脂肪酸的摄入与子宫内膜癌相关性的荟萃分析

目的: 系统评价脂肪的摄入与子宫内膜癌发病风险间的相关性。方法: 采用计算机检索PubMed、Web of science、EMbase、CBM、维普数据库、万方数据库,查找有关脂肪酸摄入与子宫内膜癌发病风险间相关性的流行病研究,文献检索时限至2016年6月止。所有文献均由2位研究者严格地按照纳入和排除标准筛选和提取,采用Stata 11.0软件分别对总脂肪、饱和脂肪酸、多不饱和脂肪酸及单一不饱和脂肪酸进行荟萃分析。结果: 最终纳入16篇研究,共6 480个研究对象。结果显示,与低摄入量人群相比,高总脂肪[OR=1.22,95%CI为1.02~1.46）、高饱和脂肪酸（OR=1.21,95%CI为1.00~1.47）摄入均增加了子宫内膜癌的发病危险。在亚型分析中,病例对照组合并OR值后亦显示,高总脂肪（OR=1.39,95%CI为1.14~1.70）、高饱和脂肪酸（OR=1.34,95%CI为1.13~1.60）摄入增加了子宫内膜癌的发病危险;在队列研究中未发现总脂肪酸水平与子宫内膜癌发病间具有相关性。在美国（OR=1.39,95%CI为1.00~1.93）的高能量饮食摄入人群（OR=2.17,95%CI为1.57~2.99）和吸烟人群（OR=1.30,95%CI为1.04~1.62）中,饱和脂肪酸高摄入均增加了子宫内膜癌的发病风险。结论: 病例对照研究显示,高摄入总脂肪及饱和脂肪酸升高了子宫内膜癌的发病风险。美国的高能量饮食摄入人群及吸烟人群中,饱和脂肪酸高摄入增加子宫内膜癌的发病风险。但尚未发现不饱和脂肪酸与子宫内膜癌发生间存在相关性。仍需纳入更多的流行病学研究,以探讨脂肪摄入与子宫内膜癌间的相关性。

Dietary fat and risk of endometrial cancer: A meta-analysis

Objective: To evaluate the relationship between dietary fat and risk of endometrial cancer (EC). Methods: This meta-analysis was a systematic review of literature published up to June, 2016. Data from PubMed, Web of Science, EMbase, CBM, VIP, and WanFang Data were retrieved and analyzed the relationship between dietary fat and risk of endometrial cancer. All literatures retrieved were screened and extracted according to the inclusion and exclusion criteria by two researchers independently using Stata 11.0 software. The meta-analysis was performed by study design of fat types (total fat, saturated fat, monounsaturated fat and polyunsaturated fat). Results: A total of 15 studies involving 6 480 participants were included. Compared with low intake of fat, high intake of total fat, saturated fat led to a higher risk of endometrial cancer [OR=1.22, 95%CI: 1.02-1.46; OR=1.21, 95%CI: 1.00-1.41]. According to subgroup analysis, the OR for case-control studies were 1.39 (95%CI: 1.14-1.70) in total fat and 1.34 (95%CI: 1.13-1.60) in saturated fat. The summarized RR based on cohort studies was 0.80(0.65-0.98) for total fat. Positive correlation between dietary saturated fat intake and risk of endometrial cancer was observed in studies in United States (OR=1.39, 95%CI: 1.00-1.93), also with high total energy intake（OR=2.17, 95%CI: 1.57-2.99) and smokers(OR=1.30, 95%CI: 1.04-1.62). Conclusions: The meta-analysis of case-control studies reveal that high intake of total fat and saturated fat increase the risk of endometrial cancer. The results of subtype analysis also indicate that high saturated fat intake might increase the risk of endometrial cancer in smoking and high energy intake group. Additional experimental and epidemiological studies with larger participants worldwide are necessary to validate the association between fat intake and risk of endometrial cancer.