Biospecimen long-chain N-3 PUFA and risk of colorectal cancer: a meta-analysis of data from 60,627 individuals.
BACKGROUND
Several prospective cohort and case-control studies reported the inconsistent association between biospecimen composition of C20 and C22 long-chain (LC) n-3 polyunsaturated fatty acid (PUFA) and colorectal cancer (CRC) risk. The aim of the present study was to investigate the association of biospecimen LC n-3 PUFA with CRC risk based on prospective cohort and case-control studies.


RESULTS
Cochrane Library, PubMed, and EMBASE database were searched up to February 2014 for eligible studies. Risk ratios (RRs) or odds ratios (ORs) from prospective and case-control studies were combined using a random-effects model in the highest vs. lowest categorical analysis. Nonlinear dose-response relationships were assessed using restricted cubic spline regression models. Difference in tissue composition of LC n-3 PUFA between cases and noncases was analyzed as standardized mean difference (SMD). Three prospective cohort studies and 8 case-control studies were included in the present study, comprising 60,627 participants (1,499 CRC cases and 59,128 noncases). Higher biospecimen LC n-3 PUFA was significantly associated with a lower risk of CRC in case-control (pooled OR: 0.76; 95% CI: 0.59, 0.97; I2 = 10.00%) and prospective cohort studies (pooled RR: 0.70; 95% CI: 0.55, 0.88; I2 = 0.00%), respectively. A significant dose-response association was found of biospecimen C20:5n-3 (P for nonlinearity  = 0.02) and C22:6n-3 (P for trend  = 0.01) with CRC risk, respectively. Subjects without CRC have significantly higher biospecimen compositions of C20:5n-3 (SMD: 0.27; 95%: 0.13, 0.41), C22:6n-3 (SMD: 0.23; 95%: 0.11, 0.34) and total LC n-3 PUFA (SMD: 0.22; 95% CI: 0.07, 0.37) compared with those with CRC.


CONCLUSIONS
The present evidence suggests human tissue compositions of LC n-3 PUFA may be an independent predictive factor for CRC risk, especially C20:5n-3 and C22:6n-3. This needs to be confirmed with more large-scale prospective cohort studies.
Department of Food Science and Nutrition, Zhejiang University, Hangzhou, China; Department of Preventive Medicine, Wenzhou Medical University, Wenzhou, China.
Bo
B
Yang
Department of Food Science and Nutrition, Zhejiang University, Hangzhou, China.
Feng-Lei
FL
Wang
Medical Laboratory Animal Center, Wenzhou Medical University, Wenzhou, China.
Xiao-Li
XL
Ren
Department of Food Science and Nutrition, Zhejiang University, Hangzhou, China.
Duo
D
Li
D015415:Biomarkers / Q000378:metabolism; D015179:Colorectal Neoplasms / Q000209:etiology* / Q000378:metabolism; D015525:Fatty Acids, Omega-3 / Q000378:metabolism*; D006801:Humans; D012306:Risk
D015415:Biomarkers; D015525:Fatty Acids, Omega-3