Fourteen case-control studies were included in the analysis (5362 cases, 11,497 controls). We estimated odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for the association between dietary intake of vitamin C and GC, adjusted for relevant confounders and for intake of fruit and vegetables. The dose-response relationship was evaluated using mixed-effects logistic models with second-order fractional polynomials.
Individuals in the highest quartile of dietary vitamin C intake had reduced odds of GC compared with those in the lowest quartile (OR: 0.64; 95% CI: 0.58, 0.72). Additional adjustment for fruit and vegetables intake led to an OR of 0.85 (95% CI: 0.73, 0.98). A significant inverse association was observed for noncardia GC, as well as for both intestinal and diffuse types of the disease. The results of the dose-response analysis showed decreasing ORs of GC up to 150-200 mg/day of vitamin C (OR: 0.54; 95% CI: 0.41, 0.71), whereas ORs for higher intakes were close to 1.0.
The findings of our pooled study suggest that vitamin C is inversely associated with GC, with a potentially beneficial effect also for intakes above the currently recommended daily intake (90 mg for men and 75 mg for women).
方法:纳入14项病例对照研究(5362例,11497个控件)。我们估计了维生素C的膳食摄入量与GC之间的关联的比值比(ORs)和相应的95%置信区间(CIs)。根据相关的混杂因素和水果和蔬菜的摄入量进行了调整。使用具有二阶分数多项式的混合效应逻辑模型评估剂量反应关系。
结果:膳食维生素C摄入量最高四分位数的个体与最低四分位数的个体相比,GC的几率降低(OR:0.64;95%CI:0.58,0.72)。对水果和蔬菜摄入量的额外调整导致OR为0.85(95%CI:0.73,0.98)。观察到非贲门GC的显着负相关,以及肠道和弥漫性疾病。剂量反应分析的结果表明,维生素C的GCOR降低至150-200mg/天(OR:0.54;95%CI:0.41,0.71),而较高摄入量的OR接近1.0。
结论:我们的联合研究结果表明,维生素C与GC呈负相关,对于超过目前推荐的每日摄入量(男性90mg,女性75mg)的摄入量也具有潜在的有益效果。