisc,and CNKI for relevant reports;manual search was also done to retrieve reports from the references of identified ones.According to the predefined inclusion and exclusion criteria,prospective and case-control studies on the relationship of folate intake with risk of pancreatic cancer were included.After evaluating the quality of studies,we performed meta-analysis by Stata version 11 software.Results A total of 6 cohort studies and 3 case-control studies,which involving 2,209 patients,were included in the present analysis.The results of meta-analysis showed that people with highest dietary folate intake was associated with a 28% reduced risk of pancreatic cancer compared with those with the lowest dietary folate intake,and this descending trend of risk was more obvious in the cohort studies with relative risk（RR） as the effect size（pooled RR=0.51 [95%CI,0.29-0.89],P=0.017）;meanwhile,the pooled odds ratio（OR） in the case-control studies was 0.79（95%CI [0.66-0.94],P=0.008）.People with the highest total folate intake（dietary and supplement folate） was associated with a 33% reduced risk of pancreatic cancer compared with those with the lowest one,with the pooled OR in the case-control studies being 0.53（95%CI [0.30-0.96],P=0.036）.Conclusion The findings in this study indicate that increase of total folate（dietary and supplement folate） and dietary folate intake may be a protective factor for pancreatic cancer.