Ni Haibo, Liu Huixiang, Gao Rong
Department of Neurosurgery, The First People's Hospital of Zhangjiagang City, Suzhou, Jiangsu, China.
PLoS One. 2015 Nov 10;10(11):e0142669. doi: 10.1371/journal.pone.0142669. eCollection 2015.
Epidemiologic studies exploring causal associations between serum lipids and breast cancer risk have reported contradictory results. We conducted a meta-analysis of prospective cohort studies to evaluate these associations.
Relevant studies were identified by searching PubMed and EMBASE through April 2015. We included prospective cohort studies that reported relative risk (RR) estimates with 95% confidence intervals (CIs) for the associations of specific lipid components (i.e., total cholesterol [TC], high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], and triglycerides [TG]) with breast cancer risk. Either a fixed- or a random-effects model was used to calculate pooled RRs.
Fifteen prospective cohort studies involving 1,189,635 participants and 23,369 breast cancer cases were included in the meta-analysis. The pooled RRs of breast cancer for the highest versus lowest categories were 0.96 (95% CI: 0.86-1.07) for TC, 0.92 (95% CI: 0.73-1.16) for HDL-C, 0.90 (95% CI: 0.77-1.06) for LDL-C, and 0.93 (95% CI: 0.86-1.00) for TG. Notably, for HDL-C, a significant reduction of breast cancer risk was observed among postmenopausal women (RR = 0.77, 95% CI: 0.64-0.93) but not among premenopausal women. Similar trends of the associations were observed in the dose-response analysis.
Our findings suggest that serum levels of TG but not TC and LDL-C may be inversely associated with breast cancer risk. Serum HDL-C may also protect against breast carcinogenesis among postmenopausal women.
探索血清脂质与乳腺癌风险之间因果关联的流行病学研究报告了相互矛盾的结果。我们进行了一项前瞻性队列研究的荟萃分析，以评估这些关联。
通过检索截至2015年4月的PubMed和EMBASE来确定相关研究。我们纳入了前瞻性队列研究，这些研究报告了特定脂质成分（即总胆固醇[TC]、高密度脂蛋白胆固醇[HDL-C]、低密度脂蛋白胆固醇[LDL-C]和甘油三酯[TG]）与乳腺癌风险关联的相对风险（RR）估计值及95%置信区间（CI）。采用固定效应模型或随机效应模型计算合并RR。
荟萃分析纳入了15项前瞻性队列研究，涉及1,189,635名参与者和23,369例乳腺癌病例。TC最高类别与最低类别相比，乳腺癌的合并RR为0.96（95%CI：0.86 - 1.07），HDL-C为0.92（95%CI：0.73 - 1.16），LDL-C为0.90（95%CI：0.77 - 1.06），TG为0.93（95%CI：0.86 - 1.00）。值得注意的是，对于HDL-C，绝经后女性乳腺癌风险显著降低（RR = 0.77，95%CI：0.64 - 0.93），但绝经前女性未观察到这种情况。在剂量反应分析中观察到类似的关联趋势。
我们的研究结果表明，血清TG水平而非TC和LDL-C水平可能与乳腺癌风险呈负相关。血清HDL-C也可能在绝经后女性中预防乳腺癌发生。
