脂肪肝指数与乳腺癌风险的关联：一项全国性基于人群的研究。
Association Between Fatty Liver Index and Risk of Breast Cancer: A Nationwide Population-Based Study.
机构信息
Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea.
Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea.
出版信息
Clin Breast Cancer. 2020 Aug;20(4):e450-e457. doi: 10.1016/j.clbc.2020.02.004. Epub 2020 Feb 22.
BACKGROUND
Although nonalcoholic fatty liver disease (NAFLD) has been linked to breast cancer risk, the actual relationship remains unclear. Fatty liver index (FLI) is a noninvasive method for predicting NAFLD. We aimed to assess the association between FLI, a predictor of NAFLD, and breast cancer risk.
PATIENTS AND METHODS
Using the Korean National Health Insurance Corporation data, we reviewed 7,046,153 women who underwent biennial evaluations between 2009 and 2010. FLI was calculated using body mass index, waist circumference, triglyceride level, and gamma-glutamyl transferase level. FLI < 30 ruled out hepatic steatosis, while FLI ≥ 60 indicated NAFLD. Cox regression models were used for analysis.
RESULTS
Among the subjects, 51.8% (n = 3,606,079) were premenopausal women. In the premenopausal and postmenopausal groups, 32,145 (0.89%) and 28,103 (0.82%) women developed breast cancer, respectively (median follow-up, 7.02 years; interquartile range, 6.39-7.39 years). Mean FLI and standard deviation were lower in premenopausal women (11.24 ± 14.72 vs. 23.88 ± 19.54, P < .0001). Three groups were formed according to FLI: < 30 (n = 5,693,730, 80.81%), 30-60 (n = 1,031,025, 14.63%), and ≥ 60 (n = 321,398, 4.56%). FLIs of 30-60 and ≥ 60 were significantly associated with increased breast cancer risk in postmenopausal women (hazard ratio, 1.07; 95% confidence interval, 1.04-1.11; and hazard ratio, 1.11; 95% confidence interval, 1.05-1.17, respectively). No association was found in premenopausal women.
CONCLUSION
High FLI, an indicator of NAFLD, could predict breast cancer in postmenopausal women.
背景
非酒精性脂肪性肝病（NAFLD）与乳腺癌风险相关，但实际关系尚不清楚。脂肪肝指数（FLI）是一种预测 NAFLD 的非侵入性方法。本研究旨在评估 FLI（一种预测 NAFLD 的指标）与乳腺癌风险之间的关系。
患者和方法
我们利用韩国国民健康保险数据，对 2009 年至 2010 年期间接受两年一次评估的 7046153 名女性进行了回顾性研究。通过体重指数、腰围、三酰甘油水平和γ-谷氨酰转移酶水平计算 FLI。FLI<30 排除了肝脂肪变性，而 FLI≥60 则表示存在 NAFLD。采用 Cox 回归模型进行分析。
结果
在研究对象中，51.8%（n=3606079）为绝经前女性。在绝经前和绝经后组中，分别有 32145（0.89%）和 28103（0.82%）名女性发生乳腺癌（中位随访时间为 7.02 年；四分位间距为 6.39-7.39 年）。绝经前女性的平均 FLI 和标准差均较低（11.24±14.72 与 23.88±19.54，P<0.0001）。根据 FLI 值将研究对象分为三组：<30（n=5693730，80.81%）、30-60（n=1031025，14.63%）和≥60（n=321398，4.56%）。FLI 在 30-60 和≥60 的绝经后女性发生乳腺癌的风险显著增加（危险比分别为 1.07；95%置信区间为 1.04-1.11；和 1.11；95%置信区间为 1.05-1.17）。在绝经前女性中未发现相关性。
结论
高 FLI（一种 NAFLD 指标）可预测绝经后女性的乳腺癌。
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