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出生体重与乳腺癌发病风险:前瞻性研究的剂量-反应荟萃分析。

Birth Weight and Incidence of Breast Cancer: Dose-Response Meta-analysis of Prospective Studies.

机构信息

Department of Health Management Center, Guangzhou Hospital of Integrated Traditional and West Medicine, Guangzhou, China.

Department of Health Services Section, The Eighth Affiliated Hospital Sun Yat-sen university, Shenzhen, China.

出版信息

Clin Breast Cancer. 2020 Oct;20(5):e555-e568. doi: 10.1016/j.clbc.2020.04.011. Epub 2020 May 8.

Abstract

BACKGROUND

Many studies have shown the association between birth weight and breast cancer (BC), but the evidence remains limited and inconsistent, especially in different menopause status. We sought to clarify the relationship and shape of the dose-response relation between birth weight and BC.

METHODS

The Web of Science, PubMed, and Embase databases were searched for prospective studies involving the relationship between birth weight and risk of BC published to November 2019. Random effects of generalized least squares regression models were used to estimate the quantitative dose-response association, and restricted cubic splines were used to model the association.

RESULTS

We included reports of 16 prospective studies describing 16,000 incident cases among 553,644 participants. We identified a modest-in-magnitude, but significant, association between birth weight and BC risk: risk increased by 2% (risk ratio, 1.02, 95% confidence interval, 1.01-1.03) and 9% (risk ratio, 1.09, 95% confidence interval, 1.04-1.15) with a per-500 g birth weight increment in all ages and premenopausal women, respectively. Our results showed a linear dose-response relationship between birth weight and BC risk (P = .311) in premenopausal women, with statistical significance when birth weight was above about 3.5 kg. No significant association was found in postmenopausal women.

CONCLUSION

Higher birth weight has a relationship with increased risk of BC in premenopausal women, particularly when birth weight is above 3.5 kg.

摘要

背景

许多研究表明出生体重与乳腺癌(BC)之间存在关联,但证据仍然有限且不一致,尤其是在不同绝经状态下。我们试图阐明出生体重与 BC 之间的关系和剂量反应关系的形状。

方法

我们检索了 Web of Science、PubMed 和 Embase 数据库,以获取截至 2019 年 11 月发表的关于出生体重与 BC 风险之间关系的前瞻性研究报告。使用广义最小二乘回归模型的随机效应来估计定量剂量反应关联,并使用限制立方样条来建模关联。

结果

我们纳入了 16 项前瞻性研究报告,描述了 553644 名参与者中 16000 例乳腺癌发病情况。我们发现出生体重与 BC 风险之间存在适度但显著的关联:在所有年龄段和绝经前妇女中,每增加 500 克出生体重,风险分别增加 2%(风险比,1.02,95%置信区间,1.01-1.03)和 9%(风险比,1.09,95%置信区间,1.04-1.15)。我们的结果表明,在绝经前妇女中,出生体重与 BC 风险之间存在线性剂量反应关系(P=.311),当出生体重高于约 3.5 公斤时具有统计学意义。在绝经后妇女中未发现显著关联。

结论

较高的出生体重与绝经前妇女乳腺癌风险增加有关,尤其是当出生体重高于 3.5 公斤时。

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