他莫昔芬治疗与亚洲乳腺癌患者高脂血症风险降低：一项基于人群的队列研究。

Tamoxifen Treatment and the Reduced Risk of Hyperlipidemia in Asian Patients With Breast Cancer: A Population-Based Cohort Study.

作者信息

Lim Yun-Ping, Lin Cheng-Li, Lin Yen-Ning, Ma Wei-Chih, Hung Dong-Zong, Kao Chia-Hung

机构信息

Department of Pharmacy, College of Pharmacy, China Medical University, Taichung, Taiwan; Department of Emergency, Toxicology Center, China Medical University Hospital, Taichung, Taiwan.

Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.

出版信息

Clin Breast Cancer. 2015 Aug;15(4):294-300. doi: 10.1016/j.clbc.2015.03.005. Epub 2015 Mar 24.

DOI:10.1016/j.clbc.2015.03.005

PMID:25922283

Abstract

PURPOSE

The association between tamoxifen (TMX) treatment and the risk of developing hyperlipidemia remains unclear.

METHODS

The records of 41,726 patients with breast cancer (28,266 received TMX and 13,460 did not) were obtained from the Taiwan National Health Insurance Research Database for the period from January 2000 to December 2008. Three-fold women without breast cancer were the control group (N = 125, 178). The main end point was developing hyperlipidemia during the follow-up.

RESULTS

During a mean follow-up of 9 years, the patients with breast cancer demonstrated a rate of developing hyperlipidemia that was 6% less (adjusted hazard ratio [HR], 0.94; 95% confidence interval [CI], 0.90-0.97) than that of the control participants without breast cancer. Stratification by age group indicated that only women aged ≥ 55 years who were diagnosed with breast cancer exhibited a significantly reduced risk of hyperlipidemia compared with the control group. With the use of 2 types of adjusted models, we observed that the TMX users (aged ≥ 55 years) consistently exhibited a significantly lower risk of hyperlipidemia than the non-TMX users and control participants (adjusted HRs, 0.79 and 0.82 from models 1 and 2, respectively). Within the 8-year follow-up period, patients with breast cancer and 366 to 1500 days of TMX therapy and > 1500 days of TMX therapy had significantly lower risks of hyperlipidemia compared with patients with ≤ 365 days of TMX therapy (adjusted HR, 0.54; 95% CI, 0.50-0.59; adjusted HR, 0.21; 95% CI, 0.18-0.24, respectively).

CONCLUSIONS

In Asian patients with breast cancer, TMX use was associated with reduced risks of hyperlipidemia.

摘要

目的

他莫昔芬（TMX）治疗与发生高脂血症风险之间的关联仍不明确。

方法

从台湾国民健康保险研究数据库获取了2000年1月至2008年12月期间41726例乳腺癌患者的记录（28266例接受TMX治疗，13460例未接受）。选取三倍数量的无乳腺癌女性作为对照组（N = 125178）。主要终点是随访期间发生高脂血症。

结果

在平均9年的随访期间，乳腺癌患者发生高脂血症的发生率比无乳腺癌的对照参与者低6%（调整后风险比[HR]，0.94；95%置信区间[CI]，0.90 - 0.97）。按年龄组分层显示，只有年龄≥55岁且被诊断为乳腺癌的女性与对照组相比，发生高脂血症的风险显著降低。使用两种调整模型，我们观察到TMX使用者（年龄≥55岁）发生高脂血症的风险始终显著低于非TMX使用者和对照参与者（模型1和模型2调整后的HR分别为0.79和0.82）。在8年随访期内，与TMX治疗≤365天的患者相比，接受TMX治疗366至1500天以及>1500天的乳腺癌患者发生高脂血症的风险显著更低（调整后HR分别为0.54；95%CI，0.50 - 0.59；调整后HR为0.21；95%CI，0.18 - 0.24）。