Kaiser Isabelle, Rappl Anja, Bolay Lena S, Pfahlberg Annette B, Heppt Markus V, Gefeller Olaf
Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany.
Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany.
Nutrients. 2025 Apr 8;17(8):1296. doi: 10.3390/nu17081296.
BACKGROUND/OBJECTIVES: Furocoumarins, chemical compounds found in many plant species, have a photosensitizing effect on the skin when applied topically and, by interacting with ultraviolet radiation (UVR), stimulate melanoma cells to proliferate. Whether dietary intake of furocoumarins acts as a melanoma risk factor has been investigated in several epidemiological studies, which are synthesized in our systematic review.
The study protocol was registered with PROSPERO (registration number: CRD42023428596). We conducted an in-depth literature search in three databases coupled with forward and backward citation tracking and expert consultations to identify all epidemiological studies, irrespective of their design, addressing the association between a furocoumarin-containing diet and melanoma risk. We extracted information on the study details and results in a standardized manner and evaluated the risk of bias of the results using the Joanna Briggs Institute's critical appraisal tools.
We identified 20 publications based on 19 different studies providing information on the association between dietary furocoumarin intake and melanoma risk. We refrained from a meta-analytical synthesis of the results because of the large heterogeneity in exposure assessment, operationalization of furocoumarin intake in the analyses, and analytical methods of the studies. In a qualitative synthesis, we found moderate evidence supporting the notion that dietary furocoumarin intake at higher levels acts as a risk factor for cutaneous melanoma.
Our systematic review provides an overview of the current epidemiological evidence, but it could not clearly answer whether and to what extent dietary furocoumarin intake increases melanoma risk. Future epidemiological analyses focusing on this topic require more comprehensive dietary and UVR exposure data to better characterize the individual total furocoumarin intake and its interplay with UVR exposure patterns.
背景/目的：补骨脂素是在许多植物物种中发现的化合物，局部应用时对皮肤具有光敏作用，并且通过与紫外线（UVR）相互作用，刺激黑色素瘤细胞增殖。饮食中补骨脂素的摄入是否为黑色素瘤的危险因素已在多项流行病学研究中进行了调查，本系统评价对这些研究进行了综合分析。
该研究方案已在国际前瞻性系统评价注册库（PROSPERO）注册（注册号：CRD42023428596）。我们在三个数据库中进行了深入的文献检索，并结合向前和向后的引文追踪以及专家咨询，以识别所有流行病学研究，无论其设计如何，均涉及含补骨脂素饮食与黑色素瘤风险之间的关联。我们以标准化方式提取了有关研究细节和结果的信息，并使用乔安娜·布里格斯研究所的批判性评价工具评估了结果的偏倚风险。
我们基于19项不同研究确定了20篇出版物，这些研究提供了饮食中补骨脂素摄入量与黑色素瘤风险之间关联的信息。由于暴露评估、分析中补骨脂素摄入量的操作化以及研究的分析方法存在很大异质性，我们没有对结果进行荟萃分析。在定性综合分析中，我们发现有适度证据支持以下观点：较高水平的饮食中补骨脂素摄入是皮肤黑色素瘤的危险因素。
我们的系统评价概述了当前的流行病学证据，但无法明确回答饮食中补骨脂素的摄入是否以及在多大程度上会增加黑色素瘤风险。未来针对该主题的流行病学分析需要更全面的饮食和UVR暴露数据，以更好地描述个体补骨脂素的总摄入量及其与UVR暴露模式的相互作用。
