代谢综合征与子宫内膜癌发病风险的Meta分析

    Metabolic Syndrome and Risk of Endometrial Cancer: A Meta-Analysis

    • 摘要: 目的 探讨代谢综合征与子宫内膜癌发病风险的关系。 方法 计算机检索中国生物医学文献数据库。中国知网、万方、PubMed、Web of Science和Cochrane图书馆等数据库,收集2014年10月以前发表的关于子宫内膜癌与代谢综合征关系的符合纳入标准的队列研究及病例对照研究,由两位评价员按纳入与排除标准独立筛选文献、提取资料并用卡斯尔-渥太华量表评价质量后,用 Stata 12.0软件进行统计分析,采用Q检验和I2进行异质性检验。 结果 纳入5个研究,参与者428 665人,包括3 112例子宫内膜癌患者。代谢综合征与子宫内膜癌发病风险增加密切相关相对危险度=1.96,95%可信区间(1.32,2.89),P=0.001;异质性检验提示,研究间存在明显异质性 (I2=94%,P=0.000),Meta分析采用随机效应模型;Egger’s 检验分析结果提示无发表偏倚(P=0.240);敏感性分析提示剔除2个研究后, 异质性显著下降 (I2=14.2%,P=0.312)。亚组分析显示,高体重指数/高腰围患子宫内膜癌的相对危险度为1.86(P<0.001),高血糖/糖尿病患子宫内膜癌的相对危险度为1.81 (P=0.044),高血压患子宫内膜癌的相对危险度为1.81(P=0.024),高甘油三酯患子宫内膜癌的相对危险度为1.17 (P<0.001),高密度脂蛋白胆固醇低与子宫内膜癌发病风险关系不大(P=0.259)。 结论 代谢综合征为子宫内膜癌的危险因素,其中,肥胖/高腰围与子宫内膜癌的关系最为密切。

       

      Abstract: Objective To assess the association between metabolic syndrome and risk of endometrial cancer. Methods We searched references from CBM、CNKI、Wangfang、PubMed、Web of Science and Cochrane Library before October 2014 to select articles on the association between metabolic syndrome and risk of endometrial cancer which met initial criteria. Two evaluators independently reviewed and selected articles based on predetermined selection criteria and assessed articles with Newcastle-Ottawa Quality Scale. Stata 12.0 was used to conduct meta-analysis. Q test and I2 were used to conduct heterogeneity test. Results A total of 5 studies were included in the final analyses, involving 428 665 participants and 3 112 cases of endometrial cancer. Metabolic syndrome was associated with an increased risk of endometrial cancer RR=1.96, 95%CI(1.32,2.89), P=0.001, with significant heterogeneity among studies (I2=94%, P=0.000), so results were summarized by random effects meta-analysis,but no indication for publication bias in the Egger’s test (P=0.240). A sensitivity analysis omitting two studies produced no heterogeneity (I2=14.2%, P=0.312). The risk estimates for any single factor of the syndrome were 1.86(P<0.001) for higher values of body mass index and/or waist, 1.81(P=0.044) for hyperglycemia, 1.81 (P=0.024) for higher blood pressure values, and 1.17 (P<0.001) for high triglyceride levels; there was no significant association with low HDL-cholesterol (P=0.259). Conclusions Metabolic syndrome is associated with an increased risk of endometrial cancer;among the components of the syndrome, obesity/high waist is more strongly associated with endometrial cancer.

       

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