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维生素 D 摄入、血液 25(OH)D 水平与乳腺癌风险或死亡率:一项荟萃分析。

Vitamin D intake, blood 25(OH)D levels, and breast cancer risk or mortality: a meta-analysis.

机构信息

Department of Food and Nutrition, Kyung Hee University, 26 Kyunghee-daero, Dongdaemun-gu, Seoul, South Korea.

出版信息

Br J Cancer. 2014 May 27;110(11):2772-84. doi: 10.1038/bjc.2014.175. Epub 2014 Apr 8.

Abstract

BACKGROUND

Experimental studies suggest potential anti-carcinogenic properties of vitamin D against breast cancer risk, but the epidemiological evidence to date is inconsistent.

METHODS

We searched MEDLINE and EMBASE databases along with a hand search for eligible studies to examine the association between vitamin D status (based on diet and blood 25-hydroxyvitamin D (25(OH)D)) and breast cancer risk or mortality in a meta-analysis. A random-effect model was used to calculate a pooled adjusted relative risk (RR).

RESULTS

A total of 30 prospective studies (nested case-control or cohort) were included for breast cancer incidence (n=24 studies; 31 867 cases) or mortality (n=6 studies; 870 deaths) among 6092 breast cancer patients. The pooled RRs of breast cancer incidence for the highest vs the lowest vitamin D intake and blood 25(OH)D levels were 0.95 (95% CI: 0.88-1.01) and 0.92 (95% CI: 0.83-1.02), respectively. Among breast cancer patients, high blood 25(OH)D levels were significantly associated with lower breast cancer mortality (pooled RR=0.58, 95% CI: 0.40-0.85) and overall mortality (pooled RR=0.61, 95% CI: 0.48-0.79). There was no evidence of heterogeneity and publication bias.

CONCLUSIONS

Our findings suggest that high vitamin D status is weakly associated with low breast cancer risk but strongly associated with better breast cancer survival.

摘要

背景

实验研究表明维生素 D 具有潜在的抗癌特性,可以降低乳腺癌风险,但迄今为止的流行病学证据并不一致。

方法

我们搜索了 MEDLINE 和 EMBASE 数据库以及手工检索,以纳入合格的研究,用荟萃分析来检查维生素 D 状态(基于饮食和血液 25-羟维生素 D(25(OH)D))与乳腺癌风险或死亡率之间的关联。使用随机效应模型计算合并调整后的相对风险(RR)。

结果

共有 30 项前瞻性研究(巢式病例对照或队列研究)纳入了 6092 例乳腺癌患者中的乳腺癌发病率(n=24 项研究;31867 例病例)或死亡率(n=6 项研究;870 例死亡)。最高与最低维生素 D 摄入量和血液 25(OH)D 水平的乳腺癌发病率的合并 RR 分别为 0.95(95% CI:0.88-1.01)和 0.92(95% CI:0.83-1.02)。在乳腺癌患者中,高血液 25(OH)D 水平与较低的乳腺癌死亡率(合并 RR=0.58,95% CI:0.40-0.85)和总死亡率(合并 RR=0.61,95% CI:0.48-0.79)显著相关。没有异质性和发表偏倚的证据。

结论

我们的研究结果表明,高维生素 D 状态与低乳腺癌风险弱相关,但与更好的乳腺癌生存强相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1052/4037823/2c2fa1030605/bjc2014175f1.jpg

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