乳製品的攝取與乳癌罹患風險之間的相關性：系統性回顧與統合分析

Milk/Dairy Products Consumption and Breast Cancer Incidence: A Systematic Review and Meta-Analysis

蔡慈儀(Tzu-Yi Tsai) ； 趙蓓敏(Pei-Min Chao) ； 廖文伶(Wen-Ling Liao)

《台灣營養學會雜誌》 44卷1期 (2020/03) Pp. 1-17

https://doi.org/10.6691/NSJ.202003_44(1).0001

摘要

乳製品是人類重要的能量與營養素來源，但目前針對乳製品對於乳癌發生率影響的結果仍不一致，故本研究採用系統性文獻回顧之方法，利用關鍵字“Dairy products＂、“Dairy fat＂、“Dairy protein＂、“Dairy＂或“Milk＂與“breast cancer＂進行布林邏輯交集，自PubMed資料庫搜集至2018年12月為止發表之相關文章。共有26篇世代研究納入統合分析，並依文章間是否存在異質性，選取固定或隨機模式計算綜合效應。統合結果顯示，總乳製品（TDF）高攝取相較於低攝取可輕微但顯著降低乳癌發生率（RR, 0.95; 95% CI, 0.90-1.00（n = 11））。若將牛奶獨立出來，其攝取量多寡與乳癌風險則無關連（RR, 0.93; 95% CI, 0.83-1.04（= 11））。進一步的次群組分析中發現，低脂／脫脂乳製品（RR, 0.90; 95% CI, 0.84-0.98）或停經前飲用牛奶（RR, 0.79; 95% CI, 0.67-0.94）高攝取（相對低攝取）具有保護性。考量身體質量指數（BMI）調整，不僅上述關係增強，也發現停經前婦女TDF攝取輕微但顯著降低乳癌危險（RR, 0.90; 95% CI, 0.81-1.00）。總結，根據統合分析結果，TDF或牛奶攝取並不會增加乳癌風險，甚至在停經前婦女或者是選用低脂乳製品具有保護作用。

關鍵字

乳製品 ； 牛奶 ； 乳癌 ； 世代研究 ； 統合分析

並列摘要

Dairy products are considered as one of the most important energy and nutrient resources for human being. However, the importance of consuming dairy food has been regarded with suspicion recently since the results on the association of dairy products consumption with breast cancer have been conflicting. In order to address this issue, we conducted a systematic review and meta-analysis by analyzing 26 relevant cohort studies published on PubMed database until December 2018. Our results showed that the total dairy food (TDF) consumption slightly but significantly reduced the breast cancer risk. The relative risk (RR) of breast cancer for high vs. low intake was 0.95 (95% CI, 0.90-1.00 (n = 11)). However, there is no significant effect on higher milk consumption and breast cancer risk (RR, 0.93; 95% CI, 0.83-1.04 (n = 11)). In subgroup analyses, we found that high consumption of low-fat dairy products (RR, 0.90; 95% CI, 0.84-0.98) or high consumption of milk in premenopausal women (RR, 0.79; 95% CI, 0.67-0.94) conferred protective effects. Considering BMI adjustment, associations in aforementioned turned stronger and a mildly reduced risk was observed for premenopausal women with higher TDF intake (RR, 0.90; 95% CI, 0.81-1.00). In conclusion, TDF or milk intake did not increase breast cancer risk whereas the inverse associations were noted for both low-fat dairy products and among premenopausal women.

並列關鍵字

Dairy products ； Milk ； Breast cancer ； Risk assessment ； Cohort studies ； Meta-analysis