Departments of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, VA, 23284, USA.
Breast Cancer Res Treat. 2021 Jun;187(2):587-596. doi: 10.1007/s10549-021-06102-0. Epub 2021 Jan 28.
Allostatic load (AL), a composite index, has been used to capture variation in life-course stresses. However, few studies have been carried out among breast cancer patients.
In this study, we examined the cross-sectional association of AL with demographics, healthy behaviors, tumor characteristics, and mitochondrial DNA copy number in breast cancer patients. The study used a sub-sample of 934 women with newly diagnosed breast cancer at M.D. Anderson from 2013 to 2018. To construct the AL score, the study used a battery of seventeen factors that represents the activity of five physiological systems: metabolic, cardiovascular, immunological, renal, and liver.
AL was positively associated with the age of disease diagnosis (P = 0.002), and was higher in Black and Hispanic populations than White (P = 0.001 and 0.032, respectively). AL was also found more abundant in those who experienced marital dissolution (P = 0.006), lacked a college education (P = 0.045), currently smoked (P = 0.011), and had low levels of physical activity (P = 0.037) than their counterparts. The study then found that higher AL was associated with increased odds of having poorly differentiated tumors (Odds ratio (OR): 1.40, 95% confidence interval (CI): 1.28, 1.62). An additional significant association was observed between AL with estrogen receptor negative (ER-) (OR = 1.56, 95%CI: 1.02, 2.36) among Black patients. Finally, we observed a significant positive correlation between AL with leukocyte mitochondrial DNA copy number variation (P < 0.001).
We conclude AL is influenced by selected demographics and healthy behaviors, and further is correlated with tumor characteristics and mitochondrial DNA copy number in breast cancer patients.
适应负荷(AL)是一种综合指数,用于捕捉生命过程中压力的变化。然而,针对乳腺癌患者的研究较少。
本研究检测了 AL 与乳腺癌患者的人口统计学特征、健康行为、肿瘤特征和线粒体 DNA 拷贝数之间的横断面相关性。该研究使用了 2013 年至 2018 年期间在 M.D.安德森癌症中心新诊断为乳腺癌的 934 名女性的子样本。为了构建 AL 评分,该研究使用了一套由 17 个因素组成的电池,代表五个生理系统的活动:代谢、心血管、免疫、肾脏和肝脏。
AL 与疾病诊断年龄呈正相关(P=0.002),并且在黑人和西班牙裔人群中高于白人(P=0.001 和 0.032)。在经历婚姻破裂(P=0.006)、缺乏大学教育(P=0.045)、目前吸烟(P=0.011)和缺乏体力活动(P=0.037)的人群中,AL 更为丰富。然后,研究发现,较高的 AL 与肿瘤分化不良的几率增加相关(比值比(OR):1.40,95%置信区间(CI):1.28,1.62)。在黑人患者中,还观察到 AL 与雌激素受体阴性(ER-)之间存在显著的相关性(OR=1.56,95%CI:1.02,2.36)。最后,我们观察到 AL 与白细胞线粒体 DNA 拷贝数变化之间存在显著的正相关(P<0.001)。
我们得出结论,AL 受选定的人口统计学特征和健康行为影响,进一步与乳腺癌患者的肿瘤特征和线粒体 DNA 拷贝数相关。