Ballard-Barbash R, Schatzkin A, Carter C L, Kannel W B, Kreger B E, D'Agostino R B, Splansky G L, Anderson K M, Helsel W E
Cancer Prevention Studies Branch, National Cancer Institute, Bethesda, MD 20892.
J Natl Cancer Inst. 1990 Feb 21;82(4):286-90. doi: 10.1093/jnci/82.4.286.
We examined the relation between central body fat distribution and breast cancer in a prospective cohort of women who participated in the Framingham Study. At the baseline examination in 1948, a total of 2,201 women aged 30-62 years were analyzed. An index of central to peripheral body fat (the central adiposity ratio) was calculated from the sum of the trunkal skinfolds (chest, subscapular, and abdominal) divided by the sum of the extremity skinfolds (triceps and thigh). These skinfolds were measured at the fourth examination in 1954. The cohort was followed for up to 28 years and yielded 106 cases of breast cancer. When divided into quartiles based on the central adiposity ratio, only women in the fourth quartile (those with the highest central to peripheral body fat distribution) demonstrated an increased risk for breast cancer. The age- and adiposity-adjusted relative risk estimate for having an increased central adiposity ratio (fourth quartile) compared to lower central adiposity ratios was 1.8 (95% confidence interval, 1.2-2.6). Adjustment for potential confounders of height, parity, and education did not appreciably alter this estimate (1.7, 1.1-2.5). There was no association between degree of adiposity, as measured by the sum of the five skinfolds or by body mass index (weight in kg divided by height in m2), and subsequent breast cancer. The results of this study suggest that increased central to peripheral body fat distribution predicts breast cancer risk independently of the degree of adiposity and may be a more specific marker of a premalignant hormonal pattern than degree of adiposity.
我们在参与弗雷明汉姆研究的女性前瞻性队列中，研究了中心体脂分布与乳腺癌之间的关系。在1948年的基线检查中，共分析了2201名年龄在30至62岁之间的女性。根据躯干皮褶（胸部、肩胛下和腹部）之和除以四肢皮褶（肱三头肌和大腿）之和计算中心与外周体脂指数（中心肥胖率）。这些皮褶在1954年的第四次检查时进行测量。该队列随访长达28年，共出现106例乳腺癌病例。根据中心肥胖率分为四分位数时，只有第四四分位数的女性（中心与外周体脂分布最高者）显示患乳腺癌的风险增加。与较低中心肥胖率相比，中心肥胖率增加（第四四分位数）的年龄和肥胖调整后相对风险估计值为1.8（95%置信区间，1.2 - 2.6）。对身高、生育史和教育程度等潜在混杂因素进行调整后，该估计值没有明显变化（1.7，1.1 - 2.5）。通过五个皮褶之和或体重指数（体重千克数除以身高米数的平方）衡量的肥胖程度与随后的乳腺癌之间没有关联。这项研究的结果表明，中心与外周体脂分布增加可独立于肥胖程度预测乳腺癌风险，并且可能比肥胖程度更具体地反映癌前激素模式。
