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[中国人群体重指数与肺癌风险的荟萃分析]

[A meta-analysis of body mass index and the risk of lung cancer in the Chinese population].

作者信息

Guo Lanwei, Liu Shuzheng, Zhang Shaokai, Chen Qiong, Zhang Meng, Quan Peiliang, Lu Jianbang, Sun Xibin

机构信息

Affiliated Cancer Hospital of Zhengzhou University; Henan Cancer Hospital; Henan Office for Cancer Control and Research, Zhengzhou 450008, China.

Affiliated Cancer Hospital of Zhengzhou University; Henan Cancer Hospital; Henan Office for Cancer Control and Research, Zhengzhou 450008, China; Email:

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2015 Jul;49(7):649-53.

Abstract

OBJECTIVE

To investigate the association between obesity and the risk of lung cancer and evaluate a dose-response relationship between body mass index (BMI) and incidence risk of lung cancer in the Chinese population.

METHODS

A systematic literature search for BMI and incidence risk of lung cancer in the Chinese population, as well as through the reference lists of retrieved articles. The literature databases including Chinese National Knowledge Infrastructure, Wanfang, PubMed, Embase and Google Scholar. Time range was from the founding of each database to September 2014 and a total of 93 research papers were collected. Meta-analysis was conducted to calculate pooled odds ratio and corresponding 95% CI. Generalized least-squares regression methods were used to make a dose-response meta-analysis between BMI and incidence risk of lung cancer.

RESULTS

Seven studies were included in the meta-analysis, with a number of 2 351 lung cancer cases. Results showed that obesity was inversely associated with lung cancer incidence (OR = 0.68, 95% CI: 0.59-0.79) (heterogeneity test: I² = 0, P = 0.594). The association did not change with stratification by study design, sex, smoking status, BMI measurement method and study population. A linear dose-response association between BMI and risk of lung cancer was visually significant, and lung cancer risk would be reduced 21% for per 5 kg/m² BMI increase (OR = 0.79, 95% CI: 0.71-0.89) (heterogeneity test: q = 22.43, P = 0.002).

CONCLUSION

The results of this meta-analysis indicated that higher BMI was a protective factor against lung cancer, but smoking may play a stronger role as a confounding factor for the most important role with lung cancer incidence.

摘要

目的

探讨肥胖与肺癌风险之间的关联,并评估中国人群中体重指数(BMI)与肺癌发病风险之间的剂量反应关系。

方法

对中国人群中BMI与肺癌发病风险进行系统的文献检索,并通过检索文章的参考文献列表进行补充。文献数据库包括中国知网、万方、PubMed、Embase和谷歌学术。时间范围为各数据库建库至2014年9月,共收集到93篇研究论文。进行荟萃分析以计算合并比值比及相应的95%可信区间。采用广义最小二乘法回归方法对BMI与肺癌发病风险进行剂量反应荟萃分析。

结果

荟萃分析纳入7项研究,肺癌病例数为2351例。结果显示,肥胖与肺癌发病率呈负相关(OR = 0.68,95%CI:0.59 - 0.79)(异质性检验:I² = 0,P = 0.594)。该关联在按研究设计、性别、吸烟状况、BMI测量方法和研究人群分层后未发生改变。BMI与肺癌风险之间的线性剂量反应关联在视觉上具有显著性,每增加5 kg/m²的BMI,肺癌风险将降低21%(OR = 0.79,95%CI:0.71 - 0.89)(异质性检验:q = 22.43,P = 0.002)。

结论

该荟萃分析结果表明,较高的BMI是肺癌的一个保护因素,但吸烟作为肺癌发病最重要的混杂因素可能发挥更强的作用。

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