背景:一些研究表明,通过后验和混合方法确定的饮食模式与胃肠道(GI)癌症风险和死亡率相关。这些研究应用了不同的方法来分析饮食数据,并报告了不一致的发现。
目的:本系统综述和荟萃分析旨在确定膳食模式之间的关联,使用主成分分析(PCA)和降阶回归(RRR)得出,和胃肠道癌症风险和胃肠道癌症引起的死亡率。
方法:截至2023年6月以英文发表的文章符合纳入条件。Medline,Scopus,科克伦图书馆,CINHAL,PsycINFO,ProQuest,和WebofSciences数据库用于确定前瞻性研究。系统评价和荟萃分析方案2020的首选报告项目用于报告结果。
方法:共有28项研究符合纳入条件。使用了各种方法来得出饮食模式,包括PCA(n=22),RRR(n=2),PCA和RRR组合(n=1),聚类分析(CA;n=2)和PCA和CA组合(n=1)。
方法:两种膳食模式,“健康”和“不健康”,“是使用PCA和RRR得出的。健康的膳食模式的特点是水果摄入量较高,全谷物,豆类,蔬菜,牛奶,和其他乳制品,而不健康的饮食模式的特点是红色和加工肉类的摄入量较高,酒精,以及精制和含糖饮料。研究结果表明,PCA衍生的健康饮食模式与8%的风险降低相关(相对风险[RR],0.92;95%CI,0.87-0.98),不健康的饮食模式与14%的风险增加相关(RR,1.14;95%CI,1.07-1.22)的胃肠道癌症。同样,RRR衍生的健康膳食模式(RR,0.83;95%CI,0.61-1.12)可能与胃肠道癌症风险降低有关。相比之下,RRR衍生的不健康膳食模式(RR,0.93;95%CI,0.57-1.52)与胃肠道癌症风险降低无关。同样,证据表明,PCA衍生的健康饮食模式可以降低死于胃肠道癌症的风险,而PCA衍生的不健康饮食模式可能会增加风险。
结论:关于PCA衍生的饮食模式与胃肠道癌症风险的相关性的前瞻性研究的结果支持健康和不健康的饮食模式作为胃肠道癌症的保护或风险增加因素的证据和生存。分别。研究结果还表明,RRR衍生的健康饮食模式降低了胃肠道癌症的风险(尽管精度较低)。但未发现与RRR衍生的不健康饮食模式相关.需要进行前瞻性研究,以进一步阐明PCA和RRR衍生的饮食模式与胃肠道癌症风险之间的相关性差异。系统审查注册:PROSPERO注册号。CRD42022321644。
BACKGROUND: Several studies have demonstrated that dietary patterns identified by a posteriori and hybrid methods are associated with
gastrointestinal (GI) cancer risk and mortality. These studies applied different methods for analyzing dietary data and reported inconsistent findings.
OBJECTIVE: This systematic
review and meta-analysis were aimed to determine the association between dietary patterns, derived using principal component analysis (PCA) and reduced rank regression (RRR), and GI cancer risk and GI cancer-caused mortality.
METHODS: Articles published up to June 2023 in English were eligible for inclusion. The Medline, SCOPUS, Cochrane Library, CINHAL, PsycINFO, ProQuest, and Web of Sciences databases were used to identify prospective studies. The Preferred Reporting Item for Systematic
Review and Meta-analysis Protocol 2020 was used to report results.
METHODS: A total of 28 studies were eligible for inclusion. Varied approaches to deriving dietary patterns were used, including PCA (n = 22), RRR (n = 2), combined PCA and RRR (n = 1), cluster analysis (CA; n = 2) and combined PCA and CA (n = 1).
METHODS: Two dietary patterns, \"healthy\" and \"unhealthy,\" were derived using PCA and RRR. The healthy dietary pattern was characterized by a higher intake of fruits, whole grains, legumes, vegetables, milk, and other dairy products, whereas the unhealthy dietary pattern was characterized by a higher intake of red and processed meat, alcohol, and both refined and sugar-sweetened beverages. The findings indicated that the PCA-derived healthy dietary pattern was associated with an 8% reduced risk (relative risk [RR], 0.92; 95% CI, 0.87-0.98), and the unhealthy dietary pattern was associated with a 14% increased risk (RR, 1.14; 95% CI, 1.07-1.22) of GI cancers. Similarly, the RRR-derived healthy dietary pattern (RR, 0.83; 95% CI, 0.61-1.12) may be associated with reduced risk of GI cancers. In contrast, the RRR-derived unhealthy dietary pattern (RR, 0.93; 95% CI, 0.57-1.52) had no association with a reduced risk of GI cancers. Similarly, evidence suggested that PCA-derived healthy dietary patterns may reduce the risk of death from GI cancers, whereas PCA-derived unhealthy dietary patterns may increase the risk.
CONCLUSIONS: Findings from prospective studies on the association of PCA-derived dietary patterns and the risk of GI cancers support the evidence of healthy and unhealthy dietary patterns as either protective or risk-increasing factors for GI cancers and for survivorship, respectively. The findings also suggest that the RRR-derived healthy dietary pattern reduces the risk of GI cancers (albeit with low precision), but no association was found for the RRR-derived unhealthy dietary pattern. Prospective studies are required to further clarify disparities in the association between PCA- and RRR-derived dietary patterns and the risk of GI cancers. Systematic
review registration: PROSPERO registration no. CRD42022321644.