大豆异黄酮摄入对乳腺癌发病风险影响的荟萃分析

Meta Analysis for Soybean isoflavones Intake and the Risk of Breast Cancer

通过荟萃分析研究饮食摄入大豆异黄酮对妇女乳腺癌发病风险的影响。以"大豆异黄酮"、"大豆"、"植物雌激素"和"乳腺癌"为主题词及关键词,联合检索1996年1月至2011年12月Medline、Pubmed、Embase、CNKI和万方数据库发表的有关文献。纳入文献限定于队列研究和巢式病例对照研究。使用RevMan软件进行效应值的合并和异质性检验,使用Stata12.0统计软件进行Meta回归,并通过漏斗图和Egger回归计算发表偏倚。研究共纳入16篇文献,包括6159名乳腺癌病例。通过比较最高摄入组和最低摄入组乳腺癌的发病风险,大豆异黄酮能够使绝经后妇女乳腺癌发病风险降低20%(合并RR=0.80,95%CI:0.71～0.91;I2=34%,P=0.17),对绝经前妇女乳腺癌发病风险的影响不具有统计学意义;大豆异黄酮能降低亚洲人群乳腺癌发病风险(合并RR=0.82,95%CI:0.70～0.96;I2=23%,P=0.26),但是对欧美人群乳腺癌发病风险的影响不具有统计学意义(合并RR=0.98,95%CI:0.90～1.08;I2=33%,P=0.14)。表明饮食摄入大豆异黄酮可降低绝经后妇女乳腺癌的发病风险,对于亚洲妇女作用尤其明显。

To study the association between soybean isoflavones intake and the risk of breast cancer by conducting Meta analysis.Using the key words,soybean isoflavones,soy,phytoestrogen,in combination with breast cancer,the databases of the Medline,Pubmed,Embase,CNKI and Wanfang from January 1996 to December 2011 were searched.The epidemiological studies met the inclusion criteria,and extracted data using a standardized form were selected.The cohort study and nested case-control study were included only.The analysis of combine RR/OR and homogeneity was performed using Review Manager.Meta-regression was conducted by Stata12.0,and the funnel plot and the Egger’s test were adopted to examine the potential publication bias.A total of sixteen studies met the inclusion criteria and were included,with the cases number of 6159.Compared the highest with the lowest intake,soybean isoflavones intake significantly reduced the breast cancer risk by 20% in post-menopausal women（pooled RR=0.80,95%CI：0.71-0.91;I2=34%,P=0.17）,but it had no significance association in pre-menopausal women.The protective effect of soy isoflavones was observed only among studies conducted in Asian women（pooled RR=0.82,95%CI：0.70-0.96;I2=23%,P=0.26）,but not in western women（pooled RR=0.98,95%CI：0.90-1.08;I2=33%,P=0.14）.Results suggest soybean isoflavones intake could reduce the risk of breast cancer in post-menopausal women,especially for Asian women.