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糖尿病前期、糖尿病与乳腺癌风险:病例对照研究。

Prediabetes, diabetes, and risk of breast cancer: a case-control study.

机构信息

Unidad de Investigación Epidemiológica y en Servicios de Salud No. 34, Instituto Mexicano del Seguro Social, Centro Médico Nacional del Norte, Monterrey, N.L., México; Universidad Autónoma de Nuevo León, Facultad de Salud Pública y Nutrición, Monterrey, N.L., México.

Unidad de Investigación Epidemiológica y en Servicios de Salud No. 34, Instituto Mexicano del Seguro Social, Centro Médico Nacional del Norte, Monterrey, N.L., México.

出版信息

Arch Med Res. 2014 Jul;45(5):432-8. doi: 10.1016/j.arcmed.2014.06.004. Epub 2014 Jun 14.

Abstract

BACKGROUND AND AIMS

Although underlying mechanisms have been described to account for the association between prediabetes and diabetes with breast cancer, reported results have been inconsistent. We undertook this study to determine whether prediabetes and diabetes are risk factors for breast cancer in Mexican women with no family history of breast cancer in the mother, daughters, or sisters.

METHODS

A case-control study was carried out during 2011-2013. "Case" referred to patients with a histopathological diagnosis of breast cancer (incident and primary cases) (n = 240); "controls" were those with a BI-RADS 1 or 2 mammography result (n = 406). Categorization of prediabetes and diabetes was based on self-reporting or fasting glucose and glycated hemoglobin blood sampling results. Reproductive and sociodemographic data were collected by interview. Odds ratios (ORs) and 95% confidence intervals (CI) were calculated using multivariate unconditional binary logistic regression analysis.

RESULTS

Prediabetes increased the risk of breast cancer in postmenopausal women (adjusted OR 2.08, 95% CI 1.10-3.96) as did diabetes (adjusted OR 2.85, 95% CI 1.55-5.26). A history of diabetes preceding breast cancer by ≥7 years and <7 years were both associated with an increased risk for breast cancer (adjusted OR 2.80, 95% CI 1.40-5.60 and 3.00, 95% CI 1.50-5.90, respectively).

CONCLUSIONS

This is the first study in Mexico evaluating prediabetes and diabetes as breast cancer risk factors in women with no first-degree relatives with breast cancer. Our findings suggest that women with prediabetes and diabetes should be considered a more vulnerable population for early breast cancer detection.

摘要

背景和目的

尽管已经描述了导致前驱糖尿病和糖尿病与乳腺癌之间关联的潜在机制,但报告的结果并不一致。我们进行这项研究是为了确定前驱糖尿病和糖尿病是否是墨西哥女性中无乳腺癌家族史(母亲、女儿或姐妹)的乳腺癌的危险因素。

方法

这是一项在 2011 年至 2013 年期间进行的病例对照研究。“病例”是指有组织病理学诊断为乳腺癌的患者(包括新发病例和原发性病例)(n=240);“对照”是指乳腺 X 线摄影术 BI-RADS 1 或 2 结果的患者(n=406)。前驱糖尿病和糖尿病的分类是基于自我报告或空腹血糖和糖化血红蛋白血样结果。通过访谈收集生殖和社会人口统计学数据。使用多变量无条件二元逻辑回归分析计算比值比(OR)和 95%置信区间(CI)。

结果

前驱糖尿病增加了绝经后妇女患乳腺癌的风险(调整后的 OR 2.08,95%CI 1.10-3.96),糖尿病也是如此(调整后的 OR 2.85,95%CI 1.55-5.26)。糖尿病在乳腺癌之前的时间≥7 年和<7 年都与乳腺癌风险增加相关(调整后的 OR 分别为 2.80、95%CI 1.40-5.60 和 3.00、95%CI 1.50-5.90)。

结论

这是墨西哥第一项评估前驱糖尿病和糖尿病作为无一级亲属乳腺癌女性乳腺癌风险因素的研究。我们的研究结果表明,前驱糖尿病和糖尿病的女性应被视为早期乳腺癌检测的更脆弱人群。

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