Division of Nutritional Epidemiology, The National Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden.
Diabetologia. 2011 May;54(5):1013-8. doi: 10.1007/s00125-011-2051-6. Epub 2011 Jan 28.
AIMS/HYPOTHESIS: Diabetes is associated with increased risk of cancer at several sites, but its association with cancer of the kidney is unclear. We performed a systematic review with meta-analysis to examine the association between diabetes and incidence of kidney cancer.
Pertinent studies were identified by searching PubMed (from January 1966 to December 2010) and reviewing the reference lists of relevant articles. We included cohort studies reporting RR estimates and 95% CI (or data to calculate them) of the association between diabetes and kidney cancer incidence. Summary RRs were calculated using a random-effects model.
Nine cohort studies met the inclusion criteria. Analysis of all studies showed that compared with individuals without diabetes, patients with diabetes had a statistically significant increased risk of kidney cancer (RR 1.42, 95% CI 1.06-1.91). There was heterogeneity among studies (p < 0.001 for heterogeneity). The association was stronger in women (RR 1.70, 95% CI 1.47-1.97) than in men (RR 1.26, 95% CI 1.06-1.49). When restricting the analysis to studies that had adjusted for body mass index (n = 3) or cigarette smoking (n = 3), the RRs were 1.12 (95% CI 0.99-1.27) and 1.29 (95% CI 1.05-1.58), respectively.
CONCLUSIONS/INTERPRETATION: This meta-analysis indicates a positive association between diabetes and risk of kidney cancer. Future research should attempt to establish whether this association is causal.
目的/假设：糖尿病与多个部位的癌症风险增加相关，但与肾癌的关系尚不清楚。我们进行了一项系统评价和荟萃分析，以研究糖尿病与肾癌发病风险之间的关系。
通过检索 PubMed（从 1966 年 1 月至 2010 年 12 月）并查阅相关文章的参考文献，确定了相关研究。我们纳入了报告糖尿病与肾癌发病风险之间 RR 估计值和 95%CI（或计算这些数据的资料）的队列研究。使用随机效应模型计算汇总 RR。
有 9 项队列研究符合纳入标准。对所有研究的分析表明，与无糖尿病者相比，糖尿病患者肾癌发病风险显著增加（RR 1.42，95%CI 1.06-1.91）。研究之间存在异质性（异质性检验 p<0.001）。这种相关性在女性中更强（RR 1.70，95%CI 1.47-1.97），而在男性中则较弱（RR 1.26，95%CI 1.06-1.49）。当将分析仅限于调整了体重指数（n=3）或吸烟状况（n=3）的研究时，RR 分别为 1.12（95%CI 0.99-1.27）和 1.29（95%CI 1.05-1.58）。
结论/解释：本荟萃分析表明，糖尿病与肾癌发病风险之间存在正相关。未来的研究应努力确定这种相关性是否具有因果关系。
