Association of the ratio of ω-6/ω-3 polyunsaturated fatty acids with various tumor types risk:a systematic review and Meta-analysis
Objective The purpose of this study was to systematically evaluate the relationship between the ratio of ω-6/ω-3 polyunsaturated fatty acids(omega-6/omega-3 polyunsaturated fatty acids)and the risk of various types of tumors.Methods A systematic search was carried out in 9 databases(Pubmed,Embase,Web of Science,Cochrane Library,Medline,CNKI,VIP,Wanfang,CBM)up to January 31,2024,for studies related to the association be-tween the ratio of ω-6/ω-3PUFAs and tumor incidence risk.The quality of the finally included literature was assessed u-sing the Newcastle-Ottawa Scale(NOS).Meta-analysis was performed using the R version 4.3.3 software.Results A total of 27 studies investigating the effect of the ratio of ω-6/ω-3PUFAs on different tumor incidence rates were includ-ed,comprising 7 cohort studies and 20 case-control studies.A total of 197,401 subjects were involved,with 81,950 ca-ses and exposed participants and 115,451 controls and unexposed participants.Meta-analysis results showed that there was no statistically significant association between the ratio of ω-6/ω-3 PUFAs and the incidence risk of different tumors(OR＝1.03,95%CI:0.98-1.09,P＝0.18).Subgroup analysis revealed that a higher ratio of ω-6/ω-3 PUFAs was asso-ciated with an increased risk of breast cancer incidence(OR＝1.05,95%CI:1.01-1.10,P＝0.01),but not with prostate cancer(OR＝1.26,95%CI:0.67-2.38,P＝0.47)or colorectal cancer(OR＝0.99,95%CI:0.89-1.10,P＝0.85).In non-European and American regions,a higher ω-6/ω-3PUFAs ratio significantly increased the risk of various tumor inci-dences(OR＝1.24,95%CI:1.01-1.51,P＝0.04),while in European and American regions,this association was not statistically significant(OR＝1.02,95%CI:0.97-1.07,P＝0.46).When evaluating the relationship between exposure indicators and the incidence risk of various cancers,neither dietary intake(OR＝1.04,95%CI:0.98-1.09,P＝0.17)nor the ratio of ω-6/ω-3PUFAs measured in blood components(red blood cells,serum,plasma)(OR＝1.00,95%CI:0.92-1.09,P＝0.96)showed statistically significant associations with cancer risk.Subgroup analysis focusing on breast cancer revealed that in European and American regions,a higher ω-6/ω-3PUFAs ratio was associated with an increased risk of breast cancer incidence(OR＝1.05,95%CI:1.011.11,P＝0.03),but this link was not statistically significant in non-European and American regions(OR＝1.05,95%CI:0.97-1.14,P＝0.22).A higher dietary intake ratio of ω-6/ω-3PUFAs was correlated with an elevated risk of breast cancer incidence(OR＝1.05,95%CI:1.01-1.10,P＝0.02),whereas the ratio of ω-6/ω-3PUFAs in blood(red blood cells,serum,plasma)did not show a statistically significant association with breast cancer risk(OR＝1.07,95%CI:0.93-1.23,P＝0.37).Conclusion The influence of the ratio of ω-6/ω-3PUFAs on the risk of different tumors remains inconclusive.However,a higher ω-6/ω-3PUFAs ratio is associ-ated with an increased risk of breast cancer,particularly in the European and American regions.In non-European and American regions,a higher ratio was found to significantly increase the risk of various types of tumor.Furthermore,a higher dietary ratio of ω-6/ω-3PUFAs intake is also associated with an increased risk of breast cancer development.These findings warrant further confirmation through additional prospective interventional studies.
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