Li Qianwen, Cui Lingling, Tian Yalan, Cui Han, Li Li, Dou Weifeng, Li Haixia, Wang Ling
College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China.
Nutrients. 2017 May 18;9(5):510. doi: 10.3390/nu9050510.
Although several epidemiological studies have investigated the association between dietary calcium intake and the risk of esophageal cancer, the results are inconsistent. This study aimed to make a comprehensive evaluation regarding the association between calcium intake and risk of esophageal cancer through a meta-analysis approach. We searched for all relevant articles from the inception to April 2017, using PUBMED, EMBASE, and Web of Knowledge. The pooled odds ratio (ORs) with the 95% confidence interval (95% CI) for the highest versus the lowest categories of calcium intake was calculated using a Mantel-Haenszel fixed-effect model. In total, 15 articles reporting 17 studies including 3396 esophageal cancer cases and 346,815 controls were selected for the meta-analysis. By comparing the highest vs. the lowest levels of dietary calcium intake, we found that dietary calcium intake was inversely associated with the risk of esophageal cancer (OR = 0.80, 95% CI: 0.71-0.91, ² = 33.6%). The subgroup analysis indicated that the protective function of dietary calcium intake were observed in esophageal squamous cell cancer, but not in esophageal adenocarcinoma in the studies conducted in Asia, but not those in Europe and America. In conclusion, our results suggest that higher dietary calcium intake is associated with a lower risk of esophageal cancer-especially esophageal squamous cell cancer-in Asian populations, though more data from prospective cohort studies are needed.
尽管多项流行病学研究调查了膳食钙摄入量与食管癌风险之间的关联，但其结果并不一致。本研究旨在通过荟萃分析方法对钙摄入量与食管癌风险之间的关联进行综合评估。我们使用PUBMED、EMBASE和Web of Knowledge检索了从创刊至2017年4月的所有相关文章。采用Mantel-Haenszel固定效应模型计算钙摄入量最高组与最低组的合并比值比（OR）及95%置信区间（95%CI）。总共筛选出15篇报告17项研究的文章，其中包括3396例食管癌病例和346,815例对照，纳入荟萃分析。通过比较膳食钙摄入量的最高水平与最低水平，我们发现膳食钙摄入量与食管癌风险呈负相关（OR = 0.80，95%CI：0.71 - 0.91，I² = 33.6%）。亚组分析表明，在亚洲进行的研究中，膳食钙摄入量对食管鳞状细胞癌具有保护作用，但对食管腺癌无此作用，而在欧美进行的研究中则未观察到这种差异。总之，我们的结果表明，较高的膳食钙摄入量与较低的食管癌风险相关——尤其是食管鳞状细胞癌——在亚洲人群中，不过仍需要更多来自前瞻性队列研究的数据。
