循环脂肪酸与前列腺癌风险：前瞻性研究的个体参与者荟萃分析。
Circulating fatty acids and prostate cancer risk: individual participant meta-analysis of prospective studies.
机构信息
Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK (FLC, PNA, RCT, TJK); Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA (MB, GEG, IBK, MLN); Department of Internal Medicine, Division of Cancer Prevention and Control, The Ohio State University College of Medicine, Columbus, OH (TMB); National Institute for Public Health and the Environment - RIVM, Bilthoven, the Netherlands (HBB); Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, the Netherlands (HBB); School of Public Health, Imperial College London, London, UK (HBB); Nutrition and Metabolism Section and the Nutritional Epidemiology Group, International Agency for Research on Cancer, Lyon, France (VC); Departments of Nutrition and Epidemiology, Harvard School of Public Health and Channing Division of Network Medicine, Boston, MA (JEC, MJS); Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (JEC, MJS); Department of Epidemiology, Murcia Regional Health Authority, Spain (MC); CIBER Epidemiology and Public Health CIBERESP, Spain (MC); Cancer Epidemiology Centre, Cancer Council Victoria, Carlton, Victoria, Australia (DRE, GGG, GS); Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, The University of Melbourne, Victoria, Australia (DRE, GGG, GS); FOODplus Research Centre, Waite Campus, The University of Adelaide, Glen Osmond, South Australia, Australia (RAG); Center for Human Nutrition, David Geffen School of Medicine, University of California, Los Angeles, CA (SMH); Department of Cancer Epidemiology, German Cancer Research Center - DKFZ, Heidelberg, Germany (RK); Department of Internal Medicine, University of New Mexico, Albuquerque, NM (IBK); Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI (LNK, SYP, LRW); Cancer Prevention Program, Division of Public Health Sciences, Fred Hu
出版信息
J Natl Cancer Inst. 2014 Sep 10;106(9). doi: 10.1093/jnci/dju240. Print 2014 Sep.
BACKGROUND
Individual studies have suggested that some circulating fatty acids are associated with prostate cancer risk, but have not been large enough to provide precise estimates of associations, particularly by stage and grade of disease.
METHODS
Principal investigators of prospective studies on circulating fatty acids and prostate cancer were invited to collaborate. Investigators provided individual participant data on circulating fatty acids (weight percent) and other characteristics of prostate cancer cases and controls. Prostate cancer risk by study-specific fifths of 14 fatty acids was estimated using multivariable-adjusted conditional logistic regression. All statistical tests were two-sided.
RESULTS
Five thousand and ninety-eight case patients and 6649 control patients from seven studies with an average follow-up of 5.1 (SD = 3.3) years were included. Stearic acid (18:0) was inversely associated with total prostate cancer (odds ratio [OR] Q5 vs Q1 = 0.88, 95% confidence interval [CI] = 0.78 to 1.00, P trend = .043). Prostate cancer risk was, respectively, 14% and 16% greater in the highest fifth of eicosapentaenoic acid (20:5n-3) (OR = 1.14, 95% CI = 1.01 to 1.29, Ptrend = .001) and docosapentaenoic acid (22:5n-3) (OR = 1.16, 95% CI = 1.02 to 1.33, P trend = .003), but in each case there was heterogeneity between studies (P = .022 and P < .001, respectively). There was heterogeneity in the association between docosapentaenoic acid and prostate cancer by grade of disease (P = .006); the association was statistically significant for low-grade disease but not high-grade disease. The remaining 11 fatty acids were not statistically associated with total prostate cancer risk.
CONCLUSION
There was no strong evidence that circulating fatty acids are important predictors of prostate cancer risk. It is not clear whether the modest associations of stearic, eicosapentaenoic, and docosapentaenoic acid are causal.
背景
个别研究表明，一些循环脂肪酸与前列腺癌风险有关，但这些研究的规模还不够大，无法提供关联的精确估计，特别是在疾病的阶段和分级方面。
方法
我们邀请了进行循环脂肪酸与前列腺癌相关研究的主要研究人员进行合作。研究人员提供了关于循环脂肪酸（重量百分比）和前列腺癌病例和对照者其他特征的个体参与者数据。使用多变量调整后的条件逻辑回归，根据 14 种脂肪酸的研究特异性五分位数来估计前列腺癌风险。所有的统计检验都是双侧的。
结果
来自 7 项研究的 5098 例病例患者和 6649 例对照患者被纳入研究，平均随访时间为 5.1（标准差=3.3）年。硬脂酸（18:0）与总前列腺癌呈负相关（五分位 Q5 与 Q1 的比值比[OR]为 0.88，95%置信区间[CI]为 0.78 至 1.00，P 趋势=.043）。在二十碳五烯酸（20:5n-3）（OR=1.14，95%CI=1.01 至 1.29，Ptrend=.001）和二十二碳五烯酸（22:5n-3）（OR=1.16，95%CI=1.02 至 1.33，Ptrend=.003）的最高五分位数中，前列腺癌风险分别增加了 14%和 16%，但在每种情况下，研究之间存在异质性（P=.022 和 P <.001）。二十二碳五烯酸与前列腺癌之间的关联存在疾病分级的异质性（P=.006）；这种关联在低级别疾病中具有统计学意义，但在高级别疾病中没有统计学意义。其余 11 种脂肪酸与总前列腺癌风险无统计学关联。
结论
没有强有力的证据表明循环脂肪酸是前列腺癌风险的重要预测因子。尚不清楚硬脂酸、二十碳五烯酸和二十二碳五烯酸的适度关联是否具有因果关系。
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