McCullough Lauren E, Eng Sybil M, Bradshaw Patrick T, Cleveland Rebecca J, Steck Susan E, Terry Mary Beth, Shen Jing, Crew Katherine D, Rossner Pavel, Ahn Jiyoung, Ambrosone Christine B, Teitelbaum Susan L, Neugut Alfred I, Santella Regina M, Gammon Marilie D
Department of Epidemiology, University of North Carolina, Chapel Hill.
Department of Epidemiology, Columbia University, New York, NY.
Ann Epidemiol. 2015 Apr;25(4):263-9. doi: 10.1016/j.annepidem.2015.01.009. Epub 2015 Jan 24.
Obesity is associated with increased bioavailability of estrogen, hyperinsulinemia, and chronic inflammation, all of which may promote tumor growth. Given DNA repair and oxidative stress pathways may work together with these mechanisms to influence carcinogenesis, we hypothesized that genetic variation in these pathways may modify the obesity-postmenopausal breast cancer (BC) association.
Resources from a population-based case-control study (990 cases and 970 controls) were used to construct logistic regression models. Body mass index (BMI, weight [kilogram]/height [square meter]) was assessed 1 year before reference date. We characterized interactions between BMI and 29 genetic polymorphisms in oxidative stress and DNA repair pathways.
Age-adjusted odds ratios (95% confidence intervals) for postmenopausal BC were 1.24 (1.00-1.52) and 1.35 (1.09-1.71) for 25 ≥ BMI < 30 and BMI ≥ 30 kg/m(2), respectively. We observed multiplicative interactions (P ≤ .05) for eight gene polymorphisms in DNA repair and oxidative stress pathways. For example, among MPO variant allele carriers, obesity was associated with a twofold increased risk of postmenopausal BC (2.13 [1.35-3.36]); however, in wild-type homozygotes, the relationship was less pronounced (1.33 [0.93-1.89]). Our findings were no longer significant after Bonferroni correction.
Obesity may be particularly deleterious for postmenopausal BC development in the presence of biologically plausible DNA repair or oxidative stress genotypes.
肥胖与雌激素生物利用度增加、高胰岛素血症及慢性炎症相关,所有这些都可能促进肿瘤生长。鉴于DNA修复和氧化应激途径可能与这些机制共同作用影响致癌作用,我们推测这些途径中的基因变异可能会改变肥胖与绝经后乳腺癌(BC)之间的关联。
基于人群的病例对照研究(990例病例和970例对照)的资源用于构建逻辑回归模型。在参考日期前1年评估体重指数(BMI,体重[千克]/身高[平方米])。我们对BMI与氧化应激和DNA修复途径中的29种基因多态性之间的相互作用进行了表征。
绝经后BC的年龄调整优势比(95%置信区间)在BMI为25≥<30和BMI≥30 kg/m²时分别为1.24(1.00 - 1.52)和1.35(1.09 - 1.71)。我们在DNA修复和氧化应激途径中观察到8种基因多态性的相乘相互作用(P≤.05)。例如,在MPO变异等位基因携带者中,肥胖与绝经后BC风险增加两倍相关(2.13 [1.35 - 3.36]);然而,在野生型纯合子中,这种关系不太明显(1.33 [0.93 - 1.89])。经Bonferroni校正后,我们的发现不再显著。
在存在生物学上合理的DNA修复或氧化应激基因型的情况下,肥胖可能对绝经后BC的发生特别有害。