Van Puyvelde Heleen, Dimou Niki, Katsikari Aikaterini, Indave Ruiz Blanca Iciar, Godderis Lode, Huybrechts Inge, De Bacquer Dirk
Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, 4K3, 9000 Ghent, Belgium; Research Foundation - Flanders (FWO), Egmontstraat 5, 1000 Brussels, Belgium; Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35 blok D box 7001, 3000 Leuven, Belgium.
Nutrition and Metabolism Branch, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon CEDEX 08, France.
Cancer Epidemiol. 2023 Apr;83:102322. doi: 10.1016/j.canep.2023.102322. Epub 2023 Jan 24.
This study evaluates the associations between dietary intakes and circulating blood levels of methionine, choline or betaine and breast cancer risk, which remains currently unclear.
Systematic searches for observational epidemiological studies were performed of the MEDLINE, Embase, and Web of Science databases through July, 2022. Two review authors independently screened titles and abstracts against the eligibility criteria at a first stage, and screened full texts of potentially eligible records at a second stage, followed by data extraction from qualified studies. Quality of evidence was assessed using the Newcastle-Ottawa scale quality assessment tool. Risk estimates were calculated using random-effects meta-analysis.
In total, 21 studies were selected for qualitative analyses and 18 studies were included in the meta-analyses. Random-effects analysis combining prospective cohort (N = 8) or case-control studies (N = 10) showed little evidence of an association between dietary intake of methionine or betaine and the risk of breast cancer. However, inconclusive evidence for a significant inverse association between choline intake and breast cancer risk was found in case-control studies (odds ratio [OR] estimates for highest vs. lowest intakes = 0.38; 95 % CI: 0.16-0.86) but not in prospective cohort studies (hazard ratio [HR] estimates for highest vs. lowest intakes = 1.01; 95 % CI: 0.92-1.12).
This study did not suggest an effect of dietary intake of methionine, choline, nor betaine on breast cancer risk, mainly due to the lack of precision of the combined risk estimates as few studies are available. To overcome this uncertainty, more well-designed studies with relevant individual-level covariates are needed.
本研究评估了膳食摄入量与蛋氨酸、胆碱或甜菜碱的循环血液水平之间的关联以及乳腺癌风险，目前这一关联尚不清楚。
对MEDLINE、Embase和Web of Science数据库进行系统检索，截至2022年7月。两位综述作者在第一阶段根据纳入标准独立筛选标题和摘要，在第二阶段筛选潜在合格记录的全文，随后从合格研究中提取数据。使用纽卡斯尔-渥太华量表质量评估工具评估证据质量。使用随机效应荟萃分析计算风险估计值。
总共选择了21项研究进行定性分析，18项研究纳入荟萃分析。结合前瞻性队列研究（N = 8）或病例对照研究（N = 10）的随机效应分析显示，几乎没有证据表明膳食中蛋氨酸或甜菜碱的摄入量与乳腺癌风险之间存在关联。然而，在病例对照研究中发现胆碱摄入量与乳腺癌风险之间存在显著负相关的证据不明确（最高摄入量与最低摄入量的比值比[OR]估计值 = 0.38；95%可信区间：0.16 - 0.86），但在前瞻性队列研究中未发现（最高摄入量与最低摄入量的风险比[HR]估计值 = 1.01；95%可信区间：0.92 - 1.12）。
本研究未表明膳食中蛋氨酸、胆碱或甜菜碱的摄入量对乳腺癌风险有影响，主要原因是由于可用研究较少，合并风险估计的精度不足。为克服这种不确定性，需要更多设计良好且包含相关个体水平协变量的研究。
