Am J Epidemiol. 2015 Feb 1;181(3):155-62. doi: 10.1093/aje/kwu261. Epub 2015 Jan 13.
Experimental and epidemiologic data support a protective role for melatonin in breast cancer etiology, yet studies in premenopausal women are scarce. In a case-control study nested within the Nurses' Health Study II cohort, we measured the concentration of melatonin's major urinary metabolite, 6-sulfatoxymelatonin (aMT6s), in urine samples collected between 1996 and 1999 among 600 breast cancer cases and 786 matched controls. Cases were predominantly premenopausal women who were diagnosed with incident breast cancer after urine collection and before June 1, 2007. Using multivariable conditional logistic regression, we computed odds ratios and 95% confidence intervals. Melatonin levels were not significantly associated with total breast cancer risk (for the fourth (top) quartile (Q4) of aMT6s vs. the first (bottom) quartile (Q1), odds ratio (OR) = 0.91, 95% confidence interval (CI): 0.64, 1.28; Ptrend = 0.38) or risk of invasive or in situ breast cancer. Findings did not vary by body mass index, smoking status, menopausal status, or time between urine collection and diagnosis (all Pinteraction values ≥ 0.12). For example, the odds ratio for total breast cancer among women with ≤5 years between urine collection and diagnosis was 0.74 (Q4 vs. Q1; 95% CI: 0.45, 1.20; Ptrend = 0.09), and it was 1.20 (Q4 vs. Q1; 95% CI: 0.72, 1.98; Ptrend = 0.70) for women with >5 years. Our data do not support an overall association between urinary melatonin levels and breast cancer risk.
实验和流行病学数据支持褪黑素在乳腺癌病因学中的保护作用,但针对绝经前女性的研究却很少。在一项嵌套于护士健康研究 II 队列的病例对照研究中,我们测量了 1996 年至 1999 年期间收集的 600 例乳腺癌病例和 786 例匹配对照的尿液样本中褪黑素主要尿代谢物 6-硫酸褪黑素(aMT6s)的浓度。病例主要为绝经前女性,在尿液采集后和 2007 年 6 月 1 日之前被诊断出患有乳腺癌。使用多变量条件逻辑回归,我们计算了比值比和 95%置信区间。褪黑素水平与总乳腺癌风险无显著相关性(第 4 (最高)四分位数(Q4)与第 1 (最低)四分位数(Q1)相比,比值比(OR)=0.91,95%置信区间(CI):0.64,1.28;Ptrend = 0.38)或浸润性或原位乳腺癌风险。研究结果不因体重指数、吸烟状况、绝经状态或尿液采集与诊断之间的时间而变化(所有 P 交互值≥0.12)。例如,尿液采集与诊断之间≤5 年的女性总乳腺癌的比值比为 0.74(Q4 与 Q1 相比;95%CI:0.45,1.20;Ptrend = 0.09),而尿液采集与诊断之间>5 年的女性的比值比为 1.20(Q4 与 Q1 相比;95%CI:0.72,1.98;Ptrend = 0.70)。我们的数据不支持尿液褪黑素水平与乳腺癌风险之间存在总体关联。