Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.
Cancer Prev Res (Phila). 2013 Jul;6(7):701-10. doi: 10.1158/1940-6207.CAPR-12-0475. Epub 2013 May 16.
Metabolic syndrome has been associated with an increased risk of breast cancer; however, little is known about the association between metabolic syndrome and percent mammographic density, a strong predictor of breast cancer. We analyzed cross-sectional data from 789 premenopausal and 322 postmenopausal women in the Mexican Teacher's Cohort (ESMaestras). Metabolic syndrome was defined according to the harmonized definition. We measured percent density on mammograms using a computer-assisted thresholding method. Multivariable linear regression was used to estimate the association between density and metabolic syndrome, as well as its components by state (Jalisco, Veracruz) and menopausal status (premenopausal, postmenopausal). Among premenopausal women in Jalisco, women with metabolic syndrome had higher percent density than those without after adjusting for potential confounders including BMI [difference = 4.76; 95% confidence interval (CI), 1.72-7.81]. Among the metabolic syndrome components, only low high-density lipoprotein levels (<50 mg/dL) were associated with significantly higher percent density among premenopausal women in Jalisco (difference = 4.62; 95% CI, 1.73-7.52). Metabolic syndrome was not associated with percent density among premenopausal women in Veracruz (difference = -2.91; 95% CI, -7.19 to 1.38), nor among postmenopausal women in either state. Metabolic syndrome was associated with higher percent density among premenopausal women in Jalisco, Mexico, but was not associated with percent density among premenopausal women in Veracruz, Mexico, or among postmenopausal women in either Jalisco or Veracruz. These findings provide some support for a possible role of metabolic syndrome in mammographic density among premenopausal women; however, results were inconsistent across states and require further confirmation in larger studies.
代谢综合征与乳腺癌风险增加相关;然而,代谢综合征与乳腺密度之间的关系,乳腺密度是乳腺癌的一个强有力的预测指标,人们知之甚少。我们分析了墨西哥教师队列(ESMaestras)中 789 名绝经前和 322 名绝经后女性的横断面数据。代谢综合征根据协调定义进行定义。我们使用计算机辅助阈值方法测量乳腺 X 线照片上的密度百分比。多变量线性回归用于估计密度与代谢综合征及其成分之间的关系,以及按州(哈利斯科州、韦拉克鲁斯州)和绝经状态(绝经前、绝经后)划分的关系。在哈利斯科州的绝经前妇女中,调整包括 BMI 在内的潜在混杂因素后,患有代谢综合征的妇女的密度百分比高于无代谢综合征的妇女[差异=4.76;95%置信区间(CI),1.72-7.81]。在代谢综合征的组成部分中,只有低高密度脂蛋白水平(<50mg/dL)与哈利斯科州的绝经前妇女的密度百分比显著升高相关(差异=4.62;95%CI,1.73-7.52)。代谢综合征与韦拉克鲁斯州的绝经前妇女的密度百分比无相关性(差异=-2.91;95%CI,-7.19 至 1.38),也与两个州的绝经后妇女的密度百分比无相关性。代谢综合征与墨西哥哈利斯科州的绝经前妇女的乳腺密度百分比升高相关,但与墨西哥韦拉克鲁斯州的绝经前妇女的乳腺密度百分比无关,也与哈利斯科州或韦拉克鲁斯州的绝经后妇女的乳腺密度百分比无关。这些发现为代谢综合征在绝经前妇女的乳腺密度中可能发挥作用提供了一些支持;然而,结果在各州之间不一致,需要在更大的研究中进一步证实。