评价随机对照试验、膳食摄入量和队列研究中摄入量生物标志物的证据一致性：一项Meta 流行病学研究。

Evaluating Concordance of Bodies of Evidence from Randomized Controlled Trials, Dietary Intake, and Biomarkers of Intake in Cohort Studies: A Meta-Epidemiological Study.

出版信息

Adv Nutr. 2022 Feb 1;13(1):48-65. doi: 10.1093/advances/nmab095.

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8803500/

Abstract

We aimed to identify and compare empirical data to determine the concordance of diet-disease effect estimates of bodies of evidence (BoE) from randomized controlled trials (RCTs), dietary intake, and biomarkers of dietary intake in cohort studies (CSs). The Cochrane Database of Systematic Reviews and MEDLINE were searched for systematic reviews (SRs) of RCTs and SRs of CSs that investigated both dietary intake and biomarkers of intake published between 1 January 2010 and 31 December 2019. For matched diet-disease associations, the concordance between results from the 3 different BoE was analyzed using 2 definitions: qualitative (e.g., 95% CI within a predefined range) and quantitative (test hypothesis on the z score). Moreover, the differences in the results coming from BoERCTs, BoECSs dietary intake, and BoECSs biomarkers were synthesized to get a pooled ratio of risk ratio (RRR) across all eligible diet-disease associations, so as to compare the 3 BoE. Overall, 49 diet-disease associations derived from 41 SRs were identified and included in the analysis. Twenty-four percent, 10%, and 39% of the diet-disease associations were qualitatively concordant comparing BoERCTs with BoECSs dietary intake, BoERCTs with BoECSs biomarkers, and comparing both BoE from CSs, respectively; 88%, 69%, and 90% of the diet-disease associations were quantitatively concordant comparing BoERCTs with BoECSs dietary intake, BoERCTs with BoECSs biomarkers, and comparing both BoE from CSs, respectively. The pooled RRRs comparing effects from BoERCTs with effects from BoECSs dietary intake were 1.09 (95% CI: 1.06, 1.13) and 1.18 (95% CI: 1.10, 1.25) compared with BoECSs biomarkers. Comparing both BoE from CSs, the difference in the results was also small (RRR: 0.92; 95% CI: 0.88, 0.96). Our findings suggest that BoE from RCTs and CSs are often quantitatively concordant. Prospective SRs in nutrition research should include, whenever possible, BoE from RCTs and CSs on dietary intake and biomarkers of intake to provide the whole picture for an investigated diet-disease association.

摘要

我们旨在识别和比较实证数据，以确定来自随机对照试验 (RCT)、饮食摄入和队列研究 (CS) 中饮食摄入生物标志物的证据体 (BoE) 的饮食-疾病效应估计值的一致性。 Cochrane 系统评价数据库和 MEDLINE 搜索了 2010 年 1 月 1 日至 2019 年 12 月 31 日期间发表的关于 RCTs 和 CSs 的系统评价，这些系统评价都调查了饮食摄入和摄入量的生物标志物。对于匹配的饮食-疾病关联，使用 2 种定义分析来自 3 种不同 BoE 的结果的一致性：定性 (例如，95%CI 在预定范围内) 和定量 (根据 z 分数检验假设)。此外，综合了来自 BoERCTs、BoECSs 饮食摄入和 BoECSs 生物标志物的结果，以获得所有合格的饮食-疾病关联的风险比 (RRR) 比值，从而比较 3 种 BoE。总体而言，从 41 项系统评价中确定了 49 个饮食-疾病关联，并将其纳入分析。比较 BoERCTs 与 BoECSs 饮食摄入、BoERCTs 与 BoECSs 生物标志物以及比较来自 CS 的两种 BoE，24%、10%和 39%的饮食-疾病关联在定性上是一致的；比较 BoERCTs 与 BoECSs 饮食摄入、BoERCTs 与 BoECSs 生物标志物以及比较来自 CS 的两种 BoE，88%、69%和 90%的饮食-疾病关联在定量上是一致的。比较 BoERCTs 与 BoECSs 饮食摄入的效应与 BoECSs 生物标志物的效应的汇总 RRR 分别为 1.09(95%CI：1.06,1.13)和 1.18(95%CI：1.10,1.25)。比较来自 CS 的两种 BoE，结果的差异也很小( RRR：0.92；95%CI：0.88,0.96)。我们的研究结果表明，来自 RCTs 和 CS 的 BoE 在定量上通常是一致的。营养研究中的前瞻性系统评价应尽可能包括来自 RCT 和 CS 的关于饮食摄入和摄入量生物标志物的 BoE，以提供所研究的饮食-疾病关联的全貌。