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β-胡萝卜素补充与癌症风险的关联:随机对照试验的荟萃分析。

Association between β-carotene supplementation and risk of cancer: a meta-analysis of randomized controlled trials.

机构信息

Vanke School of Public Health, Tsinghua University, Beijing, China.

Department of Nutrition and Food Studies, New York University, New York, USA.

出版信息

Nutr Rev. 2023 Aug 10;81(9):1118-1130. doi: 10.1093/nutrit/nuac110.

Abstract

CONTEXT

β-Carotene, which is derived from most fruits and vegetables, is the most common type of carotenes. Existing studies have demonstrated that β-carotene is associated with some positive health outcomes. However, results about the effects of supplemental β-carotene on cancer are inconsistent.

OBJECTIVE

To determine the association between supplemental β-carotene intake and the risk of cancers.

DATA SOURCES

Eight databases (PubMed, Web of Science, Embase, Cochrane, China National Knowledge Infrastructure, Wangfang, China Science and Technology Journal Database, and Chinese Biomedical Literature Database) were systematically searched until September 2022.

DATA EXTRACTION

Only reports from randomized controlled trials in which an association between supplemental β-carotene intake and the risk of cancer was found were included in the meta-analysis.

DATA ANALYSIS

A total of 18 eligible studies based on 8 different randomized controlled trials were included in the meta-analysis, with varying sample sizes from 391 to 39 876 participants. There was no significant association between supplemental β-carotene intake and overall cancer incidence rate after synthesizing all the results (risk ratio [RR]: 1.02; 95% confidence interval [CI], 0.99-1.05). Results from subgroup analysis indicated that intake of supplemental β-carotene significantly increased the risk of lung cancer (RR: 1.19; 95%CI: 1.08-1.32), whereas no significant associations were observed for other site-specific cancers. In addition, smokers and the subgroup of participants with only low-dose β-carotene intake had a risk increment of cancer if they took supplemental β-carotene (RR: 1.16; 95%CI: 1.05-1.29).

CONCLUSION

β-Carotene supplementation has no beneficial or harmful effect on cancer incidence; moreover, it might have potentially harmful effects on lung cancer, especially for people who smoke. On the basis of the evidence from this study, supplemental intake of β-carotene is not recommended for preventing cancer, and the establishment of a tolerable upper intake level of β-carotene should be considered.

摘要

背景

β-胡萝卜素存在于大多数水果和蔬菜中,是最常见的类胡萝卜素。现有研究表明,β-胡萝卜素与一些健康结果呈正相关。然而,关于补充β-胡萝卜素对癌症影响的结果并不一致。

目的

确定补充β-胡萝卜素摄入与癌症风险之间的关联。

资料来源

系统检索了 8 个数据库(PubMed、Web of Science、Embase、Cochrane、中国知网、万方、中国科技期刊数据库和中国生物医学文献数据库),截至 2022 年 9 月。

资料提取

仅纳入了补充β-胡萝卜素摄入与癌症风险之间存在关联的随机对照试验报告,并进行了荟萃分析。

资料分析

共纳入了 18 项基于 8 项不同随机对照试验的合格研究,纳入的研究样本量从 391 例到 39876 例不等。综合所有结果,补充β-胡萝卜素摄入与总体癌症发生率之间无显著关联(风险比 [RR]:1.02;95%置信区间 [CI]:0.99-1.05)。亚组分析结果表明,补充β-胡萝卜素显著增加了肺癌的发病风险(RR:1.19;95%CI:1.08-1.32),而其他部位的特定癌症则无显著相关性。此外,吸烟者和仅低剂量β-胡萝卜素摄入的亚组人群,如果补充β-胡萝卜素,癌症风险会增加(RR:1.16;95%CI:1.05-1.29)。

结论

β-胡萝卜素补充剂对癌症发病率既无有益影响也无有害影响;此外,它可能对肺癌有潜在的有害影响,尤其是对吸烟者。基于本研究的证据,不建议补充β-胡萝卜素来预防癌症,应考虑建立β-胡萝卜素的可耐受最高摄入量。

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