Godos J, Bella F, Torrisi A, Sciacca S, Galvano F, Grosso G
Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele, Catania, Italy.
Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
J Hum Nutr Diet. 2016 Dec;29(6):757-767. doi: 10.1111/jhn.12395. Epub 2016 Jul 14.
Current evidence suggests that dietary patterns may play an important role in colorectal cancer risk. The present study aimed to perform a systematic review and meta-analysis of observational studies exploring the association between dietary patterns and colorectal adenomas (a precancerous condition).
Pubmed and EMBASE electronic databases were systematically searched to retrieve eligible studies. Only studies exploring the risk or association with colorectal adenomas for the highest versus lowest category of exposure to a posteriori dietary patterns were included in the quantitative analysis. Random-effects models were applied to calculate relative risks (RRs) of colorectal adenomas for high adherence to healthy or unhealthy dietary patterns. Statistical heterogeneity and publication bias were explored.
Twelve studies were reviewed. Three studies explored a priori dietary patterns using scores identifying adherence to the Mediterranean, Paleolithic and Dietary Approaches to Stop Hypertension (DASH) diet and reported an association with decreased colorectal adenoma risk. Two studies tested the association with colorectal adenomas between a posteriori dietary patterns showing lower odds of disease related to plant-based compared to meat-based dietary patterns. Seven studies identified 23 a posteriori dietary patterns and the analysis revealed that higher adherence to healthy and unhealthy dietary patterns was significantly associated risk of colorectal adenomas (RR = 0.81, 95% confidence interval = 0.71, 0.94 and RR = 1.24, 95% confidence interval = 1.13, 1.35, respectively) with no evidence of heterogeneity or publication bias.
The results of this systematic review and meta-analysis indicate that dietary patterns may be associated with the risk of colorectal adenomas.
目前的证据表明，饮食模式可能在结直肠癌风险中发挥重要作用。本研究旨在对观察性研究进行系统评价和荟萃分析，以探讨饮食模式与结直肠腺瘤（一种癌前病变）之间的关联。
系统检索PubMed和EMBASE电子数据库以检索符合条件的研究。定量分析仅纳入探讨后验饮食模式暴露最高类别与最低类别相比与结直肠腺瘤的风险或关联的研究。应用随机效应模型计算高依从健康或不健康饮食模式时结直肠腺瘤的相对风险（RR）。探讨了统计异质性和发表偏倚。
共审查了12项研究。三项研究使用识别对地中海饮食、旧石器饮食和终止高血压饮食方法（DASH）饮食的依从性评分来探讨先验饮食模式，并报告与结直肠腺瘤风险降低有关。两项研究测试了后验饮食模式与结直肠腺瘤之间的关联，结果显示与以肉类为主的饮食模式相比，以植物为主的饮食模式疾病几率较低。七项研究确定了23种后验饮食模式，分析显示，更高依从健康和不健康饮食模式分别与结直肠腺瘤风险显著相关（RR = 0.81，95%置信区间 = 0.71，0.94和RR = 1.24，95%置信区间 = 1.13，1.35），没有异质性或发表偏倚的证据。
本系统评价和荟萃分析的结果表明，饮食模式可能与结直肠腺瘤风险相关。
