环境酚类在尿液中的浓度及其与乳腺癌发病和乳腺癌死亡后的相关性。
Urinary concentrations of environmental phenols and their associations with breast cancer incidence and mortality following breast cancer.
机构信息
Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA, USA; Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA.
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
出版信息
Environ Int. 2019 Sep;130:104890. doi: 10.1016/j.envint.2019.05.084. Epub 2019 Jun 19.
BACKGROUND
Environmental phenols, compounds used widely in personal care and consumer products, are known endocrine disruptors. Few epidemiologic studies have examined the association of phenol biomarkers with breast cancer incidence and, to our knowledge, none have considered associations with mortality following breast cancer. We examined seven urinary phenol biomarkers in association with breast cancer incidence and subsequent mortality, and examined effect measure modification by body mass index (BMI).
METHODS
Participants included 711 women with breast cancer and 598 women without breast cancer who were interviewed for the population-based Long Island Breast Cancer Study Project. Among women with breast cancer, phenol biomarkers were quantified in spot urine samples collected on average within three months of a first diagnosis of primary in situ or invasive breast cancer in 1996-1997. Women with breast cancer were monitored for vital status using the National Death Index. After a median follow-up of 17.6 years, we identified 271 deaths, including 98 deaths from breast cancer. We examined creatinine-corrected phenol concentrations and the sum of parabens (Σparabens) in association with breast cancer incidence using logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs), and with mortality using Cox regression to estimate hazard ratios (HRs) and 95% CIs. We evaluated multiplicative effect measure modification using cross-product terms in nested models.
RESULTS
The highest (vs lowest) quintiles of urinary methylparaben, propylparaben, and Σparabens were associated with risk of breast cancer with ORs ranging from 1.31 to 1.50. Methylparaben, propylparaben, and Σparabens were also associated with all-cause mortality HRs ranging from 0.68 to 0.77. Associations for breast cancer incidence were more pronounced among women with BMI < 25.0 kg/m than among women with BMI ≥ 25.0 kg/m; however, associations for mortality were more pronounced among women with BMI ≥ 25 kg/m than among women with BMI < 25 kg/m.
CONCLUSIONS
Select parabens may have differential associations with risk of developing breast cancer and mortality following breast cancer.
背景
环境酚类化合物是一种广泛应用于个人护理和消费产品中的化合物，它们是已知的内分泌干扰物。很少有流行病学研究调查酚类生物标志物与乳腺癌发病率之间的关系，据我们所知，也没有研究考虑过它们与乳腺癌后死亡率之间的关系。我们研究了 7 种尿酚类生物标志物与乳腺癌发病率和随后死亡率之间的关系，并研究了体重指数（BMI）对效应测量的修饰作用。
方法
参与者包括 711 名患有乳腺癌的女性和 598 名没有乳腺癌的女性，她们参加了基于人群的长岛乳腺癌研究项目的访谈。在患有乳腺癌的女性中，于 1996-1997 年期间在首次诊断为原发性原位或浸润性乳腺癌的三个月内采集了点尿样，并对酚类生物标志物进行了定量检测。使用国家死亡指数监测患有乳腺癌的女性的生存状态。在中位随访 17.6 年后，我们确定了 271 例死亡病例，其中 98 例死于乳腺癌。我们使用逻辑回归估计比值比（ORs）和 95%置信区间（CIs），使用 Cox 回归估计风险比（HRs）和 95%CI，来研究尿肌酐校正酚浓度和对羟基苯甲酸酯总和（Σ对羟基苯甲酸酯）与乳腺癌发病率之间的关系。我们使用嵌套模型中的交叉乘积项来评估乘法效应测量修饰作用。
结果
尿中最高（vs 最低）五分位数的甲基对羟基苯甲酸酯、丙基对羟基苯甲酸酯和Σ对羟基苯甲酸酯与乳腺癌风险相关，OR 范围为 1.31 至 1.50。甲基对羟基苯甲酸酯、丙基对羟基苯甲酸酯和 Σ对羟基苯甲酸酯与全因死亡率 HR 也相关，范围为 0.68 至 0.77。在 BMI<25.0 kg/m 的女性中，与乳腺癌发病率相关的关联更为明显；然而，在 BMI≥25.0 kg/m 的女性中，与死亡率相关的关联更为明显。
结论
某些对羟基苯甲酸酯可能与乳腺癌发病风险和乳腺癌后死亡率有不同的关联。
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