Fish consumption and risk of myeloma: a meta-analysis of epidemiological studies
The relationship between fish consumption and multiple myeloma (MM) risk has not been consistent across epidemiological studies. We quantitatively assessed the aforementioned association through a systematic review and meta-analysis.
PubMed was searched through the end of March 2015 for eligible studies. Fixed or random effects models were used to pool risk estimates. Five case–control studies that involved 1,366 cases and 8,259 controls were identified. Three studies had high methodological quality, and two studies had low quality based on the Newcastle–Ottawa Quality Assessment Scale.
After pooling all risk estimates, a significant inverse association was found between the highest category versus lowest category of fish consumption and MM risk (relative risk = 0.65, 95 % confidence interval = 0.46–0.91), with relatively high heterogeneity (I 2 = 55.6 %). No evidence of publication bias was detected. The inverse association persisted in all subgroups according to study quality, type, location, and whether there were adjustments for confounders, although statistical significance was not detected in all strata. The dose–response analysis suggested a nonlinear dose–response relationship for the association, with the lowest risk linked to fish consumption once per week.
This meta-analysis suggests that the highest versus lowest category of fish consumption is inversely associated with MM risk. Furthermore, a nonlinear dose–response relationship was suggested for the association. Because this evidence is based on a small number of retrospective studies with mixed quality and because high heterogeneity was detected, further prospective studies are warranted to validate our findings and better characterize the relationship.
KeywordsDiet Epidemiology Fish Myeloma
This study was supported by Liaoning Provincial Natural Science Foundation (Grant number: No.201202288 for Y-ZW) and the Younger research fund of Shengjing Hospital (Grant 2014sj09 for Qi-Jun Wu). We would like to thank Dr. Carlo La Vecchia for providing relevant information of their study.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflicts of interest.
- 6.Lu Z, Chen TC, Zhang A, Persons KS, Kohn N, Berkowitz R, Martinello S, Holick MF (2007) An evaluation of the vitamin D3 content in fish: Is the vitamin D content adequate to satisfy the dietary requirement for vitamin D? J Steroid Biochem Mol Biol 103(3–5):642–644PubMedCentralCrossRefPubMedGoogle Scholar
- 7.Brown LM, Gridley G, Pottern LM, Baris D, Swanso CA, Silverman DT, Hayes RB, Greenberg RS, Swanson GM, Schoenberg JB, Schwartz AG, Fraumeni JF Jr (2001) Diet and nutrition as risk factors for multiple myeloma among blacks and whites in the United States. Cancer Causes Control 12(2):117–125CrossRefPubMedGoogle Scholar
- 11.Fritschi L, Ambrosini GL, Kliewer EV, Johnson KC, Canadian Cancer Registries Epidemiologic Research Group (2004) Dietary fish intake and risk of leukaemia, multiple myeloma, and non-Hodgkin lymphoma. Cancer Epidemiol Biomark Prev 13(4):532–537Google Scholar
- 14.GA Wells BS, D O’Connell, J Peterson, V Welch, M Losos, P Tugwell (2011) The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Accessed 15 Jan 2015
- 23.Puthier D, Bataille R, Barille S, Mellerin MP, Harousseau JL, Ponzio A, Robillard N, Wijdenes J, Amiot M (1996) Myeloma cell growth arrest, apoptosis, and interleukin-6 receptor modulation induced by EB1089, a vitamin D3 derivative, alone or in association with dexamethasone. Blood 88(12):4659–4666PubMedGoogle Scholar
- 24.Park WH, Seol JG, Kim ES, Jung CW, Lee CC, Binderup L, Koeffler HP, Kim BK, Lee YY (2000) Cell cycle arrest induced by the vitamin D(3) analog EB1089 in NCI-H929 myeloma cells is associated with induction of the cyclin-dependent kinase inhibitor p27. Exp Cell Res 254(2):279–286CrossRefPubMedGoogle Scholar
- 37.Kolahdooz F, van der Pols JC, Bain CJ, Marks GC, Hughes MC, Whiteman DC, Webb PM, Australian Cancer S, the Australian Ovarian Cancer Study G (2010) Meat, fish, and ovarian cancer risk: results from 2 Australian case–control studies, a systematic review, and meta-analysis. Am J Clin Nutr 91(6):1752–1763CrossRefGoogle Scholar
- 43.Chowdhury R, Stevens S, Gorman D, Pan A, Warnakula S, Chowdhury S, Ward H, Johnson L, Crowe F, Hu FB, Franco OH (2012) Association between fish consumption, long chain omega 3 fatty acids, and risk of cerebrovascular disease: systematic review and meta-analysis. BMJ 345:e6698PubMedCentralCrossRefPubMedGoogle Scholar