遵循地中海饮食与肺癌风险的关系：观察性研究的系统评价和剂量反应荟萃分析。

Adherence to the Mediterranean diet and the risk of lung cancer: a systematic review and dose-response meta-analysis of observational studies.

机构信息

Department and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Nutr Rev. 2022 Apr 8;80(5):1118-1128. doi: 10.1093/nutrit/nuab117.

DOI:10.1093/nutrit/nuab117

PMID:35224641

Abstract

CONTEXT

The literature supports the protective role of the Mediterranean diet (MD) in the prevention of some types of cancer, such as colorectal and liver cancer. The link between the MD and lung cancer, however, is still unclear.

OBJECTIVE

The aim of this systematic review and meta-analysis was to investigate the association between the MD and risk of lung cancer.

DATA SOURCES

Electronic databases (PubMed, Scopus, Embase, and Web of Science) were searched up to May 2021.

STUDY SELECTION

Case-control and cohort studies reporting the association between intake of the MD and risk of lung cancer and with accessible full texts published in English were included. Review articles, laboratory and animal studies, abstracts, letters to the editor, and studies lacking sufficient data were excluded.

DATA EXTRACTION

The risk ratio (RR) was extracted from eligible studies, and meta-analysis was performed to calculate the pooled RR of the included studies.

RESULTS

Nine studies (8 cohort, 1 case-control) were included in the meta-analysis. High adherence to the MD was associated with a lower likelihood of lung cancer compared with low adherence (RR = 0.84; 95%CI, 0.77-0.91; I2 = 52%, heterogeneity P = 0.03). Dose-response analysis showed that a 2-score increment in MD adherence was associated with a 6% lower risk of lung cancer (RR = 0.94; 95%CI, 0.91-0.96; nonlinearity P = 0.97). Subgroup analyses showed a protective association between MD adherence and risk of lung cancer among former smokers (n = 3 studies) (RR = 0.81; 95%CI, 0.74-0.89), but no significant association was observed for never smokers (n = 3 studies) (RR = 0.78; 95%CI, 0.29-2.07) or current smokers (n = 3 studies) (RR = 0.82; 95%CI, 0.58-1.16). In addition, an inverse association between the MD and lung cancer was observed in both males (RR = 0.84; 95%CI, 0.74-0.96) and females (RR = 0.87; 95%CI, 0.77-0.98).

CONCLUSIONS

High adherence to the MD is associated with a lower risk of lung cancer, especially in former smokers.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42019146460.

摘要

背景

文献支持地中海饮食（MD）在预防某些类型的癌症（如结直肠癌和肝癌）方面的保护作用。然而，MD 与肺癌之间的联系尚不清楚。

目的

本系统评价和荟萃分析旨在研究 MD 与肺癌风险之间的关联。

数据来源

截至 2021 年 5 月，检索了电子数据库（PubMed、Scopus、Embase 和 Web of Science）。

研究选择

纳入了报告 MD 摄入量与肺癌风险之间关联且可获取全文的病例对照和队列研究。排除了综述文章、实验室和动物研究、摘要、给编辑的信以及数据不足的研究。

数据提取

从合格研究中提取风险比（RR），并进行荟萃分析以计算纳入研究的汇总 RR。

结果

荟萃分析纳入了 9 项研究（8 项队列研究，1 项病例对照研究）。与低依从性相比，高依从性 MD 与肺癌发生的可能性较低相关（RR=0.84；95%CI，0.77-0.91；I²=52%，异质性 P=0.03）。剂量反应分析表明，MD 依从性增加 2 分，肺癌风险降低 6%（RR=0.94；95%CI，0.91-0.96；非线性 P=0.97）。亚组分析表明，MD 依从性与既往吸烟者（n=3 项研究）的肺癌风险之间存在保护关联（RR=0.81；95%CI，0.74-0.89），但在从不吸烟者（n=3 项研究）（RR=0.78；95%CI，0.29-2.07）或当前吸烟者（n=3 项研究）（RR=0.82；95%CI，0.58-1.16）中未观察到显著关联。此外，在男性（RR=0.84；95%CI，0.74-0.96）和女性（RR=0.87；95%CI，0.77-0.98）中均观察到 MD 与肺癌之间存在负相关。