Chi Mei Medical Center, Tainan, Taiwan.
Ann Pharmacother. 2011 Apr;45(4):476-84. doi: 10.1345/aph.1P445. Epub 2011 Apr 12.
The association between consumption of multivitamins and breast cancer is inconsistent in epidemiologic studies.
To perform a meta-analysis of cohort and case-control studies to evaluate multivitamin intake and its relationship with breast cancer risk.
The published literature was systematically searched and reviewed using MEDLINE (1950 through July 2010), EMBASE (1980 through July 2010), and the Cochrane Central Register of Controlled Trials (The Cochrane Library 2010 issue 1). Studies that included specific risk estimates were pooled using a random-effects model. The bias and quality of these studies were assessed with REVMAN statistical software (version 5.0) and the GRADE method of the Cochrane Collaboration.
Eight of 27 studies that included 355,080 subjects were available for analysis. The total duration of multivitamin use in these trials ranged from 3 to 10 years. The frequency of current use in these studies ranged from 2 to 6 times/week. In analyses by duration of use 10 years or longer or 3 years or longer and by frequency 7 or more times/week that were reported in these studies, multivitamin use was not significantly associated with the risk of breast cancer. Only 1 recent Swedish cohort study concluded that multivitamin use is associated with an increased risk of breast cancer. The results of a meta-analysis that pooled data from 5 cohort studies and 3 case-control studies indicated that the overall multivariable relative risk and odds ratio were 0.10 (95% CI 0.60 to 1.63; p = 0.98) and 1.00 (95% CI 0.51 to 1.00; p = 1.00), respectively. The association was not statistically significant.
Multivitamin use is likely not associated with a significant increased or decreased risk of breast cancer, but these results highlight the need for more case-control studies or randomized controlled clinical trials to further examine this relationship.
多种维生素的摄入与乳腺癌之间的关系在流行病学研究中并不一致。
进行荟萃分析队列研究和病例对照研究,以评估多种维生素的摄入及其与乳腺癌风险的关系。
系统地检索了已发表的文献,并使用 MEDLINE(1950 年至 2010 年 7 月)、EMBASE(1980 年至 2010 年 7 月)和 Cochrane 对照试验中心注册库(Cochrane 图书馆 2010 年第 1 期)进行了回顾。使用随机效应模型对纳入特定风险估计值的研究进行了汇总。使用 REVMAN 统计软件(版本 5.0)和 Cochrane 协作组的 GRADE 方法评估了这些研究的偏倚和质量。
共有 27 项研究中的 8 项纳入了 355080 名受试者,可供分析。这些试验中多种维生素的总使用时间从 3 年到 10 年不等。这些研究中当前使用的频率从每周 2 次到 6 次不等。在分析使用时间为 10 年或更长时间或 3 年或更长时间以及每周使用 7 次或更多次时,发现多种维生素的使用与乳腺癌的风险无显著相关性。只有一项最近的瑞典队列研究得出结论,多种维生素的使用与乳腺癌风险的增加有关。对 5 项队列研究和 3 项病例对照研究的数据进行荟萃分析的结果表明,总体多变量相对风险和比值比分别为 0.10(95%CI 0.60 至 1.63;p = 0.98)和 1.00(95%CI 0.51 至 1.00;p = 1.00),差异无统计学意义。
多种维生素的使用可能与乳腺癌的发生风险增加或降低无关,但这些结果突出表明需要更多的病例对照研究或随机对照临床试验来进一步研究这种关系。