ارتباط بین لیپیدهای سرمی و سرطان آندومتر: مطالعه مرور سیستماتیک و متاآنالیز

نوع مقاله : مروری

نویسندگان

1 دانشجوی دکترای تخصصی بهداشت باروری، کمیته پژوهشی دانشجویان، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

2 استادیار گروه مامایی و بهداشت باروری، مرکز تحقیقات مامایی و بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

3 استاد گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

4 دانشیار گروه مامایی و بهداشت باروری، مرکز تحقیقات مامایی و بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

چکیده

مقدمه: سرطان آندومتر در سراسر جهان پنجمین سرطان شایع در زنان می‌باشد. یکی از مهم‌ترین عوامل خطر ابتلاء به سرطان آندومتر، چاقی می‌باشد. ارتباط بین چاقی و سرطان آندومتر به‌علت مواجهه با عوامل بیولوژیک تولید شده در بافت چربی می‌باشد. به‌طور‌ کلی وجود لیپید‌ها برای رشد و پیشرفت سلول‌های سرطانی ضروری می‌باشد. مطالعات انجام شده در زمینه ارتباط بین لیپید پروفایل و سرطان آندومتر محدود و دارای نتایج متناقضی می‌باشند، لذا مرور سیستماتیک و متاآنالیز حاضر با هدف ارتباط بین لیپید‌های سرمی و سرطان آندومتر انجام شد.
روش‌کار: در این مطالعه مرور سیستماتیک و متاآنالیز جستجوی اطلاعات با استفاده از کلمات کلیدی لیپید، لیپوپروتئین، کلسترول، LDLکلسترول، HDL کلسترول، تری‌گلیسیرید، دیس لیپیدمی، سرطان آندومتر، کارسینوم آندومتر و نئوپلاسم آندومتر به‌تنهایی و یا به‌صورت ترکیبی با ترکیبات احتمالی آنها، در موتور جستجوی Google Scholar و پایگاه‌های اطلاعاتی PubMed، Elsevier، Scopus،web of Knowledge و SID بدون محدودیت زمانی تا تاریخ نوامبر 2017، توسط دو نفر از نویسندگان به‌طور مستقل انجام شد. برای انجام و گزارش این متاآنالیز دستورالعمل MOOSE دنبال شد. جهت آنالیز داده‌ها از نرم‌افزار آماری Stata (نسخه 14) استفاده شد.
یافته‌ها: در مجموع در این 8 مطالعه، تعداد کلی 369649 شرکت‌کننده وجود داشت که تعداد 2809 نفر مبتلا به سرطان آندومتر و 366840 نفر سالم بودند. برآورد ادغام شده خطر نسبی برای کلسترول تام (45/1-98/0:CI 95%) 21/1، برای سطح HDL-C (48/1-74/0: CI 95%) 11/1، برای بالاترین سطح LDL در مقایسه با پایین‌ترین سطح (71/1-10/1 :CI 95%) 09/1 و برآورد خطر نسبی ترکیب شده برای بالاترین سطح تری‌گلیسیرید نسبت به پایین‌ترین سطح (85/1-10/1 :CI 95%) 47/1 بود.
نتیجه‌گیری: سطح سرمی تری‌گلیسیرید با سرطان آندومتر ارتباط دارد، اما سطح سرمی کلسترول تام، HDLو LDL ارتباطی با سرطان آندومتر ندارد.

کلیدواژه‌ها

عنوان مقاله [English]

Relationship between serum lipids and endometrial cancer: A systematic review and meta-analysis

نویسندگان [English]

  • Farzaneh Rashidi Fakari 1
  • Marzieh Saei Ghare Naz 1
  • Vida Ghasemi 1
  • Hedyeh Riazi 2
  • Maryam Afrakhteh 3
  • Zohre Keshavarz 4
1 PhD Student of Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Assistant Professor, Department of Midwifery and Reproductive Health, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3 Professor, Department of Obstetrics and Gynecology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
4 Associate Professor, Department of Midwifery and Reproductive Health, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: Endometrial cancer is the fifth most common cancer in females worldwide. One of the most important risk factors for endometrial cancer is obesity. The relationship between obesity and endometrial cancer is due to the exposure to biological agents produced in the adipose tissue. In general, the presence of lipids is essential for the growth and development of cancer cells. Given the limited studies regarding the association between lipid profile and endometrial cancer and their contradictory results, the present  systematic review and meta-analysis was conducted to bridge this gap.
Methods: For the purpose of the study, the studies related to the issue of interest and published until November 2017 were searched in Google Scholar search engine and several international databases, including PubMed, Elsevier, Scopus, web of knowledge, and SID, by two authors independently. The search process was accomplished using the following keywords alone or in combination: "lipid", "lipoprotein", "cholesterol", "LDL cholesterol", "HDL cholesterol", "triglyceride", "dyslipidemia", "endometrial cancer", "endometrial carcinoma", and "endometrial neoplasm". The MOOSE instruction was employed to perform and report this meta-analysis. The data were analyzed using Stata statistical software, version 14.
Results: A total of 369,649 subjects participated in the eight reviewed studies, 2,809 of whom were inflicted with endometrial cancer, while the rest were healthy. The combined estimates of the relative risk for total cholesterol and high-density lipoprotein (HDL) cholesterol were 1.21 (95% CI: 0.98-1.45) and 1.11 (95% CI: 0.74-1.48), respectively. This value was obtained as 1.09 (95% CI: 1.10-1.71) and 1.47 (95% CI: 1.10-1.85) for the highest low-density lipoprotein (LDL) and triglyceride levels, respectively, compared to the lowest levels.
Conclusion: As the findings indicated, serum triglyceride levels were associated with endometrial cancer. However, this cancer showed no relationship with total cholesterol, HDL, and LDL levels.

کلیدواژه‌ها [English]

  • Lipid profiles
  • Endometrial Cancer
  • Meta-analysis

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مجله زنان، مامایی و نازایی ایران
دوره 21، شماره 5
مرداد 1397
صفحه 87-96

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