Renin-angiotensin system inhibitor use and colorectal cancer risk and mortality: A dose-response meta analysis
Renin-angiotensin system inhibitor use and colorectal cancer risk and mortality: A dose-response meta analysis
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DOI：
10.1177/1470320319895646
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发表时间：
2020-07-01
影响因子：
2.9
通讯作者：
Ya, Kuang-guan
中科院分区：
文献类型：
--
作者：
Chen, Xia;Yi, Chang-hong;Ya, Kuang-guan
目的：本研究旨在确定使用肾素-血管紧张素系统（RAS）抑制剂是否会增加结直肠癌的发病率和死亡率。方法：对数据库进行电子检索，收集自成立以来至2018年10月期间RAS使用与结直肠癌发病率和死亡率的数据。采用Stata 12.0软件进行meta分析。结果：共纳入16篇文献，涉及2,847,597名受试者。使用RAS抑制剂与结直肠癌风险相关(相对风险（RR）： 0.86；95%可信区间（CI）： 0.78-0.93)和死亡率（RR: 0.80; 95% CI: 0.66-0.98）下降。亚组分析显示血管紧张素转换酶抑制剂(ACEI)/血管紧张素受体阻滞剂（ARB） （RR: 0.82; 95% CI: 0.69-0.96）或ARB （RR: 0.86; 95% CI: 0.73-0.98）或ACEI （RR: 0.81; 95% CI: 0.70-0.92）与结直肠癌风险降低有关。此外，RAS抑制剂的使用与白种人（RR: 0.88; 95% CI: 0.80-0.96）和亚洲人（RR: 0.72; 95% CI: 0.61-0.85）的结直肠癌风险降低有关。此外，剂量反应显示，RAS抑制剂使用1年的时间增加与结直肠癌风险降低6%相关（RR: 0.94; 95% CI: 0.90-0.97）。结论：有证据表明，RAS抑制剂的使用与结直肠癌风险和死亡率的降低有关。
Objective: This study was undertaken to determine whether use of the renin-angiotensin system (RAS) inhibitors would increase colorectal cancer morbidity and mortality. Methods: Databases were electronically searched to collect data of RAS use and colorectal cancer morbidity and mortality from inception to October 2018. Stata 12.0 software was used to perform a meta-analysis. Results: A total of 16 publications involving 2,847,597 participants were included. RAS inhibitor use was related to colorectal cancer risk (relative risk (RR): 0.86; 95% confidence interval (CI): 0.78-0.93) and mortality (RR: 0.80; 95% CI: 0.66-0.98) decrement. Subgroup analysis showed angiotensin-converting enzyme inhibitor (ACEI)/angiotensin II receptor blocker (ARB) (RR: 0.82; 95% CI: 0.69-0.96) or ARB (RR: 0.86; 95% CI: 0.73-0.98) or ACEI (RR: 0.81; 95% CI: 0.70-0.92) were related to colorectal cancer risk decrement. Furthermore, RAS inhibitor use was related to colorectal cancer risk decrement in Caucasians (RR: 0.88; 95% CI: 0.80-0.96) and Asians (RR: 0.72; 95% CI: 0.61-0.85). Additionally, dose-response showed that per one year duration of RAS inhibitor use incremental increase was related to 6% colorectal cancer risk decrement (RR: 0.94; 95% CI: 0.90-0.97). Conclusion: According to the evidence, RAS inhibitor use was associated with colorectal cancer risk and mortality decrement.