Thomopoulos Thomas P, Ntouvelis Evangelos, Diamantaras Andreas-Antonios, Tzanoudaki Marianna, Baka Margarita, Hatzipantelis Emmanuel, Kourti Maria, Polychronopoulou Sophia, Sidi Vasiliki, Stiakaki Eftichia, Moschovi Maria, Kantzanou Maria, Petridou Eleni Th
Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece.
Program Medical Neurosciences, Charité-Universitätsmedizin, Berlin, Germany.
Cancer Epidemiol. 2015 Dec;39(6):1047-59. doi: 10.1016/j.canep.2015.08.009. Epub 2015 Aug 29.
To systematically review studies and meta-analyze the literature on the association of maternal and/or index child's coffee, tea, and cola consumption with subsequent development of childhood leukemia and its major subtypes.
Eligible studies were identified through a detailed algorithm and hand-search of eligible articles' references; thereafter, summary-effect estimates were calculated by leukemia subtype and dose-response meta-analyses were performed.
Twelve case-control studies, comprising a total of 3649 cases and 5705 controls, were included. High maternal coffee consumption was positively associated with acute lymphoblastic leukemia (ALL; OR: 1.43, 95%CI: 1.22-1.68) and acute myeloid leukemia (AML; OR: 2.52, 95%CI: 1.59-3.57). Any or low to moderate maternal cola consumption was also positively associated with overall leukemia (AL) and ALL, A linear trend between coffee and cola consumption and childhood leukemia was observed in the dose-response analyses. On the contrary, low to moderate tea consumption was inversely associated with AL (OR: 0.85, 95%CI: 0.75-0.97), although the trend was non-significant. A null association between offspring's cola consumption and leukemia was noted.
Our findings confirm the detrimental association between maternal coffee consumption and childhood leukemia risk and provide indications for a similar role of maternal cola intake. In contrast, an inverse association with tea was found, implying that other micronutrients contained in this beverage could potentially counterbalance the deleterious effects of caffeine. Further research should focus on the intake of specific micronutrients, different types of coffee and tea, specific immunophenotypes of the disease, and the modifying effect of genetic polymorphisms.
系统回顾相关研究并对文献进行荟萃分析，以探讨母亲和/或索引儿童饮用咖啡、茶和可乐与儿童白血病及其主要亚型后续发病之间的关联。
通过详细算法和手工检索符合条件文章的参考文献来确定合格研究；之后，按白血病亚型计算汇总效应估计值，并进行剂量反应荟萃分析。
纳入了12项病例对照研究，共3649例病例和5705例对照。母亲大量饮用咖啡与急性淋巴细胞白血病（ALL；比值比：1.43，95%置信区间：1.22 - 1.68）和急性髓细胞白血病（AML；比值比：2.52，95%置信区间：1.59 - 3.57）呈正相关。母亲饮用任何量或少量至适量可乐也与总体白血病（AL）和ALL呈正相关，在剂量反应分析中观察到咖啡和可乐消费与儿童白血病之间存在线性趋势。相反，少量至适量饮茶与AL呈负相关（比值比：0.85，95%置信区间：0.75 - 0.97），尽管该趋势不显著。未发现子代饮用可乐与白血病之间存在关联。
我们的研究结果证实了母亲饮用咖啡与儿童白血病风险之间的有害关联，并表明母亲饮用可乐可能也有类似作用。相比之下，发现饮茶与之呈负相关，这意味着该饮料中含有的其他微量营养素可能潜在地抵消咖啡因的有害影响。进一步的研究应关注特定微量营养素的摄入、不同类型的咖啡和茶、疾病的特定免疫表型以及基因多态性的修饰作用。
