Serum Insulin-Like Growth Factor Axis and the Risk of Pancreatic Cancer: Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Sources and Searches
2.2. Study Selection
2.3. Data Extraction and Quality Assessment
2.4. Statistical Analysis
3. Results
3.1. Data Sources and Searches
3.2. Study Characteristics
3.3. Meta-Analysis
3.4. Publication Bias
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
Abbreviations
BMI | Body mass index |
CI | Confidence interval |
DM | Diabetes mellitus |
IGF | Insulin-like growth factor |
IGFBP | Insulin-like growth factor binding protein |
OR | Odds ratio |
PaC | Pancreatic cancer |
RR | Relative risk |
SRRs | Summary relative risks |
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Author/References | Study Published/Location | Study Design | Cases | Controls | NOS | Exposure of Interest | Concentration Levels | Effect Estimate (95%CI) | Adjustments |
---|---|---|---|---|---|---|---|---|---|
Rohrmann [21] | 2012/Europe | NCC | 422 | 422 | 9 | IGF-1 | Q4 vs. Q1 | 1.15 (0.70, 1.88) | Age, sex, education, BMI, physical activity, alcohol consumption, smoking and DM |
IGFBP-3 | 1.06 (0.68, 1.65) | ||||||||
IGF-1/IGFBP-3 | 1.29 (0.77, 2.16) | ||||||||
Douglas [22] | 2010/USA | NCC | 187 | 374 | 9 | IGF-1 | Q4 vs. Q1 | 1.58 (0.91, 2.76) | Age, race, sex, smoking, education, BMI, physical activity, DM, alcohol consumption and nutrients intake |
M: 1.56 (0.78, 3.14) | |||||||||
F: 1.74 (0.67, 4.51) | |||||||||
IGF-2 | Q4 vs. Q1 | 0.86 (0.49, 1.50) | |||||||
M: 0.75 (0.36, 1.56) | |||||||||
F: 0.86 (0.49, 1.50) | |||||||||
IGFBP-3 | Q4 vs. Q1 | 0.88 (0.51, 1.51) | |||||||
M: 1.03 (0.51, 2.09) | |||||||||
F: 0.77 (0.32, 1.83) | |||||||||
IGF-1/IGFBP-3 | Q4 vs. Q1 | 1.54 (0.89, 2.66) | |||||||
M: 1.39 (0.69, 2.80) | |||||||||
F: 1.47 (0.58, 3.75) | |||||||||
Wolpin [30] | 2007/USA | NCC | 212 | 635 | 9 | IGF-1 | Q4 vs. Q1 | 0.94 (0.60, 1.48) | Age, sex, smoking, BMI, physical activity, DM, vitamin use and energy intake |
IGF-2 | 0.96 (0.61, 1.52) | ||||||||
IGFBP-3 | 1.21 (0.75, 1.92) | ||||||||
IGF-1/IGFBP-3 | 0.84 (0.54, 1.31) | ||||||||
Wolpin [29] | 2007/ USA | NCC | 144 | 429 | 9 | IGFBP-1 | Q4 vs. Q1 | 0.56 (0.31,1.01) | Age, sex, smoking, BMI, physical activity, DM, vitamin use and energy intake |
Morris [31] | 2006/UK | NCC | 38 | 114 | 8 | IGF-1 | T3 vs. T1 | 0.68 (0.23, 1.99) | Age, smoking |
IGF-2 | 0.48 (0.14, 1.68) | ||||||||
IGFBP-3 | 0.74 (0.26, 2.12) | ||||||||
Lin [32] | 2004/Japan | NCC | 69 | 207 | 8 | IGF-1 | Q4 vs. Q1 | 2.31 (0.70, 7.64) | Age, sex, BMI, smoking and DM |
IGFBP-3 | 2.53 (0.93, 6.85) | ||||||||
Stolzenberg-Solomon [33] | 2004/Finland | NCC | 93 | 400 | 8 | IGF-1 | T3 vs. T1 | 0.67 (0.37, 1.21) | Age, BMI, smoking, energy intake, alcohol consumption |
IGFBP-3 | 0.70 (0.38, 1.27) | ||||||||
IGF-1/IGFBP-3 | 0.85 (0.50, 1.46) | ||||||||
EI-Mesallamy [23] | 2013/Egypt | CC | 23 | 20 | 7 | IGF-1 (ug/L) | Continuous | 1.30 (0.64, 1.96) a | Age, sex, race |
IGFBP-3 (ug/L) | −1.04 (−1.68, −0.40) a | ||||||||
IGF-1/IGFBP-3 | 1.48 (0.80,2 .16) a | ||||||||
Meggiato [24] | 1999/Italy | CC | 35 | 22 | 6 | IGF-1 (ug/L) | Continuous | −0.10 (−0.65,0.45) a | |
Evans [25] | 1997/UK | CC | 20 | 20 | 6 | IGF-1 (ug/L) | Continuous | −0.13 (−0.75, 0.49) a | Age |
IGF-2 (U/mL) | −0.50 (−1.13, 0.13) a | ||||||||
IGFBP-3 (nmol/L) | −0.20 (−0.82, 0.42) a |
Subgroup | References | Relative Risk (95% CI) | Tests for Heterogeneity | |
---|---|---|---|---|
I2 (%) | p | |||
IGF-I | ||||
Adjustment for alcohol | ||||
Yes | [21,22,33] | 0.92 (0.60, 1.24) | 48.7 | 0.142 |
No | [30,31,32] | 0.91 (0.52, 1.30) | 0 | 0.625 |
Adjustment for DM | ||||
Yes | [21,22,30,32] | 1.10 (0.77, 1.43) | 0 | 0.560 |
No | [31,33] | 0.67 (0.29, 1.05) | 0 | 0.984 |
Adjustment for smoking, alcohol and DM | ||||
Yes | [21,22] | 1.27 (0.78, 1.77) | 0 | 0.442 |
No | [30,31,32,33] | 0.80 (0.51, 1.08) | 0 | 0.661 |
IGFBP-3 | ||||
Adjustment for alcohol | ||||
Yes | [21,22,33] | 0.87 (0.59, 1.14) | 0 | 0.562 |
No | [30,31,32] | 1.12 (0.63, 1.60) | 0 | 0.448 |
Adjustment for DM | ||||
Yes | [21,22,30,32] | 1.05 (0.75, 1.35) | 0 | 0.638 |
No | [31,33] | 0.71 (0.31, 1.11) | 0 | 0.939 |
Adjustment for smoking, alcohol and DM | ||||
Yes | [21] | 0.97 (0.62, 1.32) | 0 | 0.613 |
No | [30,31,32,33] | 0.89 (0.56, 1.22) | 4.1 | 0.372 |
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Gong, Y.; Zhang, B.; Liao, Y.; Tang, Y.; Mai, C.; Chen, T.; Tang, H. Serum Insulin-Like Growth Factor Axis and the Risk of Pancreatic Cancer: Systematic Review and Meta-Analysis. Nutrients 2017, 9, 394. https://doi.org/10.3390/nu9040394
Gong Y, Zhang B, Liao Y, Tang Y, Mai C, Chen T, Tang H. Serum Insulin-Like Growth Factor Axis and the Risk of Pancreatic Cancer: Systematic Review and Meta-Analysis. Nutrients. 2017; 9(4):394. https://doi.org/10.3390/nu9040394
Chicago/Turabian StyleGong, Yuanfeng, Bingyi Zhang, Yadi Liao, Yunqiang Tang, Cong Mai, Tiejun Chen, and Hui Tang. 2017. "Serum Insulin-Like Growth Factor Axis and the Risk of Pancreatic Cancer: Systematic Review and Meta-Analysis" Nutrients 9, no. 4: 394. https://doi.org/10.3390/nu9040394