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荟萃分析:血清维生素 D 与结直肠癌风险的纵向研究。

Meta-analysis: longitudinal studies of serum vitamin D and colorectal cancer risk.

机构信息

Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Bergheimer Strasse, Heidelberg D-69115, Germany.

出版信息

Aliment Pharmacol Ther. 2009 Jul 1;30(2):113-25. doi: 10.1111/j.1365-2036.2009.04022.x. Epub 2009 Apr 15.

Abstract

BACKGROUND

In 1980, Garland hypothesized that lower levels of vitamin D resulting from much weaker UV-B radiation at higher latitudes may account for the striking geographical pattern of cancer mortality. Further research has been conducted over the past 20 years.

AIM

To perform a systematic review and meta-analysis of longitudinal studies on the association between serum 25 hydroxyvitamin D (25(OH)D) and the risk of colorectal cancer (CRC).

METHODS

Relevant studies published until September 2008 were identified by systematically searching Ovid Medline, EMBASE, and ISI Web of Knowledge databases and by cross-referencing. Due to the heterogeneity of studies in categorizing serum vitamin D levels, all results were recalculated for an increase of serum 25(OH)D by 20 ng/mL. Summary odds ratios (ORs) were calculated using meta-analysis methods.

RESULTS

Overall, eight original articles reporting on the association between serum 25(OH) D and CRC risk were included. In meta-analyses, summary ORs (95% confidence intervals) for the incidence of CRC, colon cancer and rectal cancer associated with an increase of 25(OH)D by 20 ng/mL were 0.57 (0.43-0.76), 0.78 (0.54-1.13) and 0.41 (0.11-1.49). No indication for publication bias was found.

CONCLUSIONS

Our results support suggestions that serum 25(OH)D is inversely related to CRC risk.

摘要

背景

1980 年,Garland 假设,由于高纬度地区紫外线-B 辐射较弱,导致维生素 D 水平降低,这可能是癌症死亡率呈现明显地域分布模式的原因。在过去的 20 年中,进一步开展了相关研究。

目的

对血清 25 羟维生素 D(25(OH)D)与结直肠癌(CRC)风险之间的关联进行系统回顾和荟萃分析。

方法

通过系统搜索 Ovid Medline、EMBASE 和 ISI Web of Knowledge 数据库以及交叉引用,确定截至 2008 年 9 月发表的相关研究。由于研究在对血清维生素 D 水平进行分类时存在异质性,因此所有结果均按血清 25(OH)D 增加 20ng/ml 重新计算。使用荟萃分析方法计算汇总比值比(OR)。

结果

总体而言,纳入了 8 篇关于血清 25(OH)D 与 CRC 风险之间关联的原始文章。在荟萃分析中,血清 25(OH)D 增加 20ng/ml 与 CRC、结肠癌和直肠癌发生相关的汇总 OR(95%置信区间)分别为 0.57(0.43-0.76)、0.78(0.54-1.13)和 0.41(0.11-1.49)。未发现发表偏倚的迹象。

结论

我们的结果支持血清 25(OH)D 与 CRC 风险呈负相关的观点。

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