Dietary Fiber Intake Reduces Risk for Colorectal Adenoma: A Meta-analysis
Dietary Fiber Intake Reduces Risk for Colorectal Adenoma: A Meta-analysis
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DOI：
10.1053/j.gastro.2013.11.003
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发表时间：
2014-03-01
期刊：
影响因子：
29.4
通讯作者：
Yuan, Yaozong
中科院分区：
文献类型：
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作者：
Ben, Qiwen;Sun, Yunwei;Yuan, Yaozong
背景与目的：关于膳食纤维摄入量与结直肠癌前体结直肠腺瘤(CRA)发病风险之间关系的报道一直不一致。我们进行了病例对照和队列研究的荟萃分析，以分析这种联系。方法：应用计算机检索MEDLINE和EMBASE数据库，检索2013年7月发表的相关研究。随机效应模型被用来估计纤维摄入和CRA风险之间的汇总相对风险(SRR)和95%的可信区间(CI)。使用Cochran Q和I-2统计量评估研究之间的异质性。结果：我们的荟萃分析包括20项研究，涉及10,948名CRA受试者。在高摄入量和低摄入量分析中，CRA对总膳食纤维的SRR为0.72(95%CI，0.63-0.83)，在剂量-反应模型中，每增加10g/天纤维摄入量，CRA的SRR为0.91(95%CI，0.87-0.95)。亚组分析表明，在病例对照研究中，总纤维摄入量与CRA风险呈显著负相关(SRR，0.66；95%CI，0.56-0.77)，但在队列研究中则不存在(SRR，0.92；95%CI，0.76-1.10)。在高摄入量和低摄入量分析中，水果纤维的CRA的SRR为0.84(95%CI，0.76-0.94；n=6个研究)，植物纤维的SRR为0.93(95%CI，0.84-1.04；n=6个研究)，谷类纤维的SRR为0.76(95%CI，0.62-0.92；n=9个研究)。结论：我们的发现支持高膳食纤维摄入量与CRA风险成反比的假设。使用有效问卷和重要混杂因素对照的前瞻性设计的进一步研究是有必要的。
BACKGROUND & AIMS: Reports on the association between dietary fiber intake and risk of colorectal adenoma (CRA), the precursor of colorectal cancer, have been inconsistent. We conducted a meta-analysis of case-control and cohort studies to analyze this association. METHODS: We searched the MEDLINE and EMBASE databases to identify relevant studies published through July 2013. A random-effects model was used to estimate summary relative risks (SRRs) and 95% confidence intervals (CIs) for associations between fiber intake and CRA risk. Heterogeneity among studies was assessed using the Cochran Q and I-2 statistics. RESULTS: Our meta-analysis included 20 studies involving 10,948 subjects with CRA. The SRRs of CRA for total dietary fiber were 0.72 (95% CI, 0.63-0.83) in a highvs low-intake analysis and 0.91 (95% CI, 0.87-0.95) per 10-g/day increase in fiber intake in a dose-response model. Subgroup analyses indicated a significant inverse association between total fiber intake and CRA risk in case-control studies (SRR, 0.66; 95% CI, 0.56-0.77), but not in cohort studies (SRR, 0.92; 95% CI, 0.76-1.10). The SRRs of CRA were 0.84 for fruit fiber (95% CI, 0.76-0.94; n = 6 studies), 0.93 for vegetable fiber (95% CI, 0.84-1.04; n = 6 studies), and 0.76 for cereal fiber (95% CI, 0.62-0.92; n = 9 studies) in high-vs low-intake analyses. CONCLUSIONS: Our findings support the hypothesis that high dietary fiber intake is associated inversely with CRA risk. Further studies with prospective designs that use validated questionnaires and control for important confounders are warranted.