Akinyemiju Tomi F, Tehranifar Parisa, Flom Julie D, Liao Yuyan, Wei Ying, Terry Mary Beth
Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY; Department of Epidemiology, Ryals School of Public Health, University of Alabama at Birmingham, Birmingham.
Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY; Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY.
Ann Epidemiol. 2016 Aug;26(8):540-545.e2. doi: 10.1016/j.annepidem.2016.06.011. Epub 2016 Jul 18.
Rapid infant and childhood growth has been associated with chronic disease later in life, including breast cancer. Early life socioeconomic status (SES) influences childhood growth, but few studies have prospective measures from birth to consider the effects of early life growth and SES on breast cancer risk.
We used prospectively measured early life SES and growth (percentile weight change in height and weight between each pair of consecutive time points at birth, 4 months, 1 and 7 years). We performed linear regression models to obtain standardized estimates of the association between 1 standard deviation increase in early life SES and growth and adult mammographic density (MD), a strong risk factor for breast cancer, in a diverse birth cohort (n = 151; 37% white, 38% black, 25% Puerto Rican; average age at mammogram = 42.4).
In models adjusted for race/ethnicity, prenatal factors, birthweight, infant and childhood growth, and adult body mass index, percentile weight change from 1 year to 7 years was inversely associated with percent MD (standardized coefficient (Stdβ) = -0.28, 95% CI: -0.55 to -0.01), and higher early life SES was positively associated with percent MD (Stdβ = 0.24, 95% CI: 0.04-0.43). Similar associations were observed for dense area, but those estimates were not statistically significant.
These results suggest opposite and independent effects of early life SES and growth on MD.
婴幼儿期的快速生长与包括乳腺癌在内的成年期慢性疾病有关。生命早期的社会经济地位（SES）会影响儿童期生长，但很少有研究从出生开始进行前瞻性测量，以探讨生命早期生长和SES对乳腺癌风险的影响。
我们使用前瞻性测量的生命早期SES和生长情况（出生时、4个月、1岁和7岁时每两个连续时间点之间身高和体重的百分位变化）。我们进行线性回归模型，以获得在一个多样化的出生队列（n = 151；37%为白人，38%为黑人，25%为波多黎各人；乳房X线摄影平均年龄 = 42.4岁）中，生命早期SES和生长每增加1个标准差与成年乳房X线摄影密度（MD，乳腺癌的一个重要风险因素）之间关联的标准化估计值。
在对种族/族裔、产前因素、出生体重、婴幼儿期和儿童期生长以及成年体重指数进行调整的模型中，1岁至7岁的体重百分位变化与MD百分比呈负相关（标准化系数（Stdβ）= -0.28，95%置信区间：-0.55至-0.01），而生命早期较高的SES与MD百分比呈正相关（Stdβ = 0.24，95%置信区间：0.04 - 0.43）。在致密面积方面也观察到类似的关联，但这些估计值无统计学意义。
这些结果表明生命早期SES和生长对MD有相反且独立的影响。
