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动物脂肪或动物蛋白摄入量与结直肠癌的荟萃分析。

Meta-analysis of animal fat or animal protein intake and colorectal cancer.

作者信息

Alexander Dominik D, Cushing Colleen A, Lowe Kimberly A, Sceurman Bonnie, Roberts Mark A

机构信息

Exponent Health Sciences, Wood Dale, IL, USA.

出版信息

Am J Clin Nutr. 2009 May;89(5):1402-9. doi: 10.3945/ajcn.2008.26838. Epub 2009 Mar 4.

Abstract

BACKGROUND

In the recent World Cancer Research Fund/American Institute for Cancer Research report of diet and cancer, it was concluded that there is limited but suggestive evidence that animal fat intake increases the risk of colorectal cancer.

OBJECTIVE

To clarify this potential relation, we conducted meta-analyses across a variety of subgroups, incorporating data from additional studies.

DESIGN

Analyses of high compared with low animal fat intakes and categorical dose-response evaluations were conducted. Subgroup analyses, consisting of evaluations by study design, sex, and tumor site were also performed.

RESULTS

Six prospective cohort studies with comprehensive dietary assessments, contributing 1070 cases of colorectal cancer and approximately 1.5 million person-years of follow-up, were identified. The summary relative risk estimate (SRRE) for these studies was 1.04 (95% CI: 0.83, 1.31; P for heterogeneity = 0.221) on the basis of high compared with low intakes. When data from case-control studies were combined with the cohort data, the resulting SRRE was 1.15 (95% CI: 0.93, 1.42) with increased variability (P for heterogeneity = 0.015). In our dose-response analysis of the cohort studies, no association between a 20-g/d increment in animal fat intake and colorectal cancer was observed (SRRE: 1.02; 95% CI: 0.95, 1.09). In a separate analysis of 3 prospective cohort studies that reported data for animal protein or meat protein, no significant association with colorectal cancer was observed (SRRE: 0.90; 95% CI: 0.70, 1.15).

CONCLUSION

On the basis of the results of this quantitative assessment, the available epidemiologic evidence does not appear to support an independent association between animal fat intake or animal protein intake and colorectal cancer.

摘要

背景

在世界癌症研究基金会/美国癌症研究学会近期发布的关于饮食与癌症的报告中,得出的结论是,动物脂肪摄入量增加结直肠癌风险的证据有限但具有提示性。

目的

为阐明这种潜在关系,我们纳入更多研究的数据,对多个亚组进行了荟萃分析。

设计

对高动物脂肪摄入量与低动物脂肪摄入量进行分析,并进行分类剂量反应评估。还进行了亚组分析,包括按研究设计、性别和肿瘤部位进行评估。

结果

确定了六项进行全面饮食评估的前瞻性队列研究,这些研究共纳入1070例结直肠癌病例,随访时间约150万人年。基于高摄入量与低摄入量相比,这些研究的汇总相对风险估计值(SRRE)为1.04(95%置信区间:0.83,1.31;异质性P值 = 0.221)。当将病例对照研究的数据与队列研究数据合并时,所得的SRRE为1.15(95%置信区间:0.93,1.42),变异性增加(异质性P值 = 0.015)。在我们对队列研究的剂量反应分析中,未观察到动物脂肪摄入量每日增加20克与结直肠癌之间存在关联(SRRE:1.02;95%置信区间:0.95,1.09)。在对三项报告了动物蛋白或肉类蛋白数据的前瞻性队列研究进行的单独分析中,未观察到与结直肠癌存在显著关联(SRRE:0.90;95%置信区间:0.70,1.15)。

结论

基于这项定量评估的结果,现有流行病学证据似乎并不支持动物脂肪摄入量或动物蛋白摄入量与结直肠癌之间存在独立关联。

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