中国人群体重指数与食管癌发病风险的Meta分析

摘要:目的　探讨中国人群肥胖与食管癌发病风险的关系，评估BMI与食管癌发病风险的剂量反应关系。方法　系统性检索国内外公开发表的有关中国人群BMI与食管癌发病关系的中英文文献，并辅以文献追溯等方法，检索数据库包括中国知网、万方数据知识服务平台、PubMed、Embase和Google Scholar，时间范围从各数据库建库至2014年9月，共检索到60篇文献。采用Meta分析方法计算肥胖与食管癌发病风险的合并OR值（95%CI），运用最小二乘估计方法（GLST）估计BMI与食管癌发病风险的剂量反应关系。结果　最终纳入文献5篇，纳入食管癌病例7 215例。Meta分析结果表明，肥胖与中国人群食管癌发病风险呈负相关（OR＝0.56，95%CI:0.35～0.90），并且这种负相关不受研究类型、地区、BMI获取方式和病例来源的影响。BMI与食管癌发病风险呈线性剂量反应关系，BMI每增加5 kg/m2食管癌发病风险降低（OR＝0.57，95%CI:0.54～0.60）。结论　本次Meta分析结果显示高BMI是中国人群食管癌发病的一个保护性因素。

A meta-analysis on BMI and the risk of esophageal cancer in the Chinese population

Abstract: Objective To estimate the association between obesity and the risk of esophageal cancer and evaluate a dose-response relationship between BMI and incidence risk of esophageal cancer in the Chinese population. Methods A systematic literature search for BMI and incidence risk of esophageal cancer in the Chinese population in both Chinese and English language, as well as through the reference lists of retrieved articles. The literature databases including CNKI, Wanfang, PubMed, Embase and Google Scholar. Time range was from the founding of each database to September 2014 and a total of 60 research papers were collected. Meta-analysis was conducted to calculate pooled odds ratio and corresponding 95% confidence intervals. Generalized least-squares regression methods were used to make a dose-response meta-analysis between BMI and incidence risk of esophageal cancer. Results Five studies were included in the meta-analysis, with a number of 7215 esophageal cancer cases. Results showed that obesity was inversely associated with esophageal cancer incidence (OR=0.56, 95%CI: 0.35-0.90). The association did not change with stratification by study design, regions, BMI measurement method and study population. A linear dose-response association between BMI and risk of esophageal cancer was visually significant, and esophageal cancer risk would be reduced for per 5kg/m2 BMI increase (OR=0.57, 95%CI: 0.54-0.60). Conclusion The results of this meta-analysis indicate that higher BMI is a protective factor against esophageal cancer.