饮食因素与结直肠锯齿状息肉之间的关联：一项系统评价和荟萃分析。
Association between dietary factors and colorectal serrated polyps: a systematic review and meta-analysis.
作者信息
Zhu Zhixin, Guan Xifei, Liu Nawen, Zhu Xiaoxia, Dai Sheng, Xiong Dehai, Li Xiuyang
机构信息
Department of Big Data in Health Science, and Center for Clinical Big Data and Statistics, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
Department of General Surgery, School of Medicine, Run Run Shaw Hospital, Zhejiang University, Hangzhou, Zhejiang, China.
出版信息
Front Nutr. 2023 Jul 27;10:1187539. doi: 10.3389/fnut.2023.1187539. eCollection 2023.
BACKGROUND
Dietary factors may affect the incidence of colorectal serrated polyps (SP). However, its effects on SP are unclear as epidemiological studies on this topic have showed inconsistent results. The present systematic review and meta-analysis sought to evaluate the effects of dietary factors on SPs.
METHODS
Studies regarding the association between dietary factors and SPs were identified by searching PubMed, Cochrane library, Embase and Chinese Biomedical Literature database from inception until 27 February 2023. Search terms include serrated, hyperplastic, adenoma, polyps, colorectal, rectal, rectum and risk. Heterogeneity was assessed using statistics. The meta-analysis was conducted by using a random-effects model, and the pooled effects were expressed with odds ratios (OR) and 95% confidence intervals (95% CI). Probable sources of heterogeneity were identified through meta-regression. Subgroup analysis were based on lesion types, study designs, countries, and so on.
RESULTS
28 studies were ultimately eligible after scanning, and five dietary factors including vitamin D, calcium, folate, fiber and red or processed meat were excerpted. Higher intakes of vitamin D (OR = 0.95, 95%CI:0.90-1.02), calcium (OR = 0.97, 95%CI: 0.91-1.03) and folate (OR = 0.82, 95% CI: 0.6-1.13) were not significantly associated with SP. Fiber intake (OR = 0.90, 95% CI: 0.82-0.99) was a protective factor against SPs. Red meat intake increased the risk of SPs by 30% for the highest versus lowest intakes (OR = 1.30, 95% CI: 1.13-1.51). For different lesion types, higher folate intake was associated with a decreased risk of HPs (OR = 0.59, 95%CI: 0.44-0.79), and higher vitamin D intake decreased the risk of SPs including SSA/P (OR = 0.93, 95%CI: 0.88-0.98).
CONCLUSIONS
Higher dietary fiber intake plays an effective role in preventing SP, while red meat intake is associated with an increased risk of SP. This evidence provides guidance for us to prevent SP from a dietary perspective.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?, RecordID=340750.
背景
饮食因素可能影响结直肠锯齿状息肉（SP）的发病率。然而，由于关于这一主题的流行病学研究结果不一致，其对SP的影响尚不清楚。本系统评价和荟萃分析旨在评估饮食因素对SP的影响。
方法
通过检索PubMed、Cochrane图书馆、Embase和中国生物医学文献数据库，确定从数据库建立至2023年2月27日期间关于饮食因素与SP之间关联的研究。检索词包括锯齿状、增生性、腺瘤、息肉、结直肠、直肠、直肠和风险。使用统计学方法评估异质性。采用随机效应模型进行荟萃分析，合并效应以比值比（OR）和95%置信区间（95%CI）表示。通过荟萃回归确定可能的异质性来源。亚组分析基于病变类型、研究设计、国家等。
结果
经筛选，最终纳入28项研究，并提取了包括维生素D、钙、叶酸、纤维和红肉或加工肉在内的5种饮食因素。维生素D摄入量较高（OR = 0.95，95%CI：0.90 - 1.02）、钙摄入量较高（OR = 0.97，95%CI：0.91 - 1.03）和叶酸摄入量较高（OR = 0.82，95%CI：0.6 - 1.13）与SP无显著关联。纤维摄入量（OR = 0.90，95%CI：0.82 - 0.99）是预防SP的保护因素。红肉摄入量最高组与最低组相比，SP风险增加30%（OR = 1.30，95%CI：1.13 - 1.51）。对于不同病变类型，叶酸摄入量较高与增生性息肉（HP）风险降低相关（OR = 0.59，95%CI：0.44 - 0.79），维生素D摄入量较高降低包括锯齿状腺瘤/息肉（SSA/P）在内的SP风险（OR = 0.93，95%CI：0.88 - 0.98）。
结论
较高的膳食纤维摄入量在预防SP方面发挥有效作用，而红肉摄入量与SP风险增加相关。这一证据为我们从饮食角度预防SP提供了指导。
系统评价注册
https://www.crd.york.ac.uk/prospero/display_record.php?，记录编号 = 340750。
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