Division of Gynecology Oncology, Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, VA, USA.
Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
Gynecol Oncol. 2020 Jul;158(1):123-129. doi: 10.1016/j.ygyno.2020.04.700. Epub 2020 Apr 30.
Studies that have examined the association between cardiovascular comorbidities and epithelial ovarian cancer (EOC) have yielded inconsistent results. It remains unknown whether cardiometabolic disease is associated with EOC in African American (AA) women, who have a higher prevalence of cardiovascular disease and lower risk of EOC than White women. Here, we estimate the effect of cardiovascular comorbid conditions and EOC risk among AA women.
Data were available from 593 ovarian carcinoma patients and 752 controls enrolled in the African American Cancer Epidemiology Study (AACES). Participants were asked to self-report a history of hypertension, hyperlipidemia, and diabetes and any current medication use. The relationship between hypertension, hyperlipidemia, diabetes, and medications taken for these conditions was determined using multivariate logistic regression.
Hypertension was associated with an increased risk (adjusted odds ratio (aOR) = 1.32, 95% confidence interval (CI) = 1.01, 1.73), whereas diabetes and hyperlipidemia were associated with a decreased risk (aOR = 0.67, 95% CI = 0.49, 0.91 and aOR = 0.61, 95% CI = 0.47, 0.80, respectively) of EOC. Use of anti-diabetic medication was inversely associated with EOC risk, as was use of lipid lowering medications (in the overall study population), which were predominantly statins. Among women with hypertension, use of anti-hypertensive medications was inversely associated with EOC risk, with associations that were most pronounced for diuretics, ARBs and ACE inhibitors.
Hypertension was associated with an increased EOC risk in this patient population, whereas an inverse association was observed for diabetes and hyperlipidemia. The decreased risk of EOC identified with use of anti-hypertensive, anti-diabetes or lipid-lowering medications could have implications for risk reduction strategies.
研究表明心血管合并症与上皮性卵巢癌(EOC)之间存在关联,但结果并不一致。目前尚不清楚代谢心血管疾病是否与非洲裔美国女性(AA)的 EOC 相关,因为她们患有心血管疾病的患病率较高,而 EOC 的风险较低。在这里,我们评估了心血管合并症与 AA 女性 EOC 风险之间的关系。
数据来自参加非洲裔美国人癌症流行病学研究(AACES)的 593 名卵巢癌患者和 752 名对照者。参与者被要求报告高血压、高血脂和糖尿病病史以及当前的用药情况。使用多变量逻辑回归确定高血压、高血脂、糖尿病和用于治疗这些疾病的药物之间的关系。
高血压与风险增加相关(调整后的优势比(aOR)=1.32,95%置信区间(CI)=1.01,1.73),而糖尿病和高血脂与风险降低相关(aOR=0.67,95%CI=0.49,0.91 和 aOR=0.61,95%CI=0.47,0.80)。使用抗糖尿病药物与 EOC 风险呈负相关,使用降脂药物(在整个研究人群中)也与 EOC 风险呈负相关,这些药物主要是他汀类药物。在高血压女性中,使用抗高血压药物与 EOC 风险呈负相关,利尿剂、ARB 和 ACE 抑制剂的相关性最为显著。
在该患者人群中,高血压与 EOC 风险增加相关,而糖尿病和高血脂与风险降低相关。使用抗高血压、抗糖尿病或降脂药物与降低 EOC 风险之间的关联可能对降低风险策略具有重要意义。