van den Brandt P A, Spiegelman D, Yaun S S, Adami H O, Beeson L, Folsom A R, Fraser G, Goldbohm R A, Graham S, Kushi L, Marshall J R, Miller A B, Rohan T, Smith-Warner S A, Speizer F E, Willett W C, Wolk A, Hunter D J
Department of Epidemiology, Maastricht University, The Netherlands.
Am J Epidemiol. 2000 Sep 15;152(6):514-27. doi: 10.1093/aje/152.6.514.
The association between anthropometric indices and the risk of breast cancer was analyzed using pooled data from seven prospective cohort studies. Together, these cohorts comprise 337,819 women and 4,385 incident invasive breast cancer cases. In multivariate analyses controlling for reproductive, dietary, and other risk factors, the pooled relative risk (RR) of breast cancer per height increment of 5 cm was 1.02 (95% confidence interval (CI): 0.96, 1.10) in premenopausal women and 1.07 (95% CI: 1.03, 1.12) in postmenopausal women. Body mass index (BMI) showed significant inverse and positive associations with breast cancer among pre- and postmenopausal women, respectively; these associations were nonlinear. Compared with premenopausal women with a BMI of less than 21 kg/m2, women with a BMI exceeding 31 kg/m2 had an RR of 0.54 (95% CI: 0.34, 0.85). In postmenopausal women, the RRs did not increase further when BMI exceeded 28 kg/m2; the RR for these women was 1.26 (95% CI: 1.09, 1.46). The authors found little evidence for interaction with other breast cancer risk factors. Their data indicate that height is an independent risk factor for postmenopausal breast cancer; in premenopausal women, this relation is less clear. The association between BMI and breast cancer varies by menopausal status. Weight control may reduce the risk among postmenopausal women.
利用来自七项前瞻性队列研究的汇总数据,分析了人体测量指标与乳腺癌风险之间的关联。这些队列总共包括337819名女性和4385例浸润性乳腺癌发病病例。在控制生殖、饮食和其他风险因素的多变量分析中,绝经前女性身高每增加5厘米,乳腺癌的汇总相对风险(RR)为1.02(95%置信区间(CI):0.96,1.10),绝经后女性为1.07(95%CI:1.03,1.12)。体重指数(BMI)在绝经前和绝经后女性中分别与乳腺癌呈显著的负相关和正相关;这些关联是非线性的。与BMI小于21kg/m²的绝经前女性相比,BMI超过31kg/m²的女性RR为0.54(95%CI:0.34,0.85)。在绝经后女性中,BMI超过28kg/m²时RR没有进一步增加;这些女性的RR为1.26(95%CI:1.09,1.46)。作者几乎没有发现与其他乳腺癌风险因素存在相互作用的证据。他们的数据表明,身高是绝经后乳腺癌的一个独立风险因素;在绝经前女性中,这种关系不太明确。BMI与乳腺癌的关联因绝经状态而异。控制体重可能会降低绝经后女性的风险。