Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Prev Med. 2013 Dec;57(6):753-64. doi: 10.1016/j.ypmed.2013.08.026. Epub 2013 Sep 10.
To conduct a systematic review and meta-analysis of longitudinal studies on the association of 25(OH)D with total cancer incidence and mortality.
Relevant longitudinal observational studies were identified by systematically searching Ovid Medline, EMBASE, and ISI Web of Knowledge databases. Due to the heterogeneity across studies in categorizing 25(OH)D concentration, all results were recalculated for an increase of 25(OH)D by 50 nmol/L.
In meta-analyses with random effects models, the summary risk ratios and confidence intervals (RRs (95% CI)) for the association of an increase of 25(OH)D by 50 nmol/L with total cancer incidence (5 studies) and mortality (13 studies) were 0.89 (0.81, 0.97) and 0.83 (0.71, 0.96), respectively. In sex-specific analyses no significant association with total cancer incidence was observed among men or women. A clear inverse association with total cancer mortality was observed among women (0.76 (0.60, 0.98)) but not among men (0.92 (0.65, 1.32)). Large heterogeneity was observed for studies on total cancer mortality (P<0.01) but not for studies on cancer incidence (P=0.41). No publication bias was found.
The meta-analysis suggests a moderate inverse association of 25(OH)D concentration with total cancer incidence and mortality.
系统评价和荟萃分析 25(OH)D 与总癌症发病率和死亡率之间的纵向研究关联。
通过系统检索 Ovid Medline、EMBASE 和 ISI Web of Knowledge 数据库,确定了相关的纵向观察性研究。由于研究中 25(OH)D 浓度的分类存在异质性,因此所有结果均重新计算为 25(OH)D 增加 50 nmol/L。
在具有随机效应模型的荟萃分析中,增加 25(OH)D 50 nmol/L 与总癌症发病率(5 项研究)和死亡率(13 项研究)关联的汇总风险比和置信区间(RR(95%CI))分别为 0.89(0.81,0.97)和 0.83(0.71,0.96)。在按性别进行的分析中,男性或女性中增加 25(OH)D 与总癌症发病率均无显著关联。女性中总癌症死亡率与 25(OH)D 呈明显负相关(0.76(0.60,0.98)),而男性中则无相关性(0.92(0.65,1.32))。总癌症死亡率的研究存在很大的异质性(P<0.01),而癌症发病率的研究则没有(P=0.41)。未发现发表偏倚。
荟萃分析表明,25(OH)D 浓度与总癌症发病率和死亡率呈中度负相关。