咖啡饮用与子宫内膜癌风险：子宫内膜癌流行病学联盟（E2C2）个体参与者数据的汇总分析。
Coffee consumption and risk of endometrial cancer: a pooled analysis of individual participant data in the Epidemiology of Endometrial Cancer Consortium (E2C2).
机构信息
Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO)-Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA.
Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
出版信息
Am J Clin Nutr. 2022 Nov;116(5):1219-1228. doi: 10.1093/ajcn/nqac229. Epub 2023 Feb 10.
BACKGROUND
Epidemiologic studies suggest that coffee consumption may be inversely associated with risk of endometrial cancer (EC), the most common gynecological malignancy in developed countries. Furthermore, coffee consumption may lower circulating concentrations of estrogen and insulin, hormones implicated in endometrial carcinogenesis. Antioxidants and other chemopreventive compounds in coffee may have anticarcinogenic effects. Based on available meta-analyses, the World Cancer Research Fund (WCRF) concluded that consumption of coffee probably protects against EC.
OBJECTIVES
Our main aim was to examine the association between coffee consumption and EC risk by combining individual-level data in a pooled analysis. We also sought to evaluate potential effect modification by other risk factors for EC.
METHODS
We combined individual-level data from 19 epidemiologic studies (6 cohort, 13 case-control) of 12,159 EC cases and 27,479 controls from the Epidemiology of Endometrial Cancer Consortium (E2C2). Logistic regression was used to calculate ORs and their corresponding 95% CIs. All models were adjusted for potential confounders including age, race, BMI, smoking status, diabetes status, study design, and study site.
RESULTS
Coffee drinkers had a lower risk of EC than non-coffee drinkers (multiadjusted OR: 0.87; 95% CI: 0.79, 0.95). There was a dose-response relation between higher coffee consumption and lower risk of EC: compared with non-coffee drinkers, the adjusted pooled ORs for those who drank 1, 2-3, and >4 cups/d were 0.90 (95% CI: 0.82, 1.00), 0.86 (95% CI: 0.78, 0.95), and 0.76 (95% CI: 0.66, 0.87), respectively (P-trend < 0.001). The inverse association between coffee consumption and EC risk was stronger in participants with BMI > 25 kg/m.
CONCLUSIONS
The results of the largest analysis to date pooling individual-level data further support the potentially beneficial health effects of coffee consumption in relation to EC, especially among females with higher BMI.
背景
流行病学研究表明，咖啡的摄入可能与子宫内膜癌（EC）的风险呈负相关，EC 是发达国家最常见的妇科恶性肿瘤。此外，咖啡的摄入可能会降低循环中雌激素和胰岛素的浓度，而这两种激素都与子宫内膜癌变有关。咖啡中的抗氧化剂和其他化学预防化合物可能具有抗癌作用。基于现有的荟萃分析，世界癌症研究基金会（WCRF）得出结论，咖啡的摄入可能有助于预防 EC。
目的
我们的主要目的是通过 pooled 分析合并个体水平数据来检验咖啡摄入与 EC 风险之间的关联。我们还试图评估其他 EC 风险因素的潜在效应修饰作用。
方法
我们合并了来自癌症研究基金会（WCRF）子宫内膜癌流行病学合作组（E2C2）的 19 项流行病学研究（6 项队列研究，13 项病例对照研究）的个体水平数据，共纳入了 12159 例 EC 病例和 27479 名对照。使用 logistic 回归计算 OR 值及其对应的 95%置信区间（CI）。所有模型均调整了潜在混杂因素，包括年龄、种族、BMI、吸烟状况、糖尿病状况、研究设计和研究地点。
结果
与不喝咖啡的人相比，喝咖啡的人 EC 风险较低（多因素调整后的 OR：0.87；95%CI：0.79，0.95）。随着咖啡摄入量的增加，EC 风险呈下降趋势：与不喝咖啡的人相比，每天饮用 1、2-3 和 >4 杯咖啡的调整后 pooled OR 分别为 0.90（95%CI：0.82，1.00）、0.86（95%CI：0.78，0.95）和 0.76（95%CI：0.66，0.87）（P 趋势<0.001）。在 BMI>25kg/m2 的参与者中，咖啡摄入与 EC 风险之间的负相关关系更强。
结论
这是迄今为止最大的个体水平数据 pooled 分析，进一步支持了咖啡摄入与 EC 之间可能存在有益的健康关联，尤其是对于 BMI 较高的女性。
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