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目的系统评价青春期摄入豆类食品对女性成年后乳腺癌发病影响。方法计算机检索Cochrane Library、MEDLINE、EMbase、CNKI、VIP、WanFang Data和CBM中关于青春期食用豆类食品对女性成年后乳腺癌发病影响的队列研究和病例对照研究,同时追索纳入文献的参考文献。文献检索起止时间均为从建库至2011年8月。由两名研究者严格按照纳入和排除标准筛选文献、提取资料,并根据Cochrane协作网推荐的Newcastle-Ottawa scale(NOS)和GRADE系统推荐的分级方法进行质量评价,对符合标准的研究进行Meta分析。最后采用Stata 11.0和GRADE pro ler 3.2.2软件进行统计分析。结果共纳入6个研究,6609例病例和79538例对照。Meta分析结果显示,青春期食用豆类食品较多的女性比青春期不食用或很少食用豆类食品的女性成年后乳腺癌的发病风险低[OR=0.816,95%CI(0.670,0.993)]。亚组分析结果显示,青春期豆类食品的摄入对绝经前乳腺癌的预防作用[OR=0.661,95%CI(0.550,0.796)]强于绝经后[OR=0.782,95%CI(0.486,1.259)];而无论东、西方女性摄入豆类食品均受益[OR=0.793,95%CI(0.569,1.105);OR=0.837,95%CI(0.743,0.943)]。结论青春期食用豆类食品对女性成年后乳腺癌发病可能具有一定的预防作用,且对绝经前乳腺癌的预防作用尤其明显,而无论东、西方女性均受益。受纳入研究数量与质量的限制,上述结论尚需进一步验证。
Objective To evaluate the effect of adolescent intake of legumes on the incidence of breast cancer in adulthood. Methods Cochrane Library, MEDLINE, EMbase, CNKI, VIP, WanFang Data and CBM were used to search the cohort and case-control studies on the influence of adolescent edible legumes on the incidence of breast cancer in women. Document search start and end time are from the database to August 2011. Two researchers screened the literature strictly according to inclusion and exclusion criteria, extracted data, and evaluated the quality according to the Newcastle-Ottawa scale (NOS) recommended by the Cochrane Collaboration and the graded approach recommended by the GRADE system. Meta-analysis was performed on eligible studies . Finally, Stata 11.0 and GRADE pro ler 3.2.2 software for statistical analysis. Results A total of 6 studies, 6609 cases and 79,538 controls were included. Meta-analysis showed that women with more adolescent legumes had a lower risk of developing breast cancer than those without puberty or legumes [OR = 0.816, 95% CI (0.670, 0.993)]. Subgroup analysis showed that the preventive effect of adolescent legumes on premenopausal breast cancer [OR = 0.661,95% CI (0.550,0.796]] was stronger than that of menopause (OR = 0.782, 95% CI 0.486, 1.259)]. However, both East and West women benefited from the intake of legumes [OR = 0.793,95% CI (0.569,1.105); OR = 0.837,95% CI (0.743,0.943)]. Conclusion Adolescent consumption of legumes may have a preventive effect on the incidence of breast cancer in adulthood, especially for premenopausal breast cancer, both eastern and western women. Subject to the limitations on the quantity and quality of the studies, the above conclusion still needs to be further verified.