Seyyedsalehi Monireh Sadat, Mohebbi Elham, Tourang Fatemeh, Sasanfar Bahareh, Boffetta Paolo, Zendehdel Kazem
Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy.
Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran 1419733141, Iran.
Toxics. 2023 Feb 17;11(2):190. doi: 10.3390/toxics11020190.
N-nitroso compounds (NOCs) are a class of chemical carcinogens found in various environmental sources such as food, drinking water, cigarette smoke, the work environment, and the indoor air population. We conducted a systematic review and meta-analysis to investigate the links between nitrate, nitrite, and NOCs in food and water and the risk of gastrointestinal (GI) cancers, including esophageal cancer (EC), gastric cancer (GC), colorectal cancer (CRC), and pancreatic cancer (PC). A systematic search of the literature in Scopus, PubMed, Google Scholar, Web of Science, ScienceDirect, and Embase was performed for studies on the association between NOCs in drinking water and food sources and GI cancers. Forest plots of relative risk (RR) were constructed for all the cancer sites and the intake sources. The random-effects model was used to assess the heterogeneity between studies. Forty articles were included after removing duplicate and irrelevant articles. The meta-analysis indicated that the intake of high dose vs. low dose of these compounds was significantly associated with the overall GI cancer risk and nitrite (RR = 1.18, 95% CI = 1.07-1.29), and N-nitrosodimethylamine (NDMA) (RR = 1.32, 95% CI = 1.06-1.65). We found that dietary nitrite intake increased GC (RR = 1.33, 95% CI = 1.02-1.73), and EC (RR = 1.38, 95% CI = 1.01-1.89). Additionally, dietary NDMA intake increased the risk of CRC (RR = 1.36, 95% CI = 1.18-1.58). This meta-analysis provides some evidence that the intake of dietary and water nitrate, nitrite, and NOCs may be associated with GI cancers. In particular, dietary nitrite is linked to GC and EC risks and dietary NDMA intake is associated with CRC.
N-亚硝基化合物（NOCs）是一类化学致癌物，存在于各种环境来源中，如食物、饮用水、香烟烟雾、工作环境和室内空气。我们进行了一项系统综述和荟萃分析，以研究食物和水中的硝酸盐、亚硝酸盐和NOCs与胃肠道（GI）癌症风险之间的联系，包括食管癌（EC）、胃癌（GC）、结直肠癌（CRC）和胰腺癌（PC）。我们在Scopus、PubMed、谷歌学术、科学网、ScienceDirect和Embase中对饮用水和食物来源中的NOCs与GI癌症之间关联的研究进行了系统检索。针对所有癌症部位和摄入来源构建了相对风险（RR）的森林图。采用随机效应模型评估研究之间的异质性。在去除重复和不相关的文章后，纳入了40篇文章。荟萃分析表明，高剂量与低剂量摄入这些化合物与总体GI癌症风险以及亚硝酸盐（RR = 1.18，95%CI = 1.07 - 1.29）和N-亚硝基二甲胺（NDMA）（RR = 1.32，95%CI = 1.06 - 1.65）显著相关。我们发现，膳食亚硝酸盐摄入量增加会导致GC（RR = 1.33，95%CI = 1.02 - 1.73）和EC（RR = 1.38，95%CI = 1.01 - 1.89）风险增加。此外，膳食NDMA摄入量增加会导致CRC风险增加（RR = 1.36，95%CI = 1.18 - 1.58）。这项荟萃分析提供了一些证据，表明膳食和水中硝酸盐、亚硝酸盐和NOCs的摄入可能与GI癌症有关。特别是，膳食亚硝酸盐与GC和EC风险相关，而膳食NDMA摄入量与CRC相关。
