Xie Chuanbo, Wang Wei, Li Xiuhong, Shao Nan, Li Weidong
a Department of Cancer Prevention Research, Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China , Sun Yat-sen University Cancer Center , Guangzhou , China.
b Department of Thoracic Surgery , the Second Affiliated Hospital of Guangzhou Medical University , Guangzhou , China.
J Matern Fetal Neonatal Med. 2019 Mar;32(6):1022-1032. doi: 10.1080/14767058.2017.1397117. Epub 2017 Nov 7.
The association between gestational diabetes mellitus (GDM) and maternal breast cancer risk was controversial and inclusive. In this study, we aimed to examine the association between GDM and maternal breast cancer using meta-analysis method.
Researchers searched and reviewed the topic related articles comprehensively. For each eligible article, we extracted the effect size (odds ratio/relative risk or OR/RR) and its 95% confidence interval (CI). We used random effect models to combine the effect sizes. Subgroups analysis were used to examine whether the effects of GDM on breast cancer risk differed across GDM ascertainment methods, breast cancer ascertainment method, risk of bias, and country of study origin.
Five case-control studies and six cohort studies which met the eligible criteria were included into analysis. Overall, we didn't find significant associations between GDM and breast cancer among case-control studies (pooled OR = 0.85, 95%CI = 0.65, 1.10) and cohort studies pooled RR = 1.00, 95%CI = 0.80, 1.25). However, our subgroup analysis showed that GDM was a protective factor for breast cancer among the case-control studies in which breast cancer was ascertained via cancer registry system (OR = 0.73, 95%CI = 0.54, 1.00).
GDM during pregnancy is not associated with breast cancer in our study, suggesting that GDM mothers are not needed to be too anxious about their future breast cancer risk.
妊娠期糖尿病（GDM）与母亲患乳腺癌风险之间的关联存在争议且尚无定论。在本研究中，我们旨在采用荟萃分析方法探讨GDM与母亲患乳腺癌之间的关联。
研究人员全面检索并综述了相关主题的文章。对于每一篇符合条件的文章，我们提取效应量（比值比/相对风险或OR/RR）及其95%置信区间（CI）。我们使用随机效应模型合并效应量。亚组分析用于检验GDM对乳腺癌风险的影响在GDM确定方法、乳腺癌确定方法、偏倚风险和研究来源国之间是否存在差异。
五项病例对照研究和六项队列研究符合纳入分析的条件。总体而言，我们在病例对照研究（合并OR = 0.85，95%CI = 0.65，1.10）和队列研究（合并RR = 1.00，95%CI = 0.80，1.25）中均未发现GDM与乳腺癌之间存在显著关联。然而，我们的亚组分析表明，在通过癌症登记系统确定乳腺癌的病例对照研究中，GDM是乳腺癌的一个保护因素（OR = 0.73，95%CI = 0.54，1.00）。
在我们的研究中，孕期GDM与乳腺癌无关，这表明患有GDM的母亲无需对其未来患乳腺癌的风险过于焦虑。
