Lovegrove Julie A
Hugh Sinclair Unit of Human Nutrition, School of Food Biosciences, The University of Reading, PO Box 226, Whiteknights, Reading RG6 6AP, UK.
Nutr Res Rev. 2002 Dec;15(2):389-412. doi: 10.1079/NRR200245.
Abstract Strong epidemiological data exists implicating anthropometric risk factors in breast cancer aetiology. In premenopausal women the risk of breast cancer increases with increased height, yet decreases with increasing weight and BMI. Although the evidence is not strong, a counter-intuitive positive relationship between central adiposity and premenopausal breast cancer risk is emerging. In post-menopausal women an increased risk in breast cancer has been found for all anthropometric measures: height, weight, BMI, measures of central adiposity (waist:hip ratio and waist circumference) and weight gain, with breast size being a possible additional risk factor. Weight loss as a strategy for reducing breast cancer risk seems to offer a viable prophylaxis in obese post-menopausal women, although data are limited. The evidence for anthropometric measures in relation to breast cancer risk is consistently stronger for post-menopausal women compared with premenopausal women and seems to be dependent on age. A number of possible biological mechanisms have been offered to explain the link between breast cancer risk and anthropometric measures. It has been hypothesised that obesity, especially central fat deposits, linked to insulin resistance, increases circulating hormones such as oestrogens, androgens, insulin, insulin-like growth factor-1 (IGF-1), and decreased levels of hormone-binding proteins such as steroid hormone-binding globulin and IGF-1 binding protein-1. Thus there are resulting increased concentrations of bioavailable sex hormones, which have been linked to increased breast cancer risk. As obesity is an important modifiable risk factor, which has been linked to increased post-menopausal breast cancer, public health recommendations to maintain ideal weight throughout life are warranted.
摘要 有强有力的流行病学数据表明人体测量学风险因素与乳腺癌病因相关。在绝经前女性中，乳腺癌风险随身高增加而上升，但随体重和体重指数（BMI）增加而下降。尽管证据并不充分，但中心性肥胖与绝经前乳腺癌风险之间正出现一种有悖直觉的正相关关系。在绝经后女性中，已发现所有人体测量指标（身高、体重、BMI、中心性肥胖指标（腰臀比和腰围）以及体重增加）都会增加乳腺癌风险，乳房大小可能是另一个风险因素。尽管数据有限，但对于肥胖的绝经后女性而言，通过减重来降低乳腺癌风险似乎是一种可行的预防措施。与绝经前女性相比，绝经后女性中人体测量指标与乳腺癌风险相关的证据始终更为充分，且似乎取决于年龄。人们提出了一些可能的生物学机制来解释乳腺癌风险与人体测量指标之间的联系。据推测，肥胖，尤其是中心脂肪堆积，与胰岛素抵抗相关，会增加循环激素水平，如雌激素、雄激素、胰岛素、胰岛素样生长因子-1（IGF-1），同时降低激素结合蛋白水平，如类固醇激素结合球蛋白和IGF-1结合蛋白-1。因此，生物可利用的性激素浓度会升高，这与乳腺癌风险增加有关。由于肥胖是一个重要的可改变风险因素，且与绝经后乳腺癌增加有关，因此有必要提出终生保持理想体重的公共卫生建议。
