International Prevention Research Institute, 95 cours Lafayette, 69006 Lyon, France.
Br J Cancer. 2012 Oct 23;107(9):1608-17. doi: 10.1038/bjc.2012.414. Epub 2012 Sep 20.
The potential of an increased risk of breast cancer in women with diabetes has been the subject of a great deal of recent research.
A meta-analysis was undertaken using a random effects model to investigate the association between diabetes and breast cancer risk.
Thirty-nine independent risk estimates were available from observational epidemiological studies. The summary relative risk (SRR) for breast cancer in women with diabetes was 1.27 (95% confidence interval (CI), 1.16-1.39) with no evidence of publication bias. Prospective studies showed a lower risk (SRR 1.23 (95% CI, 1.12-1.35)) than retrospective studies (SRR 1.36 (95% CI, 1.13-1.63)). Type 1 diabetes, or diabetes in pre-menopausal women, were not associated with risk of breast cancer (SRR 1.00 (95% CI, 0.74-1.35) and SRR 0.86 (95% CI, 0.66-1.12), respectively). Studies adjusting for body mass index (BMI) showed lower estimates (SRR 1.16 (95% CI, 1.08-1.24)) as compared with those studies that were not adjusted for BMI (SRR 1.33 (95% CI, 1.18-1.51)).
The risk of breast cancer in women with type 2 diabetes is increased by 27%, a figure that decreased to 16% after adjustment for BMI. No increased risk was seen for women at pre-menopausal ages or with type 1 diabetes.
糖尿病女性患乳腺癌的风险增加已成为近期大量研究的主题。
采用随机效应模型进行荟萃分析，以研究糖尿病与乳腺癌风险之间的关联。
从观察性流行病学研究中获得了 39 个独立的风险估计值。糖尿病女性乳腺癌的汇总相对风险（SRR）为 1.27（95%置信区间（CI），1.16-1.39），无出版偏倚的证据。前瞻性研究显示的风险较低（SRR 1.23（95%CI，1.12-1.35）），而回顾性研究的风险较高（SRR 1.36（95%CI，1.13-1.63））。1 型糖尿病或绝经前女性的糖尿病与乳腺癌风险无关（SRR 1.00（95%CI，0.74-1.35）和 SRR 0.86（95%CI，0.66-1.12））。调整体重指数（BMI）的研究显示，与未调整 BMI 的研究相比，估计值较低（SRR 1.16（95%CI，1.08-1.24））（SRR 1.33（95%CI，1.18-1.51））。
2 型糖尿病女性患乳腺癌的风险增加 27%，调整 BMI 后风险降低至 16%。未绝经前年龄或 1 型糖尿病女性的风险未见增加。
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