地中海饮食与结直肠肿瘤相关性的Meta分析

Meta-Analysis on The Association of Mediterranean Diet and Colorectal Cancer

目的:系统评价地中海饮食与结直肠肿瘤的相关性。方法:计算机检索Pubmed、EMbase、The Cochrane Library(2018年1期)、CBM、CNKI、VIP、Wan Fang Data,以获得关于地中海饮食与结直肠肿瘤相关性的队列研究、病例对照研究,检索时限均为建库至2018年1月。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险,采用非随机研究偏倚风险评估方法 (Newcastle-Ottawa Scale,NOS)对纳入研究进行质量评估,应用Rev Man 5.3软件进行Meta分析,计算比值比(OR)及95%置信区间(95%CI),检验异质性并寻找其来源,应用漏斗图评估发表偏倚。结果:共纳入11项研究,其中病例对照研究5项、队列研究6项。Meta分析结果显示,地中海饮食对降低结直肠肿瘤风险有统计学意义(OR=0.82,95%CI∶0.76,0.88)。按性别亚组分析显示,对不同性别人群而言,坚持地中海饮食对降低结直肠肿瘤发病风险均有意义,似乎对男性的保护作用更强(男:OR=0.76,95%CI:0.65,0.88;女:OR=0.86,95%CI:0.77,0.97)。结论:坚持地中海饮食可能会降低结直肠肿瘤的发病风险,这将为结直肠肿瘤的一级预防提供科学依据。

[Objective] To explore the association between the mediterranean diet （MeDi） and eoloreetal cancer （CRC） . [Method] Original ease-control and cohort studies about the correlation between MeDi and CRC published to January 2018 were selected by literalure search in the databases such as PubMed, EMbase, The Coehrane Library （Issue 1, 2018）, CBM, CNKI, VlP and WanFang Data. Two reviewers independently reviewed literature, extracted data and evaluated the quality of included studies. Newcastle-Ottawa Scale （NOS） was used to define study quality. Meta-analysis was calculated using RevMan 5.3 software. Odds ratios （ORs） estimates and 95% confidence intervals （CIs） were used to ealeulate estimated effect. Sensitivity analyses were performed to detect the potential sources of heterogenei-ty. Funnel plot was used to assess publication bias. [Result] Totally 11 studies were identified including 6 cohort researches and 5 ease-con-trol studies. The results of meta-analysis showed that the MeDi was significantly associated with a modest reduced risk of CRC （ OR = 0. 82, 95% CI 0. 76, 0. 88） . In the subgroup analysis, there was a significant assoeiation both men and women, and the modest reduced risk of CRC was higher in men （OR = 0. 76, 95% CI 0. 65 to 0. 88） than women （ OR = 0. 86, 95% CI 0.77 to 0.97） . [Conclusion] MeDi may be significantly associated with a modest reduced risk of CRC, and it will provide a basis for the primary prevention of CIRC.