Xiang Yujuan, Zhou Wenzhong, Duan Xuening, Fan Zhimin, Wang Shu, Liu Shuchen, Liu Liyuan, Wang Fei, Yu Lixiang, Zhou Fei, Huang Shuya, Li Liang, Zhang Qiang, Fu Qinye, Ma Zhongbing, Gao Dezong, Cui Shude, Geng Cuizhi, Cao Xuchen, Yang Zhenlin, Wang Xiang, Liang Hong, Jiang Hongchuan, Wang Haibo, Li Guolou, Wang Qitang, Zhang Jianguo, Jin Feng, Tang Jinhai, Tian Fuguo, Ye Chunmiao, Yu Zhigang
Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, China.
Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, China.
Front Endocrinol (Lausanne). 2020 Jan 21;10:905. doi: 10.3389/fendo.2019.00905. eCollection 2019.
To investigate the association between metabolic syndrome and breast cancer and to elucidate the potential mechanism underlying this association. Based on baseline data drawn from 21 hospitals in 11 provinces of China, we performed a case-control study among 1,127 women (595 cases and 532 controls), divided into premenopausal, and postmenopausal subgroups. Student's test, Pearson's χ test, and logistic regression analyses were performed to ascertain the association between breast cancer and metabolic syndrome, including all of its components. In addition, we attempted to clarify the potential role of adiponectin in this association. Among the components of metabolic syndrome, abnormal waist circumference was the component that markedly increased breast cancer risk in premenopausal women (OR 1.447, 95% CI 1.043-2.006). Metabolic syndrome with clusters of special risk factors showed an association with breast cancer risk. Among all these components of metabolic syndrome, the hypertriglyceridemic-waist (HW) phenotype significantly increased breast cancer risk (OR 1.56, 95% CI 1.02-2.39), regardless of menopausal status, rendering it a strong predictor of breast cancer. Total adiponectin levels and high-molecular-weight adiponectin were reversely associated with metabolic syndrome. In addition, total adiponectin levels among breast cancer patients were much lower than among controls (6.67 ± 3.05 vs. 8.01 ± 4.18, = 0.014) only in the HW phenotype subgroup. Furthermore, the HW phenotype was associated with increased risk of estrogen receptor/progesterone receptor-positive (ER+/PR+) and -negative (ER-/PR-) breast cancer, with a 51% (OR 1.51, 95% CI 1.03-2.21) and 69% (OR 1.69, 95% CI 1.05-2.72) increase, respectively. However, there was no significant association between the HW phenotype and the ER+/PR- subtype. These results suggested that low adiponectin levels may be a mechanism that explains the association between the HW phenotype and breast cancer risk. Metabolic syndrome with special cluster factors is related to breast cancer risk; in particular, the HW phenotype can be regarded as a strong predictor of breast cancer. As an important factor involved in fat metabolism, adiponectin may strongly predict metabolic syndrome, especially the HW phenotype and breast cancer. Further research into this mechanism and epidemiological studies are needed. This study provides new evidence for the role of a healthy lifestyle in preventing breast cancer.
研究代谢综合征与乳腺癌之间的关联，并阐明这种关联背后的潜在机制。基于从中国11个省份的21家医院获取的基线数据，我们对1127名女性（595例病例和532例对照）进行了一项病例对照研究，这些女性被分为绝经前和绝经后亚组。采用学生t检验、Pearson卡方检验和逻辑回归分析来确定乳腺癌与代谢综合征及其所有组分之间的关联。此外，我们试图阐明脂联素在这种关联中的潜在作用。在代谢综合征的组分中，腰围异常是显著增加绝经前女性乳腺癌风险的组分（比值比1.447，95%置信区间1.043 - 2.006）。具有特殊危险因素聚集的代谢综合征与乳腺癌风险相关。在代谢综合征的所有这些组分中，高甘油三酯腰围（HW）表型显著增加乳腺癌风险（比值比1.56，95%置信区间1.02 - 2.39），无论绝经状态如何，使其成为乳腺癌的一个强预测指标。总脂联素水平和高分子量脂联素与代谢综合征呈负相关。此外，仅在HW表型亚组中，乳腺癌患者的总脂联素水平显著低于对照组（6.67±3.05对8.01±4.18，P = 0.014）。此外，HW表型与雌激素受体/孕激素受体阳性（ER+/PR+）和阴性（ER-/PR-）乳腺癌风险增加相关，分别增加51%（比值比1.51，95%置信区间1.03 - 2.21）和69%（比值比1.69，95%置信区间1.05 - 2.72）。然而，HW表型与ER+/PR-亚型之间无显著关联。这些结果表明，低脂联素水平可能是解释HW表型与乳腺癌风险之间关联的一种机制。具有特殊聚集因素分组的代谢综合征与乳腺癌风险相关；特别是，HW表型可被视为乳腺癌的一个强预测指标。作为参与脂肪代谢的一个重要因素，脂联素可能是代谢综合征尤其是HW表型和乳腺癌的一个强预测指标。需要对这种机制进行进一步研究和开展流行病学研究。本研究为健康生活方式在预防乳腺癌中的作用提供了新证据。
