Department of Epidemiology and Health Statistics, Southeast University, Dingjiaqiao Road 87th, Nanjing, 210009, Jiangsu, China.
Department of Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.
Breast Cancer Res Treat. 2019 Feb;173(3):647-655. doi: 10.1007/s10549-018-5016-3. Epub 2018 Oct 27.
The accumulating evidence indicates that weight gain in adulthood is more predictive of breast cancer risk than absolute body weight. However, the relative impact of timing of weight gain in adulthood on breast cancer as well as other characteristics of the association between weight and breast cancer has not been well documented.
This population-based case-control study of breast cancer included 818 patients with newly diagnosed primary breast cancer and 935 residence and age-matched healthy controls. The body weight values at 18 years old, 1 year before diagnosis, and at menopause were obtained during in-person interviews. Unconditional logistic regression was used to estimate the effects of the weight change over adulthood on breast cancer risk. Linear mixed-effects regression was also applied as a secondary analysis.
We found that the increased risk of breast cancer was associated with the weight gain in adulthood among postmenopausal women (OR 1.23; 95% CI 1.10-1.37 per 5 kg increase) but not in the premenopausal women. The risk associated with weight gain since menopause (OR 1.65; 95% CI 1.28-2.14 a 5-kg increase) was higher than that from age 18 to menopause (OR 1.14; 95% CI 1.02, 1.28 a 5-kg increase). The association tended to be stronger in those with higher waist circumference and who had never used hormone replacement therapy (HRT). Women who had never used HRT, the increased risk of breast cancer associated with weight gain was more consistent in leaner women at age 18 (BMI < 18.5) or at menopause (BMI < 24).
Our findings indicated that weight gain has significant impact on postmenopausal breast cancer risk. The time periods of weight gain, central body fat, and HRT may affect the observed association, which should be further studied.
越来越多的证据表明,成年后的体重增加比绝对体重更能预测乳腺癌风险。然而,成年后体重增加的时间对乳腺癌的相对影响以及体重与乳腺癌之间关联的其他特征尚未得到很好的记录。
这项基于人群的乳腺癌病例对照研究包括 818 名新诊断的原发性乳腺癌患者和 935 名居住和年龄匹配的健康对照者。通过面对面访谈获得 18 岁、诊断前 1 年和绝经时的体重值。采用非条件逻辑回归估计成年后体重变化对乳腺癌风险的影响。线性混合效应回归也作为二次分析应用。
我们发现,绝经后女性体重增加与乳腺癌风险增加相关(每增加 5 公斤,比值比 1.23;95%置信区间 1.10-1.37),但在绝经前女性中则不相关。绝经后体重增加相关的风险(比值比 1.65;95%置信区间 1.28-2.14,每增加 5 公斤)高于从 18 岁到绝经期间的体重增加(比值比 1.14;95%置信区间 1.02-1.28,每增加 5 公斤)。对于腰围较大且从未使用激素替代疗法(HRT)的女性,这种关联趋势更强。对于从未使用 HRT 的女性,体重增加与乳腺癌风险的关联在较年轻时(BMI<18.5)或绝经时(BMI<24)体重较轻的女性中更为一致。
我们的研究结果表明,体重增加对绝经后乳腺癌风险有显著影响。体重增加的时间、中心性体脂肪和 HRT 可能会影响观察到的关联,这需要进一步研究。