蔬菜(但不是水果)的摄入量增加降低肝癌的风险Meta分析

StephenW

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Increased Intake of Vegetables, but not Fruit, Reduces Risk for Hepatocellular Carcinoma: A Meta-analysis
Gastroenterology
9 August 2014

Yang Yang, Dan Zhang, Na Feng, Guochong Chen, Jianjiang Liu, Guiping Chen,
Yuan Zhu
Abstract
Background

& Aims: The anti-cancer effects of vegetables and fruit have been investigated extensively, but the association between vegetable and fruit consumption and risk of hepatocellular carcinoma (HCC) has not been quantified. We performed a meta-analysis of observational studies to clarify the association.
Methods

We identified eligible studies, published from 1956 through May 31, 2014, by searching PubMed, Web of Science and EMBASE. Random-effects models were used to calculate summary relative risks (RRs), and dose-response analyses were conducted to quantify associations. Heterogeneity among studies was evaluated using Cochran’s Q and I2 statistics.
Results

A total of 19 studies involving 1,290,045 participants and 3912 cases of HCC were included in the meta-analysis. The summary RR for HCC was 0.72 for individuals with high intake vs low intake of vegetables (95% confidence interval [CI], 0.63–0.83) and 0.92 with a daily increase in vegetable intake (100 g/day) (95% CI, 0.88−0.95). Subgroup analyses showed that this inverse association did not change regardless of history of hepatitis, alcohol drinking, smoking, or energy intake. The summary RR for HCC among individuals with high vs low intake of fruit was 0.93 (95% CI, 0.80−1.09), and 0.99 with a daily increase in fruit intake (100 g/day) (95% CI, 0.94–1.05).
Conclusions

Based on a meta-analysis, increased intake of vegetables, but not fruit, is associated with lower risk for HCC. The risk of HCC decreases by 8% for every 100 g/day increase in vegetable intake. The findings should be confirmed by future studies with validated questionnaires and strict control of confounders.
In general, both vegetables and fruit are low in fat and calories, and rich in vitamins, minerals and dietary fiber, which have been found to be inversely associated with cardiovascular disease, diabetes, and stroke35-37. However, vegetables and fruit vary widely in nutritional components, with fruit containing more calories and antioxidants such as vitamin C. Vegetables not only provide dietary fiber, and vitamins A and E, but they are also good sources of phytochemicals (e.g., isothiocyanates, glucosinolates, indole-3-carbinol, and flavonoids), which possess anti-tumor activities. Intake of cruciferous vegetables has been found to reduce the risk of colorectal cancer38, lung cancer39 and gastric cancer40. It was also recently reported that vitamin E, widely existing in vegetables, could decrease HCC risk significantly, while vitamin C and multivitamin supplements were associated with higher risk of HCC in males41. In fact, some studies suggested that too much antioxidant supplementation seemed to increase overall mortality from cancers42. We had similar results with a recent cohort study of Health Survey in England, which found that vegetables might have a more protective benefit than fruit in the general population43. Based on the above information, the different effects of vegetables and fruit might be caused by differences in their nutrient compositions

Of note, since the effects of dietary factors interact with each other, a balanced diet with proper nutrition (which includes higher intake of vegetables, fish, white meat, and coffee, and reduced intake of fat, red meat, and alcohol) is more recommended overall, especially for those patients with liver diseases49. Turati et al. recently reported that a Mediterranean diet significantly decreased the risk of HCC, which provides a new paradigm for future studies50.

StephenW

www.natap.org

蔬菜的摄入量增加，但仍未果，降低风险为肝癌的Meta分析
消化内科
2014年8月9日

杨洋张丹，冯娜，陈国翀，刘渐江，桂平陈，
袁筑
摘要
背景

与目的：蔬菜和水果的抗癌作用已被广泛研究，但蔬菜和水果的消费与肝细胞癌（HCC）的风险之间的关系并没有被量化。我们进行了一项荟萃分析观察性研究，以澄清关联。
方法

我们通过2014年5月31日确定的符合条件的研究，从1956年出版的，通过搜索医学，科学和医学文摘的网页。随机效应模型被用来计算总相对危险度（RR），以及剂量 - 反应分析进行量化关联。使用科克伦的Q和I2统计研究中的异质性进行了评价。
结果

共有19项研究，涉及1290045参与者和3912例肝癌被纳入荟萃分析。摘要RR肝癌为0.72的高摄入量与​​蔬菜摄入量低者（95％信心区间[CI]为0.63-0.83）和0.92，在蔬菜的摄入量每天增加（100克/天）（95％CI， 0.88-0.95）。亚组分析表明，这种负相关性并没有考虑历史肝炎，饮酒，吸烟，或能量摄入的变化。个体之间的总RR为肝癌的高与水果摄入量低为0.93（95％CI，0.80-1.09），和0.99，在水果的摄入量每天增加（100克/天）（95％CI，0.94-1.05） 。
结论

基于荟萃分析，增加蔬菜摄入量，而不是水果，是与肝癌风险较低有关。肝癌的危险性了8％，每100克/天增加蔬菜的摄入量减少。调查结果应与验证的问卷调查和严格控制的混杂因素对未来研究证实。
一般来说，无论蔬菜和水果是低脂肪和卡路里，并含丰富的维生素，矿物质和膳食纤维，已发现成反比与心血管疾病，糖尿病和stroke35-37有关。然而，蔬菜和水果有很大的不同的营养成分，水果中含有较多的热量和抗氧化剂，如维生素C，蔬菜不仅可以提供膳食纤维和维生素A和E，但他们也是植物化学物质（如异硫氰酸酯，硫代葡萄糖苷的良好来源，吲哚-3 - 甲醇，和类黄酮），其具有抗肿瘤活性。十字花科蔬菜的摄取已经发现，减少结肠cancer38，肺cancer39和胃cancer40的风险。另据最近报道，维生素E广泛存在于蔬菜，可降低肝癌风险显著，而维生素C和复合维生素补充剂与肝癌的males41风险较高。事实上，一些研究表明，过多的抗氧化剂的补充似乎增加从cancers42总死亡率。我们与健康调查在英国最近的一项队列研究，其中发现，蔬菜可能比水果一般population43提供更多保护的好处了类似的结果。基于上述信息，蔬菜和水果的不同影响可能通过在他们的营养组合物的不同而引起

值得注意的是，由于饮食因素的影响，互相作用，均衡的饮食与适当的营养（包括摄入量较高的蔬菜，鱼，白肉和咖啡，以及减少脂肪摄入，红肉和酒精）更建议总体而言，特别是对于那些患者的肝diseases49。图拉蒂等。最近报道说，地中海饮食显著降低肝癌的风险，这为未来studies50的新典范。