Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.
Child Health and Development Studies, Public Health Institute, Berkeley, California.
Am J Epidemiol. 2019 Sep 1;188(9):1646-1654. doi: 10.1093/aje/kwz126.
Using prospective data from the Early Determinants of Mammographic Density study (United States, 1959-2008, n = 1121), we examined the associations between maternal body size, birth size, and infant and early childhood growth during 3 time periods (0-4 months, 4-12 months, and 1-4 years) and benign breast disease (BBD) using multivariable logistic regression with generalized estimating equations. A total of 197 women (17.6%) reported receiving a diagnosis of BBD by a physician. Higher body mass index at age 7 years was inversely associated with BBD risk. Rapid weight gain from age 1 year to 4 years, defined as an increase of least 2 major percentiles (e.g., 5th, 10th, 25th, 50th, 75th, and 95th) relative to stable growth, defined as remaining within 2 percentiles, was also inversely associated with BBD (odds ratio (OR) = 0.51, 95% confidence interval (CI): 0.23, 1.15). In contrast, rapid weight gain in infancy was positively associated with BBD relative to stable growth (from 0 to 4 months, OR = 1.65, 95% CI: 1.04, 2.62; from 4 to 12 months, 1.85, 95% CI: 0.89, 3.85), independent of birth weight, which was not associated with BBD. Our results suggest that patterns of early-life weight gain are important to BBD risk. Thus, susceptibility to BBD, like susceptibility to breast cancer, might start in early life.
利用早期乳腺密度决定因素研究(美国,1959-2008 年,n = 1121)的前瞻性数据,我们使用广义估计方程的多变量逻辑回归,检查了母亲体型、出生体重以及婴儿和幼儿在三个时期(0-4 个月、4-12 个月和 1-4 岁)的生长与良性乳腺疾病(BBD)之间的关联。共有 197 名妇女(17.6%)报告经医生诊断患有 BBD。7 岁时的体重指数越高,BBD 的风险越低。从 1 岁到 4 岁的体重快速增长,定义为相对于稳定增长(定义为保持在 2 个百分位内)增加至少 2 个主要百分位(例如,第 5、10、25、50、75 和 95 百分位),与 BBD 呈负相关(比值比(OR)=0.51,95%置信区间(CI):0.23,1.15)。相反,与稳定生长相比,婴儿期体重快速增长与 BBD 呈正相关(0-4 个月时,OR=1.65,95%CI:1.04,2.62;4-12 个月时,OR=1.85,95%CI:0.89,3.85),与出生体重无关,出生体重与 BBD 无关。我们的研究结果表明,生命早期体重增长模式与 BBD 风险有关。因此,BBD 的易感性,就像乳腺癌的易感性一样,可能始于生命早期。