Rohan Thomas E, Heo Moonseong, Choi Lydia, Datta Mridul, Freudenheim Jo L, Kamensky Victor, Ochs-Balcom Heather M, Qi Lihong, Thomson Cynthia A, Vitolins Mara Z, Wassertheil-Smoller Sylvia, Kabat Geoffrey C
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
J Cancer Epidemiol. 2013;2013:754815. doi: 10.1155/2013/754815. Epub 2013 Apr 7.
Associations between anthropometric indices of obesity and breast cancer risk may fail to capture the true relationship between excess body fat and risk. We used dual-energy-X-ray-absorptiometry- (DXA-) derived measures of body fat obtained in the Women's Health Initiative to examine the association between body fat and breast cancer risk; we compared these risk estimates with those for conventional anthropometric measurements. The study included 10,960 postmenopausal women aged 50-79 years at recruitment, with baseline DXA measurements and no history of breast cancer. During followup (median: 12.9 years), 503 incident breast cancer cases were diagnosed. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards models. All baseline DXA-derived body fat measures showed strong positive associations with breast cancer risk. The multivariable-adjusted HR for the uppermost quintile level (versus lowest) ranged from 1.53 (95% CI 1.14-2.07) for fat mass of the right leg to 2.05 (1.50-2.79) for fat mass of the trunk. Anthropometric indices (categorized by quintiles) of obesity (BMI (1.97, 1.45-2.68), waist circumference (1.97, 1.46-2.65), and waist : hip ratio (1.91, 1.41-2.58)) were all strongly, positively associated with risk and did not differ from DXA-derived measures in prediction of risk.
肥胖的人体测量指数与乳腺癌风险之间的关联可能无法反映体脂过多与风险之间的真实关系。我们使用妇女健康倡议中通过双能X线吸收法（DXA）得出的体脂测量值来研究体脂与乳腺癌风险之间的关联；我们将这些风险估计值与传统人体测量指标的风险估计值进行了比较。该研究纳入了10960名年龄在50 - 79岁之间的绝经后女性，她们在招募时进行了基线DXA测量且无乳腺癌病史。在随访期间（中位数：12.9年），诊断出503例新发乳腺癌病例。使用Cox比例风险模型估计风险比（HR）和95%置信区间（CI）。所有基于基线DXA得出的体脂测量值均与乳腺癌风险呈强正相关。右上五分位数水平（相对于最低水平）的多变量调整后HR范围从右腿脂肪量的1.53（95%CI 1.14 - 2.07）到躯干脂肪量的2.05（1.50 - 2.79）。肥胖的人体测量指数（按五分位数分类）（体重指数（1.97，1.45 - 2.68）、腰围（1.97，1.46 - 2.65）和腰臀比（1.91，1.41 - 2.58））均与风险呈强正相关，并且在风险预测方面与基于DXA得出的测量值没有差异。
