He Huadong, Shui Bing
Department of Urology, Hangzhou First People's Hospital, Affiliated Hangzhou Hospital of Nanjing Medical University , Hangzhou, Zhejiang , China.
Int J Food Sci Nutr. 2014 May;65(3):286-92. doi: 10.3109/09637486.2013.866641. Epub 2013 Dec 16.
Epidemiological studies have reported conflicting results between folate intake and bladder cancer risk. We conducted a meta-analysis of epidemiological studies published between 1996 and June 2013 on the relationship between folate intake and bladder cancer. We quantified associations with bladder cancer using meta-analysis of risk estimates (REs) associated to the highest versus the lowest category of folate intake using random effect models. Seven cohort and six case-control studies were eligible for inclusion. A significantly decreased risk with bladder cancer was observed in overall folate intake group (RE = 0.84; 95% CI, 0.72-0.96) and subgroup of case-control studies (RE = 0.73; 95% CI, 0.57-0.89), but not in cohort studies (RE = 0.96; 95% CI, 0.81-1.10) when comparing the highest with the lowest category of folate intake. No heterogeneity and publication bias were observed across studies. Although the current evidence, mainly based on data from case-control studies, supports an inverse association between folate intake and bladder cancer, additional large and well-designed cohort studies are needed before definitive conclusions can be drawn.
流行病学研究报告了叶酸摄入量与膀胱癌风险之间相互矛盾的结果。我们对1996年至2013年6月发表的关于叶酸摄入量与膀胱癌关系的流行病学研究进行了荟萃分析。我们使用随机效应模型，通过对与叶酸摄入量最高类别和最低类别相关的风险估计值进行荟萃分析，来量化与膀胱癌的关联。七项队列研究和六项病例对照研究符合纳入标准。在比较叶酸摄入量最高类别和最低类别时，总体叶酸摄入组（风险估计值=0.84；95%置信区间，0.72 - 0.96）和病例对照研究亚组（风险估计值=0.73；95%置信区间，0.57 - 0.89）中观察到膀胱癌风险显著降低，但在队列研究中未观察到（风险估计值=0.96；95%置信区间，0.81 - 1.10）。各项研究之间未观察到异质性和发表偏倚。尽管目前的证据（主要基于病例对照研究数据）支持叶酸摄入量与膀胱癌之间存在负相关，但在得出明确结论之前，还需要更多大规模且设计良好的队列研究。
