Khalis Mohamed, Dossus Laure, Rinaldi Sabina, Biessy Carine, Moskal Aurélie, Charaka Hafida, Fort Emmanuel, His Mathilde, Mellas Nawfel, Nejjari Chakib, Charbotel Barbara, Soliman Amr S, Romieu Isabelle, Chajès Véronique, Gunter Marc J, Huybrechts Inge, El Rhazi Karima
School of Public Health, Mohammed VI University of Health Sciences, Anfa City : Bld Mohammed Taïeb Naciri, Hay Hassani, 82 403, Casablanca, Morocco.
UCBL, Ifsttar, UMRESTTE, University of Lyon, Lyon, France.
Breast Cancer. 2020 Jul;27(4):748-758. doi: 10.1007/s12282-020-01072-5. Epub 2020 Mar 6.
There is convincing evidence demonstrating that body size characteristics such as adiposity and height are associated with breast cancer in westernized countries. However, little is known about this relationship in North African countries currently undergoing nutritional transition and industrialization. The aim of this study was to explore associations between various body size characteristics, silhouette trajectories and the risk of breast cancer among Moroccan women.
In this case-control study conducted in the Fez region (2016-2017), detailed measures of body size were collected for 300 cases of breast cancer and 300 matched controls. Unconditional logistic regression was used to assess the association between body size and breast cancer risk adjusting for confounding factors.
Higher waist circumference and hip circumference were positively associated with breast cancer risk in pre- (highest [T3] vs. lowest tertile [T1]: OR = 2.92, 95% confidence intervals [CI]: 1.33-6.42; OR = 3.00, 95% CI: 1.42-6.33, respectively) and post-menopausal women (T3 vs. T1: OR = 4.46, 95% CI: 1.86-10.66; OR = 4.08, 95% CI: 1.76-9.42, respectively). Body shape at younger ages (6-11 years) was inversely associated with the risk of breast cancer in premenopausal women (large vs. lean silhouette: OR = 0.31, 95% CI: 0.12-0.80). Women with the greatest increase in body shape trajectory had higher risk for both pre- and post-menopausal breast cancer (T3 vs. T1: OR = 2.74, 95% CI: 1.03-7.26; OR = 3.56, 95% CI: 1.34-9.44, respectively).
Our findings suggest that adiposity, body shape at younger ages, and silhouette trajectory may play a role in the development of pre- and post-menopausal breast cancer among Moroccan women. Larger-scale prospective studies are needed to confirm our findings and to explore these associations with breast cancer subtypes.
有确凿证据表明，在西方国家，肥胖和身高之类的体型特征与乳腺癌有关。然而，对于目前正经历营养转型和工业化的北非国家，这种关系却知之甚少。本研究的目的是探讨摩洛哥女性各种体型特征、体型变化轨迹与乳腺癌风险之间的关联。
在非斯地区开展的这项病例对照研究（2016 - 2017年）中，收集了300例乳腺癌病例和300例匹配对照的详细体型测量数据。采用非条件逻辑回归评估体型与乳腺癌风险之间的关联，并对混杂因素进行校正。
较高的腰围和臀围与绝经前（最高三分位数[T3] 与最低三分位数[T1] 相比：比值比[OR] = 2.92，95%置信区间[CI]：1.33 - 6.42；OR = 3.00，95% CI：1.42 - 6.33）和绝经后女性的乳腺癌风险呈正相关（T3与T1相比：OR = 4.46，95% CI：1.86 - 10.66；OR = 4.08，95% CI：1.76 - 9.42）。年轻时（6 - 11岁）的体型与绝经前女性的乳腺癌风险呈负相关（体型丰满与体型消瘦相比：OR = 0.31，95% CI：0.12 - 0.80）。体型变化轨迹增加最大的女性，绝经前和绝经后乳腺癌的风险都更高（T3与T1相比：OR = 2.74，95% CI：1.03 - 7.26；OR = 3.56，95% CI：1.34 - 9.44）。
我们的研究结果表明，肥胖、年轻时的体型以及体型变化轨迹可能在摩洛哥女性绝经前和绝经后乳腺癌的发生中起作用。需要开展更大规模的前瞻性研究来证实我们的发现，并探索这些因素与乳腺癌亚型之间的关联。
