Han Daikwon, Nie Jing, Bonner Matthew R, McCann Susan E, Muti Paola, Trevisan Maurizio, Ramirez-Marrero Farah A, Vito Dominica, Freudenheim Jo L
Department of Social and Preventive Medicine, University at Buffalo-State, University of New York, Buffalo, NY, USA.
Int J Cancer. 2006 Dec 15;119(12):2931-7. doi: 10.1002/ijc.22236.
While there are quite consistent data regarding associations of body weight and postmenopausal breast cancer, there are now accumulating data that would indicate that weight gain in adult life is more predictive of risk than absolute body weight. There is, however, little known about the relative impact of timing of weight gain in adult life as well as other characteristics of the weight and breast cancer association that might provide insight into the mechanism of the observation. We conducted a population-based case control study of breast cancer (1996-2001), the Western New York Exposures and Breast Cancer Study. Included were 1,166 women with primary, histologically confirmed, incident breast cancer and 2,105 controls frequency-matched on age, race and county of residence. Unconditional logistic regression was used to estimate odds ratios and 95% confidence intervals. We found increased risk of breast cancer associated with lifetime adult weight gain among post- but not premenopausal women, and there was a 4% increase in risk for each 5 kg increase in adult weight. Further there was a tendency toward a stronger association for those with higher waist circumference and those with positive estrogen or progesterone status, and who had never used HRT. We also found an association with risk for weight gain since first pregnancy and for weight gain between the time of the first pregnancy and menopause, independent of body mass index and lifetime adult weight gain. Our results suggest that there are time periods of weight gain that have greater impact on risk, and that central body fat, receptor status and hormone replacement therapy may all affect the observed association.
虽然关于体重与绝经后乳腺癌之间的关联有相当一致的数据,但现在越来越多的数据表明,成年期体重增加比绝对体重更能预测风险。然而,对于成年期体重增加的时间以及体重与乳腺癌关联的其他特征的相对影响知之甚少,这些特征可能有助于深入了解这一观察结果的机制。我们进行了一项基于人群的乳腺癌病例对照研究(1996 - 2001年),即纽约西部暴露与乳腺癌研究。研究对象包括1166名患有原发性、经组织学确诊的新发乳腺癌的女性以及2105名在年龄、种族和居住县方面频率匹配的对照。采用无条件逻辑回归来估计比值比和95%置信区间。我们发现绝经后而非绝经前女性中,成年期终生体重增加与乳腺癌风险增加有关,并且成年体重每增加5千克,风险增加4%。此外,对于腰围较高、雌激素或孕激素状态为阳性且从未使用过激素替代疗法(HRT)的女性,这种关联有更强的趋势。我们还发现,首次怀孕后体重增加以及首次怀孕至绝经期间体重增加与风险有关,且独立于体重指数和成年期终生体重增加。我们的结果表明,存在一些体重增加时期对风险有更大影响,并且中心体脂、受体状态和激素替代疗法可能都会影响所观察到的关联。