膳食炎症指数与肺癌风险相关性的meta分析

doi:10.3969/j.issn.1004-583X.2026.03.001

摘要/Abstract

摘要：

目的系统评价膳食炎症指数(dietary inflammatory index,DII)与肺癌发病风险关系。方法通过计算机检索PubMed、The Cochrane Library、Embase、Web of Science、中国知网、维普中文科技期刊数据库和万方数据库,检索时限为建库至2025年8月,检索DII与肺癌相关的队列研究、病例对照研究和横断面研究,由2名研究者独立进行文献筛选和文献质量评价。采用stata 17.0软件进行统计分析,汇总RR值和95%置信区间(CI),同时根据设计类型、研究工具、地理位置、DII成分数量、总能量摄入调整、性别、吸烟史、肺癌亚型进行亚组分析。结果共纳入11篇文献,纳入研究对象785 581例,研究结束后确诊肺癌病例共13 907例。Meta分析结果显示,相比低DII饮食,高DII饮食与肺癌发生风险之间存在显著正相关关系(RR=1.22,95%CI:1.08~1.38,P<0.01),即促炎饮食模式可能会增加患肺癌的风险。在亚组分析中显示,促炎饮食的危害集中体现在吸烟人群中(RR=1.24,95%CI:1.06~1.44,P=0.011),提示两者可能存在强烈的协同效应,在小细胞肺癌亚组中存在显著的正相关关系(RR=1.33,95%CI:1.06~1.66,I²=0%,P=0.412),在腺癌亚组中未观察到显著关联(RR=0.97, 95%CI:0.86~1.08,I²=0%,P=0.375)。结论高DII饮食是增加肺癌发生风险的一个重要因素,尤其对吸烟人群而言。

关键词: 肺肿瘤, 膳食炎症指数, 膳食, 促炎饮食, Meta分析

Abstract:

Objective To quantify the association between the dietary inflammatory index (DII) and the risk of lung cancer through systematic review. Methods We performed a comprehensive literature search of PubMed, The Cochrane Library, Embase, Web of Science, CNKI, VIP, and Wanfang (from database inception to August 2025) for observational studies (cohort, case-control, cross-sectional) that examined DII in relation to lung cancer risk. Two reviewers independently screened records, extracted data, and appraised study quality. Statistical analysis was performed using Stata 17.0 software to pool the relative risks (RRs) and 95% confidence intervals (CIs). Predefined subgroup analyses examined effects by study design, assessment tool, geographic region, number of DII components, adjustment for total energy intake, sex, smoking status, and lung cancer histologic subtype. Results Eleven studies met inclusion criteria, including 785,581 participants and 13,907 incident lung cancer cases. Compared with diets with low inflammatory potential, high-DII diets were associated with a higher risk of lung cancer (pooled RR=1.22; 95%CI: 1.08-1.38; P<0.01). Subgroup analyses showed the association was more pronounced among smokers (RR=1.24; 95%CI: 1.06-1.44; P=0.011), suggesting a possible synergistic interaction between pro-inflammatory diet and tobacco exposure. By histology, a significant positive association was observed for small-cell lung cancer (RR=1.33; 95%CI: 1.06-1.66; I²=0%, heterogeneity P=0.412), however, no significant association was observed in adenocarcinoma (RR=0.97; 95%CI: 0.86-1.08; I²=0%, heterogeneity P=0.375). Conclusion Current observational evidence indicates that a pro-inflammatory dietary pattern (high DII) is associated with increased lung cancer risk, particularly in individuals with a history of smoking.

Key words: lung neoplasms, dietary inflammatory index, diet, pro-inflammatory diet, meta-analysis

中图分类号:

R734.2

汤思颖, 贾君萍, 唐雨婷, 郑玉琴, 孔悦. 膳食炎症指数与肺癌风险相关性的meta分析[J]. 临床荟萃, 2026, 41(3): 197-204.

Tang Siying, Jia Junping, Tang Yuting, Zheng Yuqin, Kong Yue. Dietary inflammatory index and lung cancer risk: A meta-analysis[J]. Clinical Focus, 2026, 41(3): 197-204.

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链接本文: https://www.lchc.cn/CN/10.3969/j.issn.1004-583X.2026.03.001

https://www.lchc.cn/CN/Y2026/V41/I3/197

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参考文献 31

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作者	出版年份	研究地点	研究设计	研究时间	年龄 (岁)	研究工具	食物参数	参与人数	病例	数据类型
Deng等^[13]	2017	美国	前瞻性队列研究	1988-1994	20~90	24 h膳食回顾法	27	13 280	168	三分位数
Bodén等^[14]	2019	瑞典	前瞻性队列研究	1990-2016	40~60	FFQ	30	100 881	442	三分位数
Sadeghi等^[15]	2022	伊朗	病例对照研究	2020.6-2021.9	>30	FFQ	32	280	3	三分位数
Hodge等^[16]	2016	墨尔本	前瞻性队列研究	1990-2011	40~69	FFQ	29	35 303	403	四分位数
Maisonneuve等^[17]	2016	意大利	前瞻性队列研究	2004-2005	≥50	FFQ	24	4 336	200	四分位数
Shivappa等^[18]	2019	新加坡	前瞻性队列研究	1993-2015	45~74	FFQ	36	60 232	1 851	五分位数
Mekonnen等^[19]	2025	美国	前瞻性队列研究	1998.12-2018.12	≥55	FFQ	33	96 607	2 127	四分位数
Park等^[20]	2021	美国	前瞻性队列研究	1993-2014	45~75	QFFQ	28	179 318	5 350	五分位数
Shi等^[21]	2025	美国	前瞻性队列研究	1993-2001	≥55	DHQ	35	101 755	1 706	四分位数
Dehghani等^[22]	2024	伊朗	病例对照研究	NA	≥18	FFQ	36	4 028	616	三分位数
Zhou等^[23]	2025	英国	前瞻性队列研究	2006-2012.6	39~72	24 h膳食回顾法	28	189 561	1 041	三分位数

作者	出版年份	研究地点	研究设计	研究时间	年龄 (岁)	研究工具	食物参数	参与人数	病例	数据类型
Deng等^[13]	2017	美国	前瞻性队列研究	1988-1994	20~90	24 h膳食回顾法	27	13 280	168	三分位数
Bodén等^[14]	2019	瑞典	前瞻性队列研究	1990-2016	40~60	FFQ	30	100 881	442	三分位数
Sadeghi等^[15]	2022	伊朗	病例对照研究	2020.6-2021.9	>30	FFQ	32	280	3	三分位数
Hodge等^[16]	2016	墨尔本	前瞻性队列研究	1990-2011	40~69	FFQ	29	35 303	403	四分位数
Maisonneuve等^[17]	2016	意大利	前瞻性队列研究	2004-2005	≥50	FFQ	24	4 336	200	四分位数
Shivappa等^[18]	2019	新加坡	前瞻性队列研究	1993-2015	45~74	FFQ	36	60 232	1 851	五分位数
Mekonnen等^[19]	2025	美国	前瞻性队列研究	1998.12-2018.12	≥55	FFQ	33	96 607	2 127	四分位数
Park等^[20]	2021	美国	前瞻性队列研究	1993-2014	45~75	QFFQ	28	179 318	5 350	五分位数
Shi等^[21]	2025	美国	前瞻性队列研究	1993-2001	≥55	DHQ	35	101 755	1 706	四分位数
Dehghani等^[22]	2024	伊朗	病例对照研究	NA	≥18	FFQ	36	4 028	616	三分位数
Zhou等^[23]	2025	英国	前瞻性队列研究	2006-2012.6	39~72	24 h膳食回顾法	28	189 561	1 041	三分位数

作者	①	②	③	④	⑤	⑥	⑦	⑧	总分
Deng等^[13]	1	1	1	1	2	1	1	0	8
Bodén等^[14]	1	1	1	1	2	1	1	0	8
Hodge等^[16]	1	1	1	1	2	1	1	1	9
Maisonneuve等^[17]	1	1	1	1	2	1	1	1	9
Shivappa等^[18]	1	1	1	1	2	1	1	1	9
Mekonnen等^[19]	1	1	1	1	2	1	1	0	8
Park等^[20]	1	1	1	1	2	1	1	0	8
Shi等^[21]	1	1	1	1	2	1	1	0	8
Zhou等^[23]	1	1	1	1	2	1	1	1	9

作者	①	②	③	④	⑤	⑥	⑦	⑧	总分
Deng等^[13]	1	1	1	1	2	1	1	0	8
Bodén等^[14]	1	1	1	1	2	1	1	0	8
Hodge等^[16]	1	1	1	1	2	1	1	1	9
Maisonneuve等^[17]	1	1	1	1	2	1	1	1	9
Shivappa等^[18]	1	1	1	1	2	1	1	1	9
Mekonnen等^[19]	1	1	1	1	2	1	1	0	8
Park等^[20]	1	1	1	1	2	1	1	0	8
Shi等^[21]	1	1	1	1	2	1	1	0	8
Zhou等^[23]	1	1	1	1	2	1	1	1	9

作者	①	②	③	④	⑤	⑥	⑦	⑧	总分
Sadeghi等^[15]	1	1	0	1	2	1	1	0	7
Dehghani等^[22]	1	1	1	1	2	1	1	0	8