Yi F, Diao S, Yuan X L, Li J Y
West China School of Public Health, Sichuan University, Chengdu 610041, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2018 Mar 6;52(3):253-259. doi: 10.3760/cma.j.issn.0253-9624.2018.03.007.
To explore the association between plasma leptin (LEP) levels, soluble leptin receptor(SLR), free leptin index and breast cancer. 245 new female cases of primary breast cancer confirmed by histopathology examination were sequentially recruited into the study. A total of 245 age-matched healthy women were enrolled as controls during the same period. A standardized questionnaire was used to collect the demographic information of the subjects. Blood samples were collected and the levels of LEP and SLR in plasma were measured by enzyme linked immunosorbent assay. The differences of LEP, SLR and FLI expression between control and cases group, as well as different breast cancer subtypes and TNM stages were compared using -test and ANOVA after stratification by menopause status. Multivariate logistic regression was used to explore the contributions of the three indexes to the risk of breast cancer. Females in both cases and control group were (50.7 ± 9.4) years old. The level of SLR and FLI ((50)((25),(75))) in premenopausal women were 18.4 (11.2, 28.7), 0.5 (0.4, 0.6) μg/L in case group and 27.7 (19.2, 43.4), 0.3 (0.3, 0.4) μg/L in control group (<0.001). While the level of postmenopausal women in case group were 20.3 (12.8, 31.8), 0.5 (0.4, 0.6) μ g/L (<0.001), and 30.1 (18.8, 40.5), 0.3 (0.3, 0.5) μg/L in control group (<0.001), respectively. After adjustment for confounding factors and BMI, the relationship between FLI and breast cancer remained significant for both pre- and postmenopausal women while the association between SLR and breast cancer was significant only in premenopausal women. Compared with the lowest level of SLR, higer levels of SLR is associated with a reduced risk of breast cancer (premenopausal women, 0.10, 95% 0.04-0.29, (trend)<0.001). Compared with the lowest level of FLI, FLI at higher levels is associated with an increased risk of breast cancer (premenopausal women, 7.14, 95% 2.86-17.83, (trend)<0.001; postmenopausal women, 8.10, 95% 2.85-22.98, (trend)<0.001). No significant association between LEP and breast cancer or association between the three indexes and breast cancer subtypes and TNM stages was found (0.05). SLR may be a protective factor for breast cancer while FLI may increase the risk of breast cancer.
探讨血浆瘦素（LEP）水平、可溶性瘦素受体（SLR）、游离瘦素指数与乳腺癌之间的关联。将245例经组织病理学检查确诊的新发女性原发性乳腺癌患者依次纳入研究。同期共纳入245例年龄匹配的健康女性作为对照。采用标准化问卷收集研究对象的人口统计学信息。采集血样，采用酶联免疫吸附测定法检测血浆中LEP和SLR水平。在按绝经状态分层后，使用t检验和方差分析比较对照组与病例组以及不同乳腺癌亚型和TNM分期之间LEP、SLR和FLI表达的差异。采用多因素逻辑回归分析探讨这三个指标对乳腺癌风险的影响。病例组和对照组女性的年龄均为（50.7±9.4）岁。绝经前女性病例组的SLR和FLI水平（（50）（（25），（75）））分别为18.4（11.2，28.7）、0.5（0.4，0.6）μg/L，对照组分别为27.7（19.2，43.4）、0.3（0.3，0.4）μg/L（<0.001）。绝经后女性病例组的水平分别为20.3（12.8，31.8）、0.5（0.4，0.6）μg/L（<0.001），对照组分别为30.1（18.8，40.5）、0.3（0.3，0.5）μg/L（<0.001）。在调整混杂因素和体重指数后，FLI与乳腺癌之间的关系在绝经前和绝经后女性中均仍然显著，而SLR与乳腺癌之间的关联仅在绝经前女性中显著。与最低水平的SLR相比，较高水平的SLR与降低的乳腺癌风险相关（绝经前女性，0.10，95% 0.04 - 0.29，（趋势）<0.001）。与最低水平的FLI相比，较高水平的FLI与增加的乳腺癌风险相关（绝经前女性，7.14，95% 2.86 - 17.83，（趋势）<0.001；绝经后女性，8.10，95% 2.85 - 22.98，（趋势）<0.001）。未发现LEP与乳腺癌之间存在显著关联，也未发现这三个指标与乳腺癌亚型和TNM分期之间存在关联（>0.05）。SLR可能是乳腺癌的一个保护因素，而FLI可能增加乳腺癌风险。
