Chen Feifei, Hu Jiyi, Liu Ping, Li Jing, Wei Zheng, Liu Peng
Department of Hematology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, People's Republic of China.
Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China.
Ann Hematol. 2017 Jun;96(6):957-965. doi: 10.1007/s00277-016-2898-1. Epub 2016 Dec 24.
Carotenoids may play a protective role in the development of non-Hodgkin lymphoma (NHL), but findings from epidemiological studies on the associations between carotenoid intake and NHL risk are inconsistent. We therefore performed a meta-analysis to systemically evaluate the associations. Eligible studies were identified by a search of PubMed, Web of Science, Embase, and article reference lists. We pooled risk estimates from individual studies using a random-effect model to quantify the associations between intakes of specific carotenoids and NHL risk. A total of 10 (7 case-control and 3 cohort) studies met our inclusion criteria. In the highest versus lowest analyses, intakes of alpha-carotene, beta-carotene, and lutein/zeaxanthin, but not lycopene or beta-cryptoxanthin, were associated with a significant reduced risk of NHL. The estimated summary relative risks (95% confidence intervals) for alpha-carotene, beta-carotene, and lutein/zeaxanthin were 0.87 (0.78-0.97), 0.80 (0.68-0.94), and 0.82 (0.69-0.97), respectively. Subgroup analyses showed that evidence supporting these protective associations was mostly based on studies with a case-control design. In addition, intakes of alpha-carotene and beta-carotene were associated with a significant decreased risk of diffuse large B-cell lymphoma, but not follicular lymphoma or small lymphocytic lymphoma/chronic lymphocytic leukemia. There was a significant inverse dose-response relationship between alpha-carotene intake and NHL risk (13% lower risk per 1000 μg/day increment of intake). In conclusion, our findings suggest that higher intakes of alpha-carotene, beta-carotene, and lutein/zeaxanthin might protect against NHL development. Further cohort studies with a control of plausible confounding are needed to confirm these associations.
类胡萝卜素可能在非霍奇金淋巴瘤（NHL）的发生发展中起到保护作用，但关于类胡萝卜素摄入量与NHL风险之间关联的流行病学研究结果并不一致。因此，我们进行了一项荟萃分析，以系统评估这些关联。通过检索PubMed、科学网、Embase以及文章参考文献列表来确定符合条件的研究。我们使用随机效应模型汇总个体研究的风险估计值，以量化特定类胡萝卜素摄入量与NHL风险之间的关联。共有10项研究（7项病例对照研究和3项队列研究）符合我们的纳入标准。在最高摄入量与最低摄入量的分析中，α-胡萝卜素、β-胡萝卜素和叶黄素/玉米黄质的摄入量与NHL风险显著降低相关，但番茄红素或β-隐黄质则不然。α-胡萝卜素、β-胡萝卜素和叶黄素/玉米黄质的估计汇总相对风险（95%置信区间）分别为0.87（0.78 - 0.97）、0.80（0.68 - 0.94）和0.82（0.69 - 0.97）。亚组分析表明，支持这些保护关联的证据大多基于病例对照设计的研究。此外，α-胡萝卜素和β-胡萝卜素的摄入量与弥漫性大B细胞淋巴瘤风险显著降低相关，但与滤泡性淋巴瘤或小淋巴细胞淋巴瘤/慢性淋巴细胞白血病无关。α-胡萝卜素摄入量与NHL风险之间存在显著的剂量反应负相关关系（摄入量每增加1000μg/天，风险降低13%）。总之，我们的研究结果表明，较高的α-胡萝卜素、β-胡萝卜素和叶黄素/玉米黄质摄入量可能预防NHL的发生。需要进一步进行有合理混杂因素控制的队列研究来证实这些关联。
