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《加利福尼亚教师研究中女性的睡眠类型与绝经后乳腺癌风险》

Chronotype and postmenopausal breast cancer risk among women in the California Teachers Study.

机构信息

Department of Epidemiology and Biostatistics, University of California San Francisco , San Francisco , CA , USA.

School of Community and Global Health, Claremont Graduate University , Claremont , CA , USA.

出版信息

Chronobiol Int. 2019 Nov;36(11):1504-1514. doi: 10.1080/07420528.2019.1658113. Epub 2019 Aug 27.

Abstract

Chronotype is the behavioral manifestation of an individual's underlying circadian rhythm, generally characterized by one's propensity to sleep at a particular time during the 24 hour cycle. Evening chronotypes ("night owls") generally suffer from worse physical and mental health compared to morning chronotypes ("morning larks") - for reasons that have yet to be explained. One hypothesis is that evening chronotypes may be more susceptible to circadian disruption, a condition where the coordinated timing of biologic processes breaks down. The role of chronotype as an independent or modifying risk factor for cancer has not been widely explored. The objective of the current study was to evaluate the risk of breast cancer associated with chronotype in a case-control study nested within the California Teachers Study (CTS) cohort. The study population consisted of 39686 post-menopausal CTS participants who provided information on chronotype by completing a questionnaire in 2012-2013. 2719 cases of primary invasive breast cancer diagnosed from 1995/1996 through completion of the chronotype questionnaire were identified by linkage of the CTS to the California Cancer Registry. 36967 CTS participants who had remained cancer-free during this same time period served as controls. Chronotype was ascertained by responses to an abbreviated version of the Horne-Ostberg Morningness-Eveningness Questionnaire (MEQ) and was characterized into five categories: definite morning, more morning than evening, neither morning or evening, more evening than morning, definite evening. Multivariable unconditional logistic regression analyses were performed to estimate the odds ratios (ORs) and 95% confidence intervals (95% CIs) for each of the chronotypes, adjusted for established breast cancer risk factors. Compared to definite morning types, definite evening types had an increased risk of breast cancer with elevated ORs that were statistically significant in both the crude (OR = 1.24, 95% CI: 1.10-1.40) and fully-adjusted models (OR = 1.20, 95% CI: 1.06-1.35). The risk estimates in the fully-adjusted model for all other chronotypes did not significantly differ from one. These results suggest that evening chronotype may be an independent risk factor for breast cancer among a population of women who are not known to have engaged in any substantial night shift work. Further research in other populations of non-shift workers is warranted.

摘要

时型是个体内在生物钟的行为表现,通常表现为在 24 小时周期中特定时间入睡的倾向。与早晨时型(“早起的鸟儿”)相比,夜间时型(“夜猫子”)的身心健康状况通常更差——原因尚未得到解释。一种假设是,夜间时型可能更容易受到昼夜节律紊乱的影响,这种情况会破坏生物过程的协调时间。时型作为癌症的独立或修饰风险因素的作用尚未得到广泛探索。本研究的目的是在加利福尼亚教师研究(CTS)队列中嵌套的病例对照研究中,评估时型与乳腺癌风险的相关性。研究人群由 39686 名绝经后 CTS 参与者组成,他们通过在 2012-2013 年完成问卷来提供时型信息。通过 CTS 与加利福尼亚癌症登记处的链接,确定了 2719 例 1995/1996 年至完成时型问卷期间诊断出的原发性浸润性乳腺癌病例。在同一时期未患癌症的 36967 名 CTS 参与者作为对照。时型通过对霍恩-奥斯特伯格晨型-晚型问卷(MEQ)缩写版的回答来确定,并分为五类:明确的早晨型、早晨型多于晚型、早晨型和晚型之间、晚型多于早晨型、明确的晚型。进行多变量非条件逻辑回归分析,以估计每种时型的优势比(OR)和 95%置信区间(95%CI),并根据已确定的乳腺癌风险因素进行调整。与明确的早晨型相比,明确的夜间型乳腺癌的风险增加,且在未调整(OR=1.24,95%CI:1.10-1.40)和完全调整模型(OR=1.20,95%CI:1.06-1.35)中均具有统计学意义。完全调整模型中所有其他时型的风险估计与一个时型没有显著差异。这些结果表明,对于那些没有从事过任何实质性夜班工作的女性人群,夜间时型可能是乳腺癌的独立危险因素。需要在其他非倒班工人的人群中进行进一步研究。

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