Is dietary fat associated with the risk of colorectal cancer? A meta-analysis of 13 prospective cohort studies
Is dietary fat associated with the risk of colorectal cancer? A meta-analysis of 13 prospective cohort studies
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DOI：
10.1007/s00394-010-0128-5
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发表时间：
2011-04-01
影响因子：
5
通讯作者：
Zhang, Hai-Yan
中科院分区：
文献类型：
--
作者：
Liu, Liu;Zhuang, Wen;Zhang, Hai-Yan
动物研究的结果表明，膳食脂肪在结直肠癌（CRC）的发展中起着重要作用。为了评价总膳食脂肪与结直肠癌发生风险之间的关系，采用基于前瞻性队列研究的荟萃分析方法，从Medline、Embase和CNKI（中国知识资源综合数据库）数据库中检索更新至2009年5月1日的已发表文献。总的来说，13项前瞻性队列研究纳入了3，635例病例和459，910例受试者，当膳食总脂肪的最高水平与（与）最低的水平。根据性别、种族、国家和年龄分层分析显示，最高水平的膳食总脂肪并不增加CRC的风险[RR（95%CI）：0.89（0.77，1.03）男性：1.09（0.94，1.26）;白人1.08（0.94，1.25）;亚洲人0.90（0.77，1.04）;美国人1.13（0.94，1.36）; 40岁以上个体0.92（0.81，1.04）]。此外，高水平的总脂肪饮食也没有增加结肠癌[RR（95%CI）：0.96（0.82，1.13）]和直肠癌[RR（95%CI）：1.07（0.63，1.82）]的风险。此外，动物脂肪和植物脂肪均与结直肠癌的风险无关[RR（95%CI）：动物脂肪为1.05（0.91-1.22），植物脂肪为0.96（0.82-1.11）]。需要在亚洲人中进行更多设计良好的研究，以进一步评估相关性。此外，本荟萃分析还应注意测量误差可能引起的偏倚，并在今后的研究中对测量误差进行调整。
The results of animal studies suggest there is a significant role for dietary fat in the development of colorectal cancer (CRC). However, inconsistent results have been reported by epidemiological studies.To evaluate the association between total dietary fat and risk of colorectal cancer development using a meta-analysis based on prospective cohort studies.Published literature was retrieved from Medline, Embase and CNKI (China Knowledge Resource Integrated Database) databases updated to 1st May, 2009. Overall, thirteen prospective cohort studies with 3,635 cases and 459,910 participants were included.The combined relative risk (RR) [95% confidence interval (95%CI)] for the risk of CRC was 0.99 (0.89,1.09) when the highest level of total dietary fat was versus (vs.) the lowest level. Stratified analyses according to gender, ethnicity, country and age showed that the highest level of total dietary fat did not increase the risk of CRC [RR (95%CI): 0.89 (0.77,1.03) for males; 1.09 (0.94,1.26) for females; 1.08 (0.94,1.25) for Caucasians; 0.90 (0.77,1.04) for Asians; 1.13 (0.94,1.36) for Americans; 0.92 (0.81,1.04) for individuals older than 40]. Besides those, the highest level of total fat diet also did not increase the risk of neither colon cancer [RR (95%CI): 0.96 (0.82,1.13)] nor rectal cancer [RR (95%CI):1.07 (0.63,1.82)]. Furthermore, neither animal fat nor plant fat were associated with the risk of CRC [RR (95%CI): 1.05 (0.91-1.22) for animal fat and 0.96 (0.82-1.11) for plant fat].This meta-analysis suggests that dietary fat may not be associated with the increased risk of CRC. More well-designed studies with larger population performed among Asians are needed to further evaluate the associations. In addition, probable bias caused by measurement error should be noticed in this meta-analysis, and measurement error needs to be adjusted in the future studies.