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血清脂联素与乳腺癌的关联:27项病例对照研究的荟萃分析

Association of serum adiponectin with breast cancer: A meta-analysis of 27 case-control studies.

作者信息

Yu Zeping, Tang Shenli, Ma Hongbing, Duan Hong, Zeng Yong

机构信息

Department of Orthopedics, Chengdu Second People's Hospital.

Department of Orthopedics, West China School of Medicine/West China Hospital, Sichuan University.

出版信息

Medicine (Baltimore). 2019 Feb;98(6):e14359. doi: 10.1097/MD.0000000000014359.

Abstract

BACKGROUND

Emerging published studies have indicated that adiponectin is involved in tumorigenesis of breast cancer. However, the results of available studies were inconsistent. The aim of this updated meta-analysis was to assess the association of adiponectin with breast cancer.

MATERIALS AND METHODS

PubMed, EMBASE, Wanfang databases, and the China National Knowledge Infrastructure (CNKI) were systematically searched from inception to June 2018. The mean difference (MD) with 95% confidence interval (CI) were estimated and pooled to investigate the effect sizes.

RESULTS

Twenty-seven eligible articles that met the study criteria were included in the current meta-analysis. Overall, there was an evident inverse association between serum adiponectin levels and breast cancer (MD = -0.29, 95%CI = (-0.38, -0.21), P < .001). Asian subgroup showed a significant negative association between serum adiponectin concentrations and breast cancer in subgroup analysis by ethnicity (MD = -2.19, 95%CI = (-3.45, -0.94), P < .001). However, no statistical significance was found in Caucasian subgroup (MD = -0.65, 95%CI = (-1.47, 0.17), P = 0.12). Additionally, a further subgroup analysis of Asian stratified by menopausal status showed higher concentrations of adiponectin in healthy control group, whether they were premenopausal (MD = -0.85, 95%CI = (-1.50, -0.19), P = .01) or postmenopausal (MD = -2.17, 95%CI = (-4.17, -0.18), P = .03). No significant difference was observed concerning the association between serum adiponectin and breast cancer metastasis (MD = -1.56, 95%CI = (-4.90, 1.78), P = .36).

CONCLUSION

The current meta-analysis suggests that the serum adiponectin may be inversely associated with breast cancer. Decreased serum adiponectin levels in premenopausal women may also be inversely associated with breast cancer risk other than postmenopausal status. In addition, low serum adiponectin levels in Asian women were more likely to be associated with breast cancer risk than Caucasian women.

摘要

背景

新发表的研究表明脂联素参与乳腺癌的肿瘤发生过程。然而,现有研究结果并不一致。本更新的荟萃分析旨在评估脂联素与乳腺癌的关联。

材料与方法

系统检索了从创刊至2018年6月的PubMed、EMBASE、万方数据库和中国知网。估计并汇总具有95%置信区间(CI)的平均差(MD)以研究效应大小。

结果

本荟萃分析纳入了27篇符合研究标准的合格文章。总体而言,血清脂联素水平与乳腺癌之间存在明显的负相关(MD = -0.29,95%CI =(-0.38,-0.21),P <.001)。在按种族进行的亚组分析中,亚洲亚组显示血清脂联素浓度与乳腺癌之间存在显著负相关(MD = -2.19,95%CI =(-3.45,-0.94),P <.001)。然而,在白种人亚组中未发现统计学意义(MD = -0.65,95%CI =(-1.47,0.17),P = 0.12)。此外,对亚洲人按绝经状态进行的进一步亚组分析显示,无论绝经前(MD = -0.85,95%CI =(-1.50,-0.19),P =.01)还是绝经后(MD = -2.17,95%CI =(-4.17,-0.18),P =.03),健康对照组的脂联素浓度均较高。血清脂联素与乳腺癌转移之间的关联未观察到显著差异(MD = -1.56,95%CI =(-4.90,1.78),P =.36)。

结论

当前的荟萃分析表明血清脂联素可能与乳腺癌呈负相关。绝经前女性血清脂联素水平降低也可能与乳腺癌风险呈负相关,而非绝经后状态。此外,亚洲女性血清脂联素水平低比白种女性更可能与乳腺癌风险相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c29/6380750/e59c5327975c/medi-98-e14359-g001.jpg

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