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出生体重与癌症风险的关联:一项剂量反应荟萃分析和孟德尔随机化研究。

Association of birth weight with cancer risk: a dose-response meta-analysis and Mendelian randomization study.

机构信息

Nanshan School, Guangzhou Medical University, Guangzhou, 511436, China.

Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China.

出版信息

J Cancer Res Clin Oncol. 2023 Jul;149(7):3925-3935. doi: 10.1007/s00432-022-04171-2. Epub 2022 Aug 27.

Abstract

BACKGROUND

Several articles have shown that birth weight is associated with the risk of many types of cancers. However, the results are inconsistent, and whether the relationship has a causal effect remains unknown.

METHODS

We searched the PubMed and Embase libraries up to March 2021 and selected observational studies reporting the relationship between birth weight and adult-onset cancer risk. Dose-response meta-analysis and two-sample Mendelian randomization (MR) analysis were used to estimate the effect.

RESULT

In our dose-response meta-analysis, six cancers from 46 studies were found to have significant associations with birth weight. (Ovarian cancer: RR: 1.21, 95% CI 1.01-1.44; breast cancer: RR: 1.12, 95% CI 1.08-1.16; colorectal cancer: RR: 1.20, 95% CI 1.01-1.43; endometrial cancer: RR: 0.85, 95% CI 0.78-0.93; prostate cancer: RR: 1.27, 95% CI 1.01-1.61; testicular cancer: RR: 1.21, 95% CI 1.03-1.43). As birth weight increased, the slope of the dose-response curve of breast cancer increased continuously, and the curve of testicular cancer was U-shaped. In the MR study, seven cancers were included. Only invasive mucinous ovarian cancer was found to have a causal effect on birth weight (OR: 0.62; 95% CI 0.39-0.97), while other cancers did not.

CONCLUSIONS

Our findings suggest that birth weight are unlikely to have a casual effect on risk of cancers via the MR analysis, although the dose-response meta-analysis shows that there is a nonlinear relationship between birth weight and breast cancer and testicular cancer. More relevant researches are needed to further investigate their effect.

摘要

背景

已有多篇文章表明,出生体重与多种癌症的发病风险相关。然而,结果并不一致,且两者之间是否存在因果关系尚不清楚。

方法

我们检索了 PubMed 和 Embase 数据库,截至 2021 年 3 月,筛选出了报道出生体重与成人期癌症发病风险之间关系的观察性研究。采用剂量-反应荟萃分析和两样本孟德尔随机化(MR)分析来评估效应。

结果

在我们的剂量-反应荟萃分析中,发现来自 46 项研究的 6 种癌症与出生体重显著相关。(卵巢癌:RR:1.21,95%CI 1.01-1.44;乳腺癌:RR:1.12,95%CI 1.08-1.16;结直肠癌:RR:1.20,95%CI 1.01-1.43;子宫内膜癌:RR:0.85,95%CI 0.78-0.93;前列腺癌:RR:1.27,95%CI 1.01-1.61;睾丸癌:RR:1.21,95%CI 1.03-1.43)。随着出生体重的增加,乳腺癌的剂量-反应曲线斜率持续增加,而睾丸癌的曲线呈 U 形。在 MR 研究中,纳入了 7 种癌症。仅发现浸润性黏液性卵巢癌与出生体重存在因果关系(OR:0.62;95%CI 0.39-0.97),而其他癌症则没有。

结论

虽然剂量-反应荟萃分析表明出生体重与乳腺癌和睾丸癌之间存在非线性关系,但通过 MR 分析,我们发现出生体重不太可能对癌症风险产生因果影响。需要开展更多的相关研究来进一步探讨它们的作用。

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