Falk Roni T, Brinton Louise A, Madigan M Patricia, Potischman Nancy, Sturgeon Susan R, Malone Kathleen E, Daling Janet R
Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20892, USA.
Breast Cancer Res Treat. 2006 Jul;98(2):157-65. doi: 10.1007/s10549-005-9144-1. Epub 2006 Feb 24.
Epidemiologic evidence suggests obese premenopausal women experience a reduced risk of breast cancer. The mechanism underlying this protection is not fully understood although it is well documented that abdominal obesity may impair ovulatory function and reduce gonadal steroidogenesis. We measured levels of several metabolic markers that are modified by obesity [measured by body mass index (BMI, (weight (kg)/height (m2)))] and play a role in the reproductive axis, including, leptin, insulin-like growth factor I (IGF-I), insulin-like growth factor binding protein 3 (IGFBP3), C-peptide and prolactin in 233 cases and 251 controls participating in a retrospective study of breast cancer in young women conducted in the Seattle/Puget Sound region between 1990 and 1992. Consistent with the finding of a reduced risk with increasing BMI, risks declined with leptin levels, although to a lesser degree with odds ratios (OR) for the highest vs. lowest quartile of BMI=0.34 (95% C.I. 0.3-0.8) and for leptin=0.71 (95% C.I. 0.5-1.3). IGF-I, IGFBP3, C-peptide and prolactin were not related to breast cancer risk in a dose-dependent manner. With the possible exception of leptin, our findings do not suggest that these markers explain the breast cancer protection provided by obesity in premenopausal women.
流行病学证据表明,绝经前肥胖女性患乳腺癌的风险降低。尽管有充分记录表明腹部肥胖可能损害排卵功能并减少性腺类固醇生成,但这种保护作用的潜在机制尚未完全了解。我们测量了233例病例和251例对照者中几种受肥胖影响(通过体重指数(BMI,体重(kg)/身高(m2))衡量)且在生殖轴中起作用的代谢标志物水平,这些标志物包括瘦素、胰岛素样生长因子I(IGF-I)、胰岛素样生长因子结合蛋白3(IGFBP3)、C肽和催乳素。这些病例和对照者参与了1990年至1992年在西雅图/普吉特海湾地区进行的一项关于年轻女性乳腺癌的回顾性研究。与BMI升高风险降低的发现一致,风险随瘦素水平下降,尽管BMI最高四分位数与最低四分位数的比值比(OR)为0.34(95%可信区间0.3 - 0.8),瘦素的比值比为0.71(95%可信区间0.5 - 1.3),下降程度较小。IGF-I、IGFBP3、C肽和催乳素与乳腺癌风险不存在剂量依赖性关系。除了瘦素可能是个例外,我们的研究结果并未表明这些标志物能够解释绝经前女性肥胖所提供的乳腺癌保护作用。