De Stavola B L, dos Santos Silva I, McCormack V, Hardy R J, Kuh D J, Wadsworth M E J
Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Am J Epidemiol. 2004 Apr 1;159(7):671-82. doi: 10.1093/aje/kwh097.
Adult height is known to be positively associated with breast cancer risk. The mechanism underlying this association is complex, since adult height is positively correlated with age at menarche, which in turn is negatively associated with breast cancer risk. The authors used prospective data from a British cohort of 2,547 girls followed from birth in 1946 to the end of 1999 to examine breast cancer risk in relation to childhood growth. As expected, adult height was positively associated with age at menarche and breast cancer. In childhood, cases were taller and leaner, on average, than noncases. Significant predictors of breast cancer risk in models containing all components of growth were height velocity at age 4-7 years (for a one-standard-deviation increase, odds ratio (OR) = 1.54, 95% confidence interval (CI): 1.13, 2.09) and age 11-15 years (OR = 1.29, 95% CI: 0.97, 1.71) and body mass index velocity (weight (kg)/height (m)(2)/year) at age 2-4 years (OR = 0.63, 95% CI: 0.48, 0.83). The effects of these variables were particularly marked in women with early menarche (age <12.5 years). These findings suggest that women who grow faster in childhood and reach an adult height above the average for their menarche category are at particularly increased risk of breast cancer.
已知成年身高与乳腺癌风险呈正相关。这种关联背后的机制很复杂，因为成年身高与初潮年龄呈正相关，而初潮年龄又与乳腺癌风险呈负相关。作者使用了来自英国一个队列的前瞻性数据，该队列包括2547名女孩，她们从1946年出生开始一直追踪到1999年底，以研究儿童期生长与乳腺癌风险的关系。正如预期的那样，成年身高与初潮年龄和乳腺癌呈正相关。在儿童期，病例平均比非病例更高更瘦。在包含生长所有组成部分的模型中，乳腺癌风险的显著预测因素为4至7岁时的身高增长速度（每增加一个标准差，优势比（OR）=1.54，95%置信区间（CI）：1.13，2.09）、11至15岁时的身高增长速度（OR = 1.29，95% CI：0.97，1.71）以及2至4岁时的体重指数增长速度（体重（千克）/身高（米）²/年）（OR = 0.63，95% CI：0.48，0.83）。这些变量的影响在初潮早（年龄<12.5岁）的女性中尤为明显。这些发现表明，在儿童期生长较快且成年身高高于其初潮类别平均水平的女性患乳腺癌的风险尤其增加。
