Liu Zhen, Zhang Ting-Ting, Zhao Jing-Jing, Qi Su-Fen, Du Pei, Liu Dian-Wu, Tian Qing-Bao
Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Shijiazhuang, China.
Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Shijiazhuang, China
Jpn J Clin Oncol. 2015 Dec;45(12):1107-15. doi: 10.1093/jjco/hyv150. Epub 2015 Oct 21.
Epidemiological studies have reported an inconsistent association between obesity and ovarian cancer. To update the current knowledge of and further qualify the association between overweight, obesity and ovarian cancer risk, we conducted a meta-analysis of published observational studies.
Using the PubMed, MEDLINE and EMBASE databases, we performed a literature search of all of the case-control and cohort studies published as original articles in English before March 2015. We included 26 observational studies, of which 13 were case-control studies (7782 cases and 21 854 controls) and 13 were cohort studies (5181 cases). Fixed- and random-effects models were used to compute summary estimates and the corresponding 95% confidence intervals. Subgroup analyses were also performed.
The pooled relative risk for overweight and obesity compared with normal weight (body mass index = 18.5-24.9 kg/m(2)) was 1.07 (95% confidence interval: 1.02-1.12) and 1.28 (95% confidence interval: 1.16-1.41), respectively. In subgroup analyses, we found that overweight/obesity increased the risk of ovarian cancer in most groups, except for the postmenopausal group (overweight: pooled relative risk = 0.97, 95% confidence interval: 0.76-1.24; obesity: pooled relative risk = 0.93, 95% confidence interval: 0.61-1.42). There was no evidence of publication bias.
Increased body weight was associated with an increased risk of ovarian cancer; in particular, severe obesity demonstrated a stronger risk effect. No statistically significant association was observed in the postmenopausal period, but was in the premenopausal period.
流行病学研究报告了肥胖与卵巢癌之间的关联并不一致。为更新当前关于超重、肥胖与卵巢癌风险之间关联的认知并进一步明确该关联,我们对已发表的观察性研究进行了荟萃分析。
利用PubMed、MEDLINE和EMBASE数据库,我们对2015年3月之前以英文发表的所有作为原创文章的病例对照研究和队列研究进行了文献检索。我们纳入了26项观察性研究,其中13项为病例对照研究(7782例病例和21854例对照),13项为队列研究(5181例病例)。采用固定效应模型和随机效应模型计算汇总估计值及相应的95%置信区间。还进行了亚组分析。
与正常体重(体重指数=18.5 - 24.9 kg/m²)相比,超重和肥胖的合并相对风险分别为1.07(95%置信区间:1.02 - 1.12)和1.28(95%置信区间:1.16 - 1.41)。在亚组分析中,我们发现超重/肥胖在大多数组中增加了卵巢癌风险,但绝经后组除外(超重:合并相对风险=0.97,95%置信区间:0.76 - 1.24;肥胖:合并相对风险=0.93,95%置信区间:0.61 - 1.42)。没有证据表明存在发表偏倚。
体重增加与卵巢癌风险增加相关;特别是重度肥胖表现出更强的风险效应。在绝经后期未观察到统计学上显著的关联,但在绝经前期观察到了。