Kechagias Konstantinos S, Katsikas Triantafyllidis Konstantinos, Kyriakidou Margarita, Giannos Panagiotis, Kalliala Ilkka, Veroniki Areti Angeliki, Paraskevaidi Maria, Kyrgiou Maria
Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London W12 0NN, UK.
Department of Dietetics, West Suffolk Hospital NHS Foundation Trust, Bury St Edmunds, Bury Saint Edmunds IP33 2QZ, UK.
Nutrients. 2021 Sep 29;13(10):3457. doi: 10.3390/nu13103457.
While the contributing factors leading to endometriosis remain unclear, its clinical heterogeneity suggests a multifactorial causal background. Amongst others, caffeine has been studied extensively during the last decade as a putative contributing factor. In this systematic review and meta-analysis, we provide an overview/critical appraisal of studies that report on the association between caffeine consumption and the presence of endometriosis. In our search strategy, we screened PubMed and Scopus for human studies examining the above association. The main outcome was the relative risk of endometriosis in caffeine users versus women consuming little or no caffeine (<100 mg/day). Subgroup analyses were conducted for different levels of caffeine intake: high (>300 mg/day) or moderate (100-300 mg/day). Ten studies were included in the meta-analysis (five cohort and five case-control studies). No statistically significant association was observed between overall caffeine consumption and risk for endometriosis (RR 1.12, 95% confidence interval (CI) 0.97-1.28, I = 70%) when compared to little or no (<100 mg/day) caffeine intake. When stratified according to level of consumption, high intake was associated with increased risk of endometriosis (RR 1.30, 95%CI 1.04-1.63, I = 56%), whereas moderate intake did not reach nominal statistical significance (RR 1.18, 95%CI 0.99-1.40, I = 37%). In conclusion, caffeine consumption does not appear to be associated with increased risk for endometriosis. However, further research is needed to elucidate the potential dose-dependent link between caffeine and endometriosis or the probable role of caffeine intake as a measurement of other unidentified biases.
虽然导致子宫内膜异位症的相关因素仍不明确，但其临床异质性提示存在多因素因果背景。在其他因素中，咖啡因在过去十年中作为一个假定的相关因素受到了广泛研究。在这项系统评价和荟萃分析中，我们对报告咖啡因摄入与子宫内膜异位症存在之间关联的研究进行了概述/批判性评估。在我们的检索策略中，我们在PubMed和Scopus中筛选了研究上述关联的人体研究。主要结局是咖啡因使用者与很少或不摄入咖啡因（<100毫克/天）的女性相比患子宫内膜异位症的相对风险。针对不同水平的咖啡因摄入量进行了亚组分析：高摄入量（>300毫克/天）或中等摄入量（100 - 300毫克/天）。荟萃分析纳入了10项研究（5项队列研究和5项病例对照研究）。与很少或不摄入（<100毫克/天）咖啡因相比，总体咖啡因摄入量与子宫内膜异位症风险之间未观察到统计学上的显著关联（相对风险1.12，95%置信区间（CI）0.97 - 1.28，I² = 70%）。根据摄入量水平分层时，高摄入量与子宫内膜异位症风险增加相关（相对风险1.30，95%CI 1.04 - 1.63，I² = 56%），而中等摄入量未达到名义统计学显著性（相对风险1.18，95%CI 0.99 - 1.40，I² = 37%）。总之，咖啡因摄入似乎与子宫内膜异位症风险增加无关。然而，需要进一步研究以阐明咖啡因与子宫内膜异位症之间潜在的剂量依赖性联系，或咖啡因摄入作为其他未识别偏倚衡量指标的可能作用。
