肾素-血管紧张素系统抑制剂的使用与结直肠癌的风险和死亡率:一项剂量-反应meta分析。

IF 2.1 4区医学 Q3 PERIPHERAL VASCULAR DISEASE

Journal of the Renin-Angiotensin-Aldosterone System Pub Date : 2020-07-01 DOI:10.1177/1470320319895646

Xia Chen, Chang-Hong Yi, Kuang-Guan Ya

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引用次数: 16

摘要

目的:本研究旨在确定使用肾素-血管紧张素系统(RAS)抑制剂是否会增加结直肠癌的发病率和死亡率。方法:对数据库进行电子检索，收集自成立以来至2018年10月期间RAS使用与结直肠癌发病率和死亡率的数据。采用Stata 12.0软件进行meta分析。结果:共纳入16篇文献，涉及2,847,597名受试者。使用RAS抑制剂与结直肠癌风险相关(相对风险(RR): 0.86;95%可信区间(CI): 0.78-0.93)和死亡率(RR: 0.80;95% CI: 0.66-0.98)。亚组分析显示血管紧张素转换酶抑制剂(ACEI)/血管紧张素受体阻滞剂(ARB) (RR: 0.82;95% CI: 0.69-0.96)或ARB (RR: 0.86;95% CI: 0.73-0.98)或ACEI (RR: 0.81;95% CI: 0.70-0.92)与结直肠癌风险降低有关。此外，RAS抑制剂的使用与白种人结直肠癌风险降低有关(RR: 0.88;95% CI: 0.80-0.96)和亚洲人(RR: 0.72;95% ci: 0.61-0.85)。此外，剂量反应显示，每使用一年RAS抑制剂的时间增量增加与结直肠癌风险降低6%相关(RR: 0.94;95% ci: 0.90-0.97)。结论:有证据表明，RAS抑制剂的使用与结直肠癌风险和死亡率的降低有关。

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Renin-angiotensin system inhibitor use and colorectal cancer risk and mortality: A dose-response meta analysis.

Objective: This study was undertaken to determine whether use of the renin-angiotensin system (RAS) inhibitors would increase colorectal cancer morbidity and mortality.

Methods: Databases were electronically searched to collect data of RAS use and colorectal cancer morbidity and mortality from inception to October 2018. Stata 12.0 software was used to perform a meta-analysis.

Results: A total of 16 publications involving 2,847,597 participants were included. RAS inhibitor use was related to colorectal cancer risk (relative risk (RR): 0.86; 95% confidence interval (CI): 0.78-0.93) and mortality (RR: 0.80; 95% CI: 0.66-0.98) decrement. Subgroup analysis showed angiotensin-converting enzyme inhibitor (ACEI)/angiotensin II receptor blocker (ARB) (RR: 0.82; 95% CI: 0.69-0.96) or ARB (RR: 0.86; 95% CI: 0.73-0.98) or ACEI (RR: 0.81; 95% CI: 0.70-0.92) were related to colorectal cancer risk decrement. Furthermore, RAS inhibitor use was related to colorectal cancer risk decrement in Caucasians (RR: 0.88; 95% CI: 0.80-0.96) and Asians (RR: 0.72; 95% CI: 0.61-0.85). Additionally, dose-response showed that per one year duration of RAS inhibitor use incremental increase was related to 6% colorectal cancer risk decrement (RR: 0.94; 95% CI: 0.90-0.97).

Conclusion: According to the evidence, RAS inhibitor use was associated with colorectal cancer risk and mortality decrement.

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来源期刊

Journal of the Renin-Angiotensin-Aldosterone System 医学-外周血管病

CiteScore

6.20

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： JRAAS is a peer-reviewed, open access journal, serving as a resource for biomedical professionals, primarily with an active interest in the renin-angiotensin-aldosterone system in humans and other mammals. It publishes original research and reviews on the normal and abnormal function of this system and its pharmacology and therapeutics, mostly in a cardiovascular context but including research in all areas where this system is present, including the brain, lungs and gastro-intestinal tract.