Flinders University, College of Medicine and PublicHealth, Flinders Health and Medical Research Institute, Adelaide, South Australia, Australia; Department of Biochemistry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Flinders University, College of Medicine and PublicHealth, Flinders Health and Medical Research Institute, Adelaide, South Australia, Australia; Gastroenterology and Hepatology Department, Flinders Medical Centre, Southern Adelaide Local Health Network, Bedford Park, South Australia, Australia.
Crit Rev Oncol Hematol. 2024 Dec;204:104502. doi: 10.1016/j.critrevonc.2024.104502. Epub 2024 Sep 6.
The association between metabolic factors and colorectal cancer (CRC) risk is inconclusive. This umbrella review aimed to summarise and describe the association using existing systematic reviews and/or meta-analyses.
Four databases (Medline, Scopus, Web of Science, and Cochrane Library) were searched for systematic reviews and/or meta-analyses of observational studies. Two independent authors extracted data on the summary estimated effect and heterogeneity of studies using I from the individual reviews. The Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2) tool was used to evaluate the methodological quality.
49 articles were included in this review. Although most included studies were graded with critically low methodological quality (81.6 %), we found a significant positive association between obesity (summary relative risk (SRR) range 1.19-1.49), diabetes mellitus (SRR range 1.20-1.37), hypertension (SRR range 1.07-1.62), metabolic syndrome (SRR range 1.25-1.36), non-alcoholic fatty liver disease (pooled odds ratio (POR) range 1.13-1.56), and risk of CRC. Higher serum high-density lipoprotein cholesterol levels were associated with a lower risk of CRC in 3/6 reviews, while others did not find any association. There was no clear association between high triglyceride levels, total cholesterol levels, low-density lipoprotein cholesterol levels, and risk of CRC.
This umbrella review identified that most metabolic factors are significantly associated with increased risk of CRC. Thus, people affected by metabolic factors may be benefited from CRC screening and surveillance.
代谢因素与结直肠癌（CRC）风险之间的关联尚无定论。本综述旨在总结和描述使用现有系统评价和/或荟萃分析的关联。
在 Medline、Scopus、Web of Science 和 Cochrane Library 四个数据库中搜索观察性研究的系统评价和/或荟萃分析。两位独立作者使用个体综述中的 I 来提取关于汇总估计效应和研究异质性的数据。使用评估系统评价方法学质量（AMSTAR 2）工具评估方法学质量。
本综述共纳入 49 篇文章。尽管大多数纳入的研究方法学质量被评为极低（81.6%），但我们发现肥胖（汇总相对风险（SRR）范围 1.19-1.49）、糖尿病（SRR 范围 1.20-1.37）、高血压（SRR 范围 1.07-1.62）、代谢综合征（SRR 范围 1.25-1.36）、非酒精性脂肪性肝病（汇总优势比（POR）范围 1.13-1.56）与 CRC 风险呈显著正相关。6 项综述中有 3 项表明，较高的血清高密度脂蛋白胆固醇水平与 CRC 风险降低相关，而其他综述则未发现任何关联。高甘油三酯水平、总胆固醇水平、低密度脂蛋白胆固醇水平与 CRC 风险之间没有明确的关联。
本综述确定大多数代谢因素与 CRC 风险增加显著相关。因此，受代谢因素影响的人群可能受益于 CRC 筛查和监测。
