肥胖、成年期体重变化与绝经后乳腺癌风险。

Adiposity, adult weight change, and postmenopausal breast cancer risk.

作者信息

Ahn Jiyoung, Schatzkin Arthur, Lacey James V, Albanes Demetrius, Ballard-Barbash Rachel, Adams Kenneth F, Kipnis Victor, Mouw Traci, Hollenbeck Albert R, Leitzmann Michael F

机构信息

Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, EPS, 6120 Executive Blvd, Bethesda, MD 20892, USA.

出版信息

Arch Intern Med. 2007 Oct 22;167(19):2091-102. doi: 10.1001/archinte.167.19.2091.

DOI:10.1001/archinte.167.19.2091

PMID:17954804

Abstract

BACKGROUND

Obesity is a risk factor for postmenopausal breast cancer, but the role of the timing and amount of adult weight change in breast cancer risk is unclear.

METHODS

We prospectively examined the relations of adiposity and adult weight change to breast cancer risk among 99 039 postmenopausal women in the National Institutes of Health-AARP Diet and Health Study. Anthropometry was assessed by self-report in 1996. Through 2000, 2111 incident breast cancer cases were ascertained.

RESULTS

Current body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared), BMI at ages 50 and 35 years, and waist-hip ratio were associated with increased breast cancer risk, particularly in women not using menopausal hormone therapy (MHT). Weight gained between age 18 years and the current age, between ages 18 and 35 years, between ages 35 and 50 years, and between age 50 years and the current age was consistently associated with increased breast cancer risk in MHT nonusers (relative risk [RR], 2.15; 95% confidence interval [CI], 1.35-3.42 for a >/=50-kg weight gain between age 18 years and the current age vs stable weight) but not in current MHT users. Risk associated with adult weight change was stronger in women with later vs earlier age at menarche (RR, 4.20; 95% CI, 2.05-8.64 for >/=15 years vs RR, 1.51; 95% CI, 1.11-2.06 for 11-12 years; P = .007 for interaction). In MHT nonusers, the associations with current BMI and adult weight change were stronger for advanced disease than for nonadvanced disease (P = .009 [current BMI] and .21 [weight gain] for heterogeneity) and were stronger for hormone receptor-positive than hormone receptor-negative tumors (P < .001 for heterogeneity).

CONCLUSION

Weight gain throughout adulthood is associated with increased postmenopausal breast cancer risk in MHT nonusers.

摘要

背景

肥胖是绝经后乳腺癌的一个风险因素，但成年期体重变化的时间和幅度在乳腺癌风险中的作用尚不清楚。

方法

我们在国立卫生研究院-美国退休人员协会饮食与健康研究中，对99039名绝经后女性进行了前瞻性研究，以探讨肥胖和成年期体重变化与乳腺癌风险之间的关系。1996年通过自我报告评估人体测量学指标。截至2000年，确定了2111例新发乳腺癌病例。

结果

当前体重指数（BMI，计算方法为体重千克数除以身高米数的平方）、50岁和35岁时的BMI以及腰臀比与乳腺癌风险增加相关，尤其是在未使用绝经激素治疗（MHT）的女性中。18岁至当前年龄、18岁至35岁、35岁至50岁以及50岁至当前年龄之间增加的体重，在未使用MHT的女性中始终与乳腺癌风险增加相关（相对风险[RR]为2.15；95%置信区间[CI]为1.35 - 3.42，18岁至当前年龄体重增加≥50千克与体重稳定相比），但在当前使用MHT的女性中并非如此。月经初潮年龄较晚的女性与成年期体重变化相关的风险比月经初潮年龄较早的女性更强（RR，4.20；95%CI，15岁及以上为2.05 - 8.64，11 - 12岁为RR，1.51；95%CI，1.11 - 2.06；交互作用P = 0.007）。在未使用MHT的女性中，与晚期疾病相比，当前BMI和成年期体重变化与进展期疾病的关联更强（异质性P = 0.009[当前BMI]和0.21[体重增加]），并且与激素受体阳性肿瘤相比，与激素受体阴性肿瘤的关联更强（异质性P < 0.001）。