Blood concentrations of carotenoids and retinol and lung cancer risk: an update of the WCRF-AICR systematic review of published prospective studies.
Blood concentrations of carotenoids and retinol and lung cancer risk: an update of the WCRF-AICR systematic review of published prospective studies.
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DOI：
10.1002/cam4.676
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发表时间：
2016-08
期刊：
影响因子：
4
通讯作者：
Norat T
中科院分区：
文献类型：
--
作者：
Abar L;Vieira AR;Aune D;Stevens C;Vingeliene S;Navarro Rosenblatt DA;Chan D;Greenwood DC;Norat T
类胡萝卜素和视黄醇被认为是水果和蔬菜摄入量的生物标志物，因其抗炎和抗氧化特性而备受关注；然而，关于它们对肺癌的保护作用，证据并不一致。我们对类胡萝卜素和视黄醇血液浓度与肺癌风险的前瞻性研究进行了荟萃分析。我们通过检索PubMed和其他几个数据库，确定了截至2014年12月发表的相关前瞻性研究。我们计算了类胡萝卜素和视黄醇浓度最高者与最低者肺癌风险的汇总估计，并使用随机效应模型进行了剂量-反应meta分析。我们使用分数多项式模型来评估潜在的非线性关系。meta分析纳入了17项前瞻性研究（18篇出版物），包括3603例病例和458,434名受试者。α -胡萝卜素、β -胡萝卜素、总类胡萝卜素和视黄醇的血液浓度与肺癌风险或死亡率呈显著负相关。总相对危险度为：α -胡萝卜素每5 μg/100 mL 0.66(95%可信区间[CI]: 0.55-0.80)（研究[n] = 5）， β -胡萝卜素每20 μg/100 mL 0.84 (95% CI: 0.76-0.94) (n = 9)，类胡萝卜素每100 μg/100 mL 0.66 (95% CI: 0.54-0.81) (n = 4)，视黄醇每70 μg/100 mL 0.81 (95% CI: 0.73-0.90) （n = 8）。在性别分层分析中，β -胡萝卜素和视黄醇仅在男性中观察到显著的负相关，而在女性中没有观察到。β -胡萝卜素、β -隐黄质和番茄红素之间存在非线性关联，且在较低浓度下存在较强关联。没有足够的数据来对吸烟进行分层分析。总之，血液中几种类胡萝卜素和视黄醇的浓度较高与降低肺癌风险有关。需要对从未吸烟者和曾经吸烟者进行进一步的研究，以排除吸烟造成的混淆。
Carotenoids and retinol are considered biomarkers of fruits and vegetables intake, and are of much interest because of their anti‐inflammatory and antioxidant properties; however, there is inconsistent evidence regarding their protective effects against lung cancer. We conducted a meta‐analysis of prospective studies of blood concentrations of carotenoids and retinol, and lung cancer risk. We identified relevant prospective studies published up to December 2014 by searching the PubMed and several other databases. We calculated summary estimates of lung cancer risk for the highest compared with lowest carotenoid and retinol concentrations and dose–response meta‐analyses using random effects models. We used fractional polynomial models to assess potential nonlinear relationships. Seventeen prospective studies (18 publications) including 3603 cases and 458,434 participants were included in the meta‐analysis. Blood concentrations of α‐carotene, β‐carotene, total carotenoids, and retinol were significantly inversely associated with lung cancer risk or mortality. The summary relative risk were 0.66 (95% confidence interval [CI]: 0.55–0.80) per 5 μg/100 mL of α‐carotene (studies [n] = 5), 0.84 (95% CI: 0.76–0.94) per 20 μg/100 mL of β‐carotene (n = 9), 0.66 (95% CI: 0.54–0.81) per 100 μg/100 mL of total carotenoids (n = 4), and 0.81 (95% CI: 0.73–0.90) per 70 μg/100 mL of retinol (n = 8). In stratified analysis by sex, the significant inverse associations for β‐carotene and retinol were observed only in men and not in women. Nonlinear associations were observed for β‐carotene, β‐cryptoxanthin, and lycopene, with stronger associations observed at lower concentrations. There were not enough data to conduct stratified analyses by smoking. In conclusion, higher blood concentrations of several carotenoids and retinol are associated with reduced lung cancer risk. Further studies in never and former smokers are needed to rule out confounding by smoking.