糖尿病与胃癌风险相关性队列研究的meta分析  

A meta-analysis of cohort studies on the susceptibility of type 2 diabetes mellitus and gastric cancer

作　　者：简咏梅 李传荣[3] 袁俊清 孙永宁[1] 

机构地区：[1]上海交通大学附属第六人民医院中医科,200233 [2]上海交通大学附属第六人民医院病理科,200233 [3]同济大学附属同济医院心内科,上海200065

出　　处：《中华内分泌代谢杂志》2014年第10期839-843,共5页Chinese Journal of Endocrinology and Metabolism

基　　金：国家中医药管理局课题（JDZX2012129）;上海市科委课题（D401905000）

摘　　要：通过检索PubMed、Embase、Cochrane Library和ISI Web of knowledge数据库,收集糖尿病患者胃癌发生风险的队列研究,同时检索所有纳入文献的参考文献,没有语言和出版日期的限制.采用纽卡斯尔-渥太华（Newcastle-Ottawa）质量评价量表对文献进行质量评价.并对研究对象的性别、地域、不同糖尿病类型、糖尿病病程及对照组来源进行亚组分析,所有的统计学处理均使用Stata 12.0软件.25篇队列研究符合我们的入选标准,经异质性检验使用随机效应模型合并效应量RR及其95％ CI,得糖尿病与胃癌相关（RR=1.20,95％ CI1.12～1.28）,亚组分析显示该结果在男性（RR=1.15,95％ CI 1.02 ～ 1.29）、女性（RR=1.29,95％ CI 1.09 ～ 1.53）及1型（RR=2.20,95％ CI 1.45 ～3.35）、2型（RR=1.20,95％ CI 1.12～1.31）糖尿病患者中均具有统计学意义.与非糖尿病患者相比,糖尿病会增加胃癌的发生率约20％,可能是胃癌的危险因素之一,该趋势在1型糖尿病及女性患者中更显著.PubMed,Embase,Cochrane Library,and ISI web were searched without any limitations with regard to publication date or language,as well as the references of qualifying articles.All kinds of cohort studies comprising the risk of gastric cancer between diabetic patients and control subjects were included.We excluded studies that investigated only mortality but not incidence.25 studies met our criteria,and the qualities of these studies were evaluated using the Newcastle-Ottawa Quality Assessment Scale.Statistical analyses were carried out with STATA software version 12.0.A random-effects model meta-analysis showed an increased risk of gastric cancer in diabetic patients （RR =1.20,95 ％ CI 1.12-1.28）.Subgroup analyses indicated that this result persisted in studies of both male（RR =1.15,95％ CI 1.02-1.29） and female （RR =1.29,95％ CI 1.09-1.53） subjects,in studies of European countries（RR =1.25,95％ CI 1.07-1.46） and Asia countries （RR =1.18,95％ CI 1.09-1.28）.Compared with nondiabetics,the incidence of gastric cancer may be increased by approximately 20％ in diabetics.Thus diabetes may be an independent risk factor for gastric cancer.This effect tends to be more significant in type 1 and female patients.

关 键 词：糖尿病 胃癌 易患性 队列研究 META分析 

分 类 号：R587.1[医药卫生—内分泌] R735.2[医药卫生—内科学]