Department of Toxicology, Zhejiang University School of Public Health, Hangzhou, 310058, Zhejiang, China.
Department of Oncology, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, 310009, Zhejiang, China.
Eur J Nutr. 2017 Apr;56(3):1169-1177. doi: 10.1007/s00394-016-1166-4. Epub 2016 Feb 12.
The association between dietary carbohydrate intake, glycemic index (GI) and glycemic load (GL), and risk of gastric cancer (GC) has been investigated by many studies. However, the results of these studies were controversial. The aim of our study was to systematically assess this issue.
PUBMED and EMBASE were searched up to March 2015, and either a fixed- or a random-effects model was adopted to estimate overall relative risks (RRs). Dose-response, meta-regression, subgroup, and publication bias analyses were applied.
Twenty-six studies with approximately 540,000 participants were finally included in this meta-analysis. High level of dietary carbohydrate intake (pooled RR 1.17, 95 % CI 0.91-1.50), GI (pooled RR 1.17, 95 % CI 0.80-1.69), and GL (pooled RR 1.06, 95 % CI 0.90-1.26) were all nonsignificantly associated with incidence of GC. In addition, no significant dose-response relationship was observed between carbohydrate intake, GI and GL, and the risk of GC. However, further subgroup analyses based on gender and geographic region suggested a significant association between higher carbohydrate intake (pooled RR 1.52, 95 % CI 1.10-2.08), GL (pooled RR 1.41, 95 % CI 1.04-1.92), and GC risk in males subgroup, and between higher carbohydrate intake (pooled RR 1.69, 95 % CI 1.36-2.09) and GC risk in Asian studies.
No significant association was found between dietary carbohydrate intake, GI and GL, and risk of GC. However, significantly positive association was observed in the males subgroup and Asian studies.
许多研究探讨了膳食碳水化合物摄入量、血糖生成指数(GI)和血糖负荷(GL)与胃癌(GC)风险之间的关系。然而,这些研究的结果存在争议。本研究旨在系统评估这一问题。
检索 PUBMED 和 EMBASE 数据库,截至 2015 年 3 月,采用固定或随机效应模型估计总体相对风险(RR)。进行剂量-反应关系、荟萃回归、亚组和发表偏倚分析。
最终纳入 26 项研究,包含约 54 万名参与者。高膳食碳水化合物摄入量(汇总 RR 1.17,95%CI 0.91-1.50)、GI(汇总 RR 1.17,95%CI 0.80-1.69)和 GL(汇总 RR 1.06,95%CI 0.90-1.26)与 GC 发病率均无显著相关性。此外,碳水化合物摄入量、GI 和 GL 与 GC 风险之间未观察到显著的剂量-反应关系。然而,进一步基于性别和地理位置的亚组分析表明,男性亚组中较高的碳水化合物摄入量(汇总 RR 1.52,95%CI 1.10-2.08)、GL(汇总 RR 1.41,95%CI 1.04-1.92)与 GC 风险之间存在显著相关性,以及亚洲研究中较高的碳水化合物摄入量(汇总 RR 1.69,95%CI 1.36-2.09)与 GC 风险之间存在显著相关性。
膳食碳水化合物摄入量、GI 和 GL 与 GC 风险之间无显著相关性。然而,在男性亚组和亚洲研究中观察到显著的正相关关系。