Zhang Dongyu, Li Nan, Xi Yuzhi, Zhao Yuan, Wang Tengteng
Department of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA.
Department of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA.
Diabetes Res Clin Pract. 2017 Aug;130:43-52. doi: 10.1016/j.diabres.2017.04.005. Epub 2017 Apr 13.
Diabetes mellitus (DM) is hypothesized to be associated with an increased risk of ovarian cancer (OC), but current evidences are inconsistent. We aimed to further study this association.
PubMed, EMBASE, Web of Science, and Scopus were searched for eligible articles. After descriptive summary of the data, a random-effects model was applied in quantitative synthesis. Subgroup analysis was performed by study locales and settings, and sensitivity analysis was conducted based on restrictive selection criteria. Funnel plots and the Egger's test were used to assess publication bias. Statistical heterogeneity in meta-analysis was assessed by the P value derived from the Cochrane Q statistic and I-squared value.
Fourteen articles involving data of 15 cohort studies were included for our research. Overall, 17 risk ratios (RRs) were synthesized and yielded a pooled RR of 1.32 (95%CI: 1.14-1.52, P<0.001, I=79.8%). Thirteen RRs were synthesized for type 2DM, and the pooled RR was 1.24 (95%CI: 1.06-1.44, P<0.001, I=81.8%). Four RRs were synthesized for type 1DM, and the result was significant (RR: 1.83, 95%CI: 1.21-2.78, P=0.080, I=55.7%). Results of sensitivity analysis suggested the robustness of a positive association between DM and OC risk, and subgroup analysis demonstrated that the association between DM and OC was much more substantial among Asia population. No publication bias was identified in meta-analysis.
Our study suggests there is a moderate relative increase in the risk of OC among DM patients. Future studies should investigate the effect of duration of DM and anti-diabetes intervention to OC risk.
有假说认为糖尿病（DM）与卵巢癌（OC）风险增加有关，但目前的证据并不一致。我们旨在进一步研究这种关联。
检索了PubMed、EMBASE、Web of Science和Scopus数据库中的相关文章。在对数据进行描述性总结后，采用随机效应模型进行定量合成。按研究地点和环境进行亚组分析，并根据严格的选择标准进行敏感性分析。采用漏斗图和Egger检验评估发表偏倚。通过Cochrane Q统计量得出的P值和I²值评估荟萃分析中的统计学异质性。
本研究纳入了14篇文章，涉及15项队列研究的数据。总体而言，共合成了17个风险比（RRs），合并RR为1.32（95%CI：1.14 - 1.52，P < 0.001，I = 79.8%）。对2型糖尿病合成了13个RRs，合并RR为1.24（95%CI：1.06 - 1.44，P < 0.001，I = 81.8%）。对1型糖尿病合成了4个RRs，结果具有统计学意义（RR：1.83，95%CI：1.21 - 2.78，P = 0.080，I = 55.7%）。敏感性分析结果表明DM与OC风险之间存在正相关关系，且该关系具有稳健性，亚组分析表明DM与OC之间的关联在亚洲人群中更为显著。荟萃分析未发现发表偏倚。
我们的研究表明，DM患者发生OC的风险有适度的相对增加。未来的研究应调查DM病程和抗糖尿病干预对OC风险的影响。
