Vatten L J, Foss O P
Department of Oncology, University Hospital, Trondheim, Norway.
Cancer Res. 1990 Apr 15;50(8):2341-6.
The association between total serum cholesterol and triglycerides and the incidence rate of breast cancer has been examined in 242 incident cases of breast cancer that developed among 24,329 Norwegian women during 11-14 years of follow-up. At the time of lipid measurement they were between 35 and 51 years of age. There was an inverse relation between serum cholesterol and risk of breast cancer which was confined to women diagnosed before the age of 51. The incidence rate ratio was 0.53 (95% confidence limits, 0.32 and 0.88) for women in the highest quartile of serum cholesterol (mean = 8.52 mM = 329 mg/100 ml) compared to women in the lowest quartile (mean = 5.28 mM = 204 mg/100 ml), and the relation displayed a negative trend over quartiles of cholesterol (chi 2 for trend = 3.94, P = 0.05). No association with cholesterol was found among cases diagnosed during the initial 2 years of follow-up, whereas a strong inverse relation was observed among cases that were diagnosed during the following 4 years (chi 2 trend = 12.6, P less than 0.001). For serum triglycerides there was an overall negative, but not statistically significant, association with breast cancer incidence, which was weakened after further adjustment for body mass index and serum cholesterol. The lack of information on reproductive factors associated with breast cancer risk is a limitation of this study, since potential confounding with the results cannot be excluded. We conclude that there is an inverse relation between serum cholesterol and breast cancer risk among women diagnosed before the age of 51 years. The findings indicate that the negative association cannot easily be attributed to a preclinical effect of the cancer.
在对24329名挪威女性进行11至14年随访期间发生的242例乳腺癌发病病例中，研究了血清总胆固醇和甘油三酯与乳腺癌发病率之间的关联。在进行血脂测量时，她们的年龄在35至51岁之间。血清胆固醇与乳腺癌风险之间存在负相关，这种关系仅限于51岁之前被诊断出的女性。血清胆固醇处于最高四分位数（均值 = 8.52 mM = 329 mg/100 ml）的女性与处于最低四分位数（均值 = 5.28 mM = 204 mg/100 ml）的女性相比，发病率比值为0.53（95%置信区间，0.32至0.88），并且这种关系在胆固醇四分位数之间呈现负向趋势（趋势χ² = 3.94，P = 0.05）。在随访的最初2年内被诊断出的病例中未发现与胆固醇有关联，而在接下来4年内被诊断出的病例中观察到了强烈的负相关（趋势χ² = 12.6，P < 0.001）。对于血清甘油三酯，与乳腺癌发病率总体呈负相关，但无统计学意义，在进一步调整体重指数和血清胆固醇后这种关联减弱。本研究的一个局限性在于缺乏与乳腺癌风险相关的生殖因素信息，因为无法排除对结果的潜在混杂影响。我们得出结论，在51岁之前被诊断出的女性中，血清胆固醇与乳腺癌风险之间存在负相关。研究结果表明，这种负相关不太可能轻易归因于癌症的临床前效应。
