补充维生素B对癌症发病率、癌症死亡及总死亡率的影响：一项遵循PRISMA的随机对照试验累积荟萃分析。
Effect of vitamin B supplementation on cancer incidence, death due to cancer, and total mortality: A PRISMA-compliant cumulative meta-analysis of randomized controlled trials.
作者信息
Zhang Sui-Liang, Chen Ting-Song, Ma Chen-Yun, Meng Yong-Bin, Zhang Yu-Fei, Chen Yi-Wei, Zhou Yu-Hao
机构信息
Department of Invasive Technology, Shanghai Seventh People's Hospital Department of Traditional Chinese and Western Medicine, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University Department of Medical Laboratory, Shanghai Seventh People's Hospital Department of Traditional Chinese Medicine, Changhai Hospital, Second Military Medical University Department of Rehabilitation Institute, Shanghai Seventh People's Hospital, Shanghai, China.
出版信息
Medicine (Baltimore). 2016 Aug;95(31):e3485. doi: 10.1097/MD.0000000000003485.
BACKGROUND
Observational studies have suggested that vitamin B supplementation is associated with cancer risk, but this association remains controversial. A pooled data-based meta-analysis was conducted to summarize the evidence from randomized controlled trials (RCTs) investigating the effects of vitamin B supplementation on cancer incidence, death due to cancer, and total mortality.
METHODS
PubMed, EmBase, and the Cochrane Library databases were searched to identify trials to fit our analysis through August 2015. Relative risk (RR) was used to measure the effect of vitamin B supplementation on the risk of cancer incidence, death due to cancer, and total mortality using a random-effect model. Cumulative meta-analysis, sensitivity analysis, subgroup analysis, heterogeneity tests, and tests for publication bias were also conducted.
RESULTS
Eighteen RCTs reporting the data on 74,498 individuals were included in the meta-analysis. Sixteen of these trials included 4103 cases of cancer; in 6 trials, 731 cancer-related deaths occurred; and in 15 trials, 7046 deaths occurred. Vitamin B supplementation had little or no effect on the incidence of cancer (RR: 1.04; 95% confidence interval [CI]: 0.98-1.10; P = 0.216), death due to cancer (RR, 1.05; 95% CI: 0.90-1.22; P = 0.521), and total mortality (RR, 1.00; 95% CI: 0.94-1.06; P = 0.952). Upon performing a cumulative meta-analysis for cancer incidence, death due to cancer, and total mortality, the nonsignificance of the effect of vitamin B persisted. With respect to specific types of cancer, vitamin B supplementation significantly reduced the risk of skin melanoma (RR, 0.47; 95% CI: 0.23-0.94; P = 0.032).
CONCLUSION
Vitamin B supplementation does not have an effect on cancer incidence, death due to cancer, or total mortality. It is associated with a lower risk of skin melanoma, but has no effect on other cancers.
背景
观察性研究表明补充维生素B与癌症风险相关，但这种关联仍存在争议。我们进行了一项基于汇总数据的荟萃分析，以总结来自随机对照试验（RCT）的证据，这些试验研究了补充维生素B对癌症发病率、癌症死亡和总死亡率的影响。
方法
检索了PubMed、EmBase和Cochrane图书馆数据库，以确定截至2015年8月符合我们分析的试验。使用随机效应模型，用相对风险（RR）来衡量补充维生素B对癌症发病率、癌症死亡风险和总死亡率的影响。还进行了累积荟萃分析、敏感性分析、亚组分析、异质性检验和发表偏倚检验。
结果
荟萃分析纳入了18项报告74498名个体数据的随机对照试验。其中16项试验包括4103例癌症病例；6项试验中有731例癌症相关死亡；15项试验中有7046例死亡。补充维生素B对癌症发病率（RR：1.04；95%置信区间[CI]：0.98 - 1.10；P = 0.216）、癌症死亡（RR，1.05；95% CI：0.90 - 1.22；P = 0.521）和总死亡率（RR，1.00；95% CI：0.94 - 1.06；P = 0.952）几乎没有影响。在对癌症发病率、癌症死亡和总死亡率进行累积荟萃分析时，维生素B作用的无显著性持续存在。对于特定类型的癌症，补充维生素B显著降低了皮肤黑色素瘤的风险（RR，0.47；95% CI：0.23 - 0.94；P = 0.032）。
结论
补充维生素B对癌症发病率、癌症死亡或总死亡率没有影响。它与较低的皮肤黑色素瘤风险相关，但对其他癌症没有影响。
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