Yi Fang, Xu Bin, Diao Sha, Hou Can, Li Jia-Yuan
Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China.
Center for Cancer Prevention Research, Sichuan Cancer Hospital/Institute, School of Medicine,University of Electronic Science and Technology of China, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2021 Mar;52(2):259-266. doi: 10.12182/20210260302.
To explore the individual or combined effects of adiponectin, leptin, and soluble leptin receptor (sOB-R) on risks for premenopausal and postmenopausal breast cancer, and to provide evidence for revealing the molecular mechanism between obesity and breast cancer.
469 newly-diagnosed breast cancer cases were sequentially recruited for the study and 469 age-frequency-matched healthy women were enrolled as the controls over the same period of time. The participant baseline information was collected with questionnaires, and plasmic levels of adiponectin, leptin and sOB-R were checked with ELISA. Multivariate unconditional logistic regression was conducted and the analyses were further stratified according to waist-to-hip ratio (WHR) and body mass index (BMI) to explore the effect of the indicators on the risks for premenopausal and postmenopausal breast cancer.
A total of 480 premenopausal and 458 postmenopausal women were included in the study. Among the premenopausal subjects, 249 were breast cancer patients and 231 were controls. The median BMI was 22.9 kg/m and 23.2 kg /m , respectively, and the median WHR was 0.80 and 0.83, respectively. Among the postmenopausal subjects, 220 were breast cancer patients and 238 were controls. The median BMI was 23.4 kg/m and 23.7 kg/m , respectively, and the median WHR was 0.82 and 0.86, respectively. Multivariate logistic regression analysis showed that before and after model adjustment, the increase in sOB-R and adiponectin levels was correlated to reduced risks of premenopausal and postmenopausal breast cancer ( <0.05), while the increase in the leptin/sOB-R ratio (also known as free leptin index, FLI) and leptin/adiponectin (L/A) ratio was only correlated to increased risks of postmenopausal breast cancer. After further stratification by WHR and BMI, the association between adiponectin, FLI and postmenopausal breast cancer remained statistically significant in all subgroups. Among subjects with normal-BMI central obesity (18.5 kg/m ≤BMI<24 kg/m & WHR≥0.85) , higher L/A ratio was associated with an increased risk of postmenopausal breast cancer. No clear association between leptin and premenopausal and risks for postmenopausal breast cancer was found in the study.
Postmenopausal women with decreased levels of sOB-R and adiponectin, and increased FLI and L/A, and premenopausal women with decreased levels of sOB-R and adiponectin were found to be at high risks for breast cancer.
探讨脂联素、瘦素及可溶性瘦素受体(sOB-R)对绝经前及绝经后乳腺癌发病风险的单独或联合作用,为揭示肥胖与乳腺癌之间的分子机制提供依据。
连续纳入469例新诊断的乳腺癌患者作为研究对象,并同期纳入469例年龄频率匹配的健康女性作为对照。通过问卷调查收集参与者的基线信息,采用酶联免疫吸附测定法(ELISA)检测血浆脂联素、瘦素及sOB-R水平。进行多因素非条件logistic回归分析,并根据腰臀比(WHR)和体重指数(BMI)进一步分层分析,以探讨上述指标对绝经前及绝经后乳腺癌发病风险的影响。
本研究共纳入480例绝经前女性和458例绝经后女性。绝经前受试者中,249例为乳腺癌患者,231例为对照。其BMI中位数分别为22.9kg/m²和23.2kg/m²,WHR中位数分别为0.80和0.83。绝经后受试者中,220例为乳腺癌患者,238例为对照。其BMI中位数分别为23.4kg/m²和23.7kg/m²,WHR中位数分别为0.82和0.86。多因素logistic回归分析显示,模型调整前后,sOB-R及脂联素水平升高与绝经前及绝经后乳腺癌发病风险降低相关(P<0.05),而瘦素/sOB-R比值(又称游离瘦素指数,FLI)及瘦素/脂联素(L/A)比值升高仅与绝经后乳腺癌发病风险增加相关。经WHR及BMI进一步分层后,脂联素、FLI与绝经后乳腺癌之间的关联在所有亚组中均具有统计学意义。在BMI正常的中心性肥胖受试者(18.5kg/m²≤BMI<24kg/m²且WHR≥0.85)中,较高的L/A比值与绝经后乳腺癌发病风险增加相关。本研究未发现瘦素与绝经前及绝经后乳腺癌发病风险之间存在明确关联。
绝经后女性sOB-R及脂联素水平降低、FLI及L/A升高,以及绝经前女性sOB-R及脂联素水平降低,患乳腺癌的风险较高。