Department of Epidemiology, Public Health College, Harbin Medical University, 157, Baojian Street, Nangang District, Harbin, Heilongjiang, People's Republic of China.
Cancer Causes Control. 2011 Oct;22(10):1383-96. doi: 10.1007/s10552-011-9811-y. Epub 2011 Jul 15.
To comprehensively summarize the associations between retinol, vitamins A, C, and E and breast cancer, and quantitatively estimate their dose-response relationships.
We searched PubMed, Embase, and Cochrane databases (from January 1982 to 15 March 2011) and the references of the relevant articles in English with sufficient information to estimate relative risk or odds ratio and the 95% confidence intervals, and comparable categories of vitamins. Two reviewers independently extracted data using a standardized form, with any discrepancy adjudicated by the third reviewer.
Overall, 51 studies met the inclusion criteria. Comparing the highest with the lowest intake, total vitamin A intake reduced the breast cancer risk by 17% (pooled OR = 0.83, 95% CI: 0.78-0.88). Further subgroup analysis based on study design did not change the significant reduction. Although the dietary vitamin A, dietary vitamin E, and total vitamin E intake all reduced breast cancer risk significantly when data from all studies were pooled, the results became nonsignificant when data from cohort studies were pooled. The significant association between total retinol intake and breast cancer in all studies became nonsignificant in case-control studies but remain significant in cohort studies. No significant dose-response relationship was observed in the higher intake of these vitamins with reduced breast cancer risk.
Our results indicate that both the total intake of vitamin A and retinol could reduce breast cancer risk. However, associations between other vitamins and breast cancer seem to be limited.
全面总结视黄醇、维生素 A、C 和 E 与乳腺癌的关联，并定量评估它们的剂量-反应关系。
我们检索了 PubMed、Embase 和 Cochrane 数据库（从 1982 年 1 月至 2011 年 3 月 15 日），并检索了相关英文文献的参考文献，这些文献提供了足够的信息来估计相对风险或比值比及其 95%置信区间，以及可比类别的维生素。两位评审员使用标准化表格独立提取数据，如果存在分歧，则由第三位评审员裁决。
共有 51 项研究符合纳入标准。与最低摄入量相比，总维生素 A 摄入量降低了 17%的乳腺癌风险（汇总 OR=0.83，95%CI：0.78-0.88）。基于研究设计的进一步亚组分析并未改变这一显著降低。尽管来自所有研究的数据汇总时，膳食维生素 A、膳食维生素 E 和总维生素 E 的摄入量均显著降低了乳腺癌风险，但来自队列研究的数据汇总时，结果变得不显著。来自所有研究的总视黄醇摄入量与乳腺癌之间的显著相关性在病例对照研究中变得不显著，但在队列研究中仍然显著。在降低乳腺癌风险的较高摄入量范围内，这些维生素没有观察到显著的剂量-反应关系。
我们的结果表明，维生素 A 和视黄醇的总摄入量都可能降低乳腺癌风险。然而，其他维生素与乳腺癌之间的关联似乎有限。
