Department of Population Health Sciences, University of Texas Health San Antonio, San Antonio, TX, USA.
John B. Alexander High School, Laredo, TX, USA.
Adv Nutr. 2020 May 1;11(3):630-643. doi: 10.1093/advances/nmz120.
Some evidence indicates that carotenoids may reduce the risk of bladder cancer (BC), but the association is unclear. We conducted a systematic review and meta-analysis of case-control and cohort studies investigating the relation between carotenoid intake or circulating carotenoid concentrations and BC risk in men and women. All relevant epidemiologic studies were identified by a search of PubMed and Scopus databases, and the Cochrane Library from inception to April 2019 with no restrictions. A random-effects model was used to calculate pooled RRs and their 95% CIs across studies for high compared with low categories of intake or circulating concentrations. We also performed a dose-response meta-analysis using the Greenland and Longnecker method and random-effects models. A total of 22 studies involving 516,740 adults were included in the meta-analysis. The pooled RRs of BC for the highest compared with the lowest category of carotenoid intake and circulating carotenoid concentrations were 0.88 (95% CI: 0.76, 1.03) and 0.36 (95% CI: 0.12, 1.07), respectively. The pooled RR of BC for the highest compared with lowest circulating lutein and zeaxanthin concentrations was 0.53 (95% CI: 0.33, 0.84). Dose-response analysis showed that BC risk decreased by 42% for every 1 mg increase in daily dietary β-cryptoxanthin intake (RR: 0.58; 95% CI: 0.36, 0.94); by 76% for every 1 μmol/L increase in circulating concentration of α-carotene (RR: 0.24; 95% CI: 0.08, 0.67); by 27% for every 1 μmol/L increase in circulating concentration of β-carotene (RR: 0.73; 95% CI: 0.57, 0.94); and by 56% for every 1 μmol/L increase in circulating concentrations of lutein and zeaxanthin (RR: 0.44; 95% CI: 0.28, 0.67). Dietary β-cryptoxanthin intake and circulating concentrations of α-carotene, β-carotene, and lutein and zeaxanthin were inversely associated with BC risk. The protocol was registered at PROSPERO as CRD42019133240.
一些证据表明，类胡萝卜素可能降低膀胱癌（BC）的风险，但这种关联尚不清楚。我们对病例对照和队列研究进行了系统评价和荟萃分析，以调查男性和女性中类胡萝卜素摄入量或循环类胡萝卜素浓度与 BC 风险之间的关系。通过搜索 PubMed 和 Scopus 数据库以及 Cochrane 图书馆，从成立到 2019 年 4 月，无任何限制地确定了所有相关的流行病学研究。使用随机效应模型计算了摄入量或循环浓度较高组与较低组之间的 pooledRR 及其 95%CI。我们还使用 Greenland 和 Longnecker 方法和随机效应模型进行了剂量反应荟萃分析。共有 22 项涉及 516740 名成年人的研究纳入荟萃分析。最高与最低类胡萝卜素摄入量和循环类胡萝卜素浓度组的 BC pooledRR 分别为 0.88（95%CI：0.76，1.03）和 0.36（95%CI：0.12，1.07）。最高与最低循环叶黄素和玉米黄质浓度组的 BC pooledRR 为 0.53（95%CI：0.33，0.84）。剂量反应分析表明，每日膳食β-隐黄质摄入量每增加 1mg，BC 风险降低 42%（RR：0.58；95%CI：0.36，0.94）；循环浓度每增加 1μmol/Lα-胡萝卜素（RR：0.24；95%CI：0.08，0.67），BC 风险降低 76%；循环浓度每增加 1μmol/Lβ-胡萝卜素（RR：0.73；95%CI：0.57，0.94），BC 风险降低 27%；循环浓度每增加 1μmol/L叶黄素和玉米黄质（RR：0.44；95%CI：0.28，0.67），BC 风险降低 56%。膳食β-隐黄质摄入量和循环α-胡萝卜素、β-胡萝卜素、叶黄素和玉米黄质浓度与 BC 风险呈负相关。该方案在 PROSPERO 上注册为 CRD42019133240。
