Calcium intake and colorectal adenoma risk: Dose-response meta-analysis of prospective observational studies
Calcium intake and colorectal adenoma risk: Dose-response meta-analysis of prospective observational studies
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DOI：
10.1002/ijc.29164
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发表时间：
2015-04-01
影响因子：
6.4
通讯作者：
Giovannucci, Edward L.
中科院分区：
文献类型：
--
作者：
Keum, NaNa;Lee, Dong Hoon;Giovannucci, Edward L.
来自随机对照试验的证据表明，钙可以防止结直肠腺瘤的复发，从而可能导致随后的癌症预防。然而，这些试验只使用了大的单剂量，而且规模很小，因此，对剂量-反应关系及其对高危腺瘤的影响的了解有限。为了解决这些问题，我们进行了线性和非线性剂量反应荟萃分析，主要基于PubMed和Embase中截至2014年7月发表的前瞻性观察性研究。采用随机效应模型分别计算总钙摄入量和补充钙摄入量的总相对危险度（rr）和95%置信区间（ci）。对于总钙摄入量，每增加300 mg/天，总RR为0.95 （95% CI=0.92-0.98; I-2=45%； 8项研究共11,005例；摄入量范围为333-2,229 mg/天）。非线性的证据表明：大约，与550毫克/天的总钙摄入量相比，1000毫克/天的总RR为0.92 (95% CI=0.89-0.94)， 1450毫克/天的总RR为0.87 (95% CI=0.84-0.90) （p（非线性））。
Evidence from randomized controlled trials suggests that calcium may protect against recurrence of colorectal adenomas, which could lead to the subsequent prevention of cancer. Yet the trials used only a large single dose and were of small sizes, and thus, knowledge of the dose-response relationship and influence on high-risk adenomas is limited. To address these issues, we conducted linear and nonlinear dose-response meta-analyses primarily based on prospective observational studies published up to July 2014 identified from PubMed and Embase. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated for total and supplemental calcium intake, respectively, using a random-effects model. For total calcium intake, summary RR for each 300 mg/day increase was 0.95 (95% CI=0.92-0.98; I-2=45%; eight studies with 11,005 cases; range of intake=333-2,229 mg/day). Evidence of nonlinearity was indicated: approximately, compared to 550 mg/day of total calcium intake, the summary RR was 0.92 (95% CI=0.89-0.94) at 1,000 mg/day and 0.87 (95% CI=0.84-0.90) at 1,450 mg/day (p(nonlinearity)