Yao Baodong, Yan Yujie, Ye Xianwu, Fang Hong, Xu Huilin, Liu Yinan, Li Sheran, Zhao Yanping
Shanghai Minhang Center for Disease Control and Prevention, 965 Zhongyi Road, Shanghai, 201101, China.
Cancer Causes Control. 2014 Dec;25(12):1645-58. doi: 10.1007/s10552-014-0469-0. Epub 2014 Sep 24.
Observational studies suggest an association between fruit and vegetables intake and risk of bladder cancer, but the results are controversial.
We therefore summarized the evidence from observational studies in categorical, linear, and nonlinear, dose-response meta-analysis. Pertinent studies were identified by searching EMBASE and PubMed from their inception to August 2013.
Thirty-one observational studies involving 12,610 cases and 1,121,649 participants were included. The combined rate ratio (RR, 95 % CI) of bladder cancer for the highest versus lowest intake was 0.83 (0.69-0.99) for total fruit and vegetables, 0.81 (0.70-0.93) for total vegetables, 0.77 (0.69-0.87) for total fruit, 0.84 (0.77-0.91) for cruciferous vegetables, 0.79 (0.68-0.91) for citrus fruits, and 0.74 (0.66-0.84) for yellow-orange vegetables. Subgroup analysis showed study design and gender as possible sources of heterogeneity. A nonlinear relationship was found of citrus fruits intake with risk of bladder cancer (P for nonlinearity = 0.018), and the RRs (95 % CI) of bladder cancer were 0.87 (0.78-0.96), 0.80 (0.67-0.94), 0.79 (0.66-0.94), 0.79 (0.65-0.96), and 0.79 (0.64-0.99) for 30, 60, 90, 120, and 150 g/day. A nonlinear relationship was also found of yellow-orange vegetable intake with risk of bladder cancer risk (P for nonlinearity = 0.033). Some evidence of publication bias was observed for fruit, citrus fruits, and yellow-orange vegetables.
This meta-analysis supports the hypothesis that intakes of fruit and vegetables may reduce the risk of bladder cancer. Future well-designed studies are required to confirm this finding.
观察性研究表明水果和蔬菜摄入量与膀胱癌风险之间存在关联，但结果存在争议。
因此，我们在分类、线性和非线性剂量反应荟萃分析中总结了观察性研究的证据。通过检索EMBASE和PubMed从其创刊至2013年8月来确定相关研究。
纳入了31项观察性研究，涉及12610例病例和1121649名参与者。水果和蔬菜总摄入量最高与最低者相比，膀胱癌的合并率比（RR，95%CI）为0.83（0.69 - 0.99），蔬菜总摄入量为0.81（0.70 - 0.93），水果总摄入量为0.77（0.69 - 0.87），十字花科蔬菜为0.84（0.77 - 0.91），柑橘类水果为0.79（0.68 - 0.91），黄橙色蔬菜为0.74（0.66 - 0.84）。亚组分析显示研究设计和性别可能是异质性的来源。发现柑橘类水果摄入量与膀胱癌风险之间存在非线性关系（非线性P值 = 0.018），每天摄入30、60、90、120和150克时，膀胱癌的RR（95%CI）分别为0.87（0.78 - 0.96）、0.80（0.67 - 0.94）、0.79（0.66 - 0.94）、0.79（0.65 - 0.96）和0.79（0.64 - 0.99）。还发现黄橙色蔬菜摄入量与膀胱癌风险之间存在非线性关系（非线性P值 = 0.033）。在水果、柑橘类水果和黄橙色蔬菜方面观察到一些发表偏倚的证据。
这项荟萃分析支持水果和蔬菜摄入量可能降低膀胱癌风险的假设。需要未来设计良好的研究来证实这一发现。
