膳食维生素摄入与肝癌发病风险关系的Meta分析

A Meta-analysis of Dietary Vitamin Consumption and Risk of Hepatocellular Carcinoma

目的系统评价维生素摄入与肝癌发病风险的关系。方法系统检索1961年1月—2018年10月国内外膳食维生素与肝癌相关性的文献资料,采用ReVman5.0软件进行统计分析。结果共纳入9篇文献,总维生素合并的RR值为0.82,95%CI:0.69~0.98,P<0.05。按文献类型进行亚组分析,其中队列研究结果显示:RR=0.85,95%CI:0.75~0.96,P<0.05;病例对照研究结果显示:RR=0.60,95%CI:0.37~0.98。按维生素种类分析,摄入维生素E结果显示:RR=0.77,95%CI:0.62~0.94,P<0.05;摄入叶酸结果显示:RR=0.69,95%CI:0.54~0.89;亚组分析中维生素A、维生素C差异无统计学意义(分别为RR=0.89,95%CI:0.55~1.44,RR=0.99,95%CI:0.83~1.19)。按照溶解性分析,脂溶性维生素中结果显示:RR=0.79,95%CI:0.66~0.94,水溶性维生素差异无统计学意义:RR=0.84,95%CI:0.59~1.19。结论维生素摄入可能降低肝癌的发病风险,特别是维生素E和叶酸的摄入效果更显著。

Objective To assess the relation between vitamin consumption and risk of hepatocellular carcinoma.Methods We systematically searched for literature about the relation between dietary vitamins and liver cancer at home and abroad from inception to October 2018,and used ReVman5.0 software for statistical analysis.Results A total of 9 articles were included,with the total vitamin RR=0.82 and 95%CI:0.69-0.98,P<0.05.Subgroup analyses indicated that the RR was 0.85,95%CI:0.75-0.96,P<0.05 in cohort study group and the RR was 0.60,95%CI:0.37-0.98 in case-control study;the RR was 0.77,95%CI:0.62-0.94,P<0.05 for intake of vitamin E and the RR was 0.69,95%CI:0.54-0.89 for intake of folic acid;the difference between vitamin A and vitamin C was not statistically significant in the subgroup analysis(RR=0.89,95%CI:0.55-1.44 vs.RR=0.99,95%CI:0.83-1.19).According to the analysis of the solubility of vitamins,the intake of fat-soluble vitamins could reduce the risk of liver cancer(RR=0.79,95%CI:0.66-0.94);the difference of water-soluble vitamins was not statistically significant(RR=0.84,95%CI:0.59-1.19).Conclusion Vitamin(A,C,D,E,folic acid)intake may reduce the risk of liver cancer,especially,vitamin E and folic acid.