n-3及n-6多不饱和脂肪酸与乳腺癌关系的Meta分析

目的 系统评价n-3多不饱和脂肪酸(n-3PUFAs)、n-6多不饱和脂肪酸(n-6PUFAs)及其比例与乳腺癌发病风险的关系。方法 系统检索Pubmed、Embase、Web of Science、知网、万方等数据库截止至2022年1月1日有关n-3及n-6多不饱和脂肪酸与乳腺癌关系的研究,对最终纳入的文献进行数据提取与质量评价,采用Stata 15.1软件进行Meta分析。结果 共纳入33项针对n-3及n-6PUFAs和乳腺癌发病风险关联的观察性流行病学研究,其中队列研究14项,病例对照研究20项,共纳入研究对象1 077 178例,患者19 207例。Meta分析结果显示:n-3多不饱和脂肪酸(OR=0.933,95%CI:0.858～1.014)、n-6多不饱和脂肪酸(OR=1.018,95%CI:0.914～1.133)与乳腺癌发病风险无统计学关联(P>0.05),而较高的n-6/n-3PUFAs比值会显著增加乳腺癌的发病风险(OR=1.166,95%CI:1.047～1.299,P=0.005)。结论 n-6/n-3多不饱和脂肪酸的比值与乳腺癌的发病风险呈正相关,提示合理的膳食脂肪摄入比可能会降低乳腺癌的患病风险。而n-3及n-6多不饱和脂肪酸与乳腺癌发病风险的单独效应关系尚不明确,仍需更多前瞻性实验流行病学证据进行支持。

Meta-analysis of n-3 polyunsaturated fatty acids and n-6 polyunsaturated fatty acids with the risk of breast cancer

Objective To systematically evaluate the relationship between n-3 polyunsaturated fatty acids(n-3 PUFAs), n-6 polyunsaturated fatty acids(n-6 PUFAs)and the risk of breast cancer. Methods The Pubmed, Embase, Web of Science, CNKI, Wanfang Data were searched for literature on the relationship between n-3 polyunsaturated fatty acids//n-6 polyunsaturated fatty acids and risk of breast cancer up to January 1, 2022. Data extraction and quality evaluation of the final included literature were carried out, and a meta-analysis was performed using Stata 15.1 software. Results A total of 35 observational epidemiological studies on the association between n-3PUFAs/n-6PUFAs and the risk of breast cancer were included. There were 14 cohort studies and 20 case-control studies. A total of 1 077 178 subjects were included, including 19 207 patients. Meta-analysis results showed that intake of n-3 PUFAs(OR=0.933,95%CI:0.858-1.014)and n-6 PUFAs(OR=1.018,95%CI:0.914-1.133)had no statistical significance on the risk of breast cancer(P>0.05). However, increased intake of n-6/n-3PUFAs could significantly increase the risk of breast cancer(OR=1.166,95%CI:1.047-1.299, P=0.005). Conclusion The ratio of n-6/n-3 PUFAs is positively correlated with the risk of breast cancer, suggesting that a reasonable dietary fat intake may reduce the risk of breast cancer. However, the single effect between n-3 PUFAs or n-6 PUFAs on the risk of breast cancer is unclear, and more prospective epidemiological evidence is thus needed.