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目的探讨大豆食品摄入与乳腺癌发病的关系。方法检索1991年到2011年4月公开发表的关于大豆食品摄入与乳腺癌关系的流行病学研究进行Meta分析,结果报告合并比值比(OR)及95%可信区间(95%CI)。结果 28个研究纳入Meta分析,其中有23个病例对照研究,5个队列研究。总体分析,大豆食品摄入对乳腺癌具有保护作用(合并OR=0.86,95%CI 0.78～0.94),但按设计类型分层后,只有病例对照研究的结果显示大豆食品对乳腺癌具有保护作用(合并OR=0.86,95%CI 0.77～0.95)。在不同国家和地区人群中开展的研究结果显示,在亚洲地区人群中,合并OR=0.76(95%CI 0.67～0.87),而欧美地区人群的研究合并OR=1.01(95%CI 0.93～1.09)。对在亚洲地区人群中开展的病例对照研究和队列研究分别进行合并分析,结果显示大豆食品摄入对乳腺癌均具有保护作用,合并OR分别为0.76(95%CI 0.65～0.89)和0.81(95%CI 0.70～0.92)。但在欧美地区人群中开展的两类研究均未发现大豆食品摄入对乳腺癌有保护作用。根据绝经前后的亚组分析结果显示,仅在绝经后女性中大豆食品摄入对乳腺癌起保护作用。结论根据亚洲地区人群中开展的研究,尤其是病例对照研究结果的合并分析,提示大豆食品摄入对亚洲地区女性乳腺癌具有保护作用。
Objective To investigate the relationship between soybean food intake and the incidence of breast cancer. METHODS Meta-analysis of published epidemiological studies on the relationship between soy food intake and breast cancer published between April 1991 and April 2011 was performed and the results were reported as odds ratio (OR) and a 95% confidence interval (95% confidence interval). Results 28 studies were included in the meta-analysis, of which 23 case-control studies and 5 cohort studies. Overall, dietary soybeans had a protective effect on breast cancer (OR = 0.86, 95% CI 0.78 to 0.94), but only case-control studies showed that soy foods had a protective effect on breast cancer (Combined OR = 0.86, 95% CI 0.77 to 0.95). Results from studies conducted in different countries and regions showed that OR = 0.76 (95% CI 0.67-0.87) was associated with OR = 1.01 (95% CI 0.93-1.09) in Europeans and Americans . Case-control studies and cohort studies conducted in Asian populations showed that food intake of soybeans had a protective effect on breast cancer with a combined OR of 0.76 (95% CI 0.65-0.89) and 0.81 (95 % CI 0.70 ~ 0.92). However, two types of studies conducted in Europe and the United States population did not find a protective effect of soybean food intake on breast cancer. According to the subgroup analysis before and after menopause, the intake of soy food in postmenopausal women has a protective effect on breast cancer. Conclusions Based on studies conducted in the Asian population, and in particular the case-control studies, the results suggest that soy food intake may have a protective effect on female breast cancer in Asia.