Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, Stockholm 171 65, Sweden.
Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK.
Eur Heart J. 2021 Sep 7;42(34):3361-3370. doi: 10.1093/eurheartj/ehab502.
In recent years, microcalcifications identified in routine mammograms were found to be associated with cardiometabolic disease in women. Here, we aimed to systematically evaluate the association of microcalcifications and other mammographic features with cardiometabolic disease risk and mortality in a large screening cohort and to understand a potential genetic contribution.
This study included 57 867 women from a prospective mammographic screening cohort in Sweden (KARMA) and 49 583 sisters. Cardiometabolic disease diagnoses and mortality and medication were extracted by linkage to Swedish population registries with virtually no missing data. In the cardiometabolic phenome-wide association study, we found that a higher number of microcalcifications were associated with increased risk for multiple cardiometabolic diseases, particularly in women with pre-existing cardiometabolic diseases. In contrast, dense breasts were associated with a lower incidence of cardiometabolic diseases. Importantly, we observed similar associations in sisters of KARMA women, indicating a potential genetic overlap between mammographic features and cardiometabolic traits. Finally, we observed that the presence of microcalcifications was associated with increased cardiometabolic mortality in women with pre-existing cardiometabolic diseases (hazard ratio and 95% confidence interval: 1.79 [1.24-2.58], P = 0.002) while we did not find such effects in women without cardiometabolic diseases.
We found that mammographic features are associated with cardiometabolic risk and mortality. Our results strengthen the notion that a combination of mammographic features and other breast cancer risk factors could be a novel and affordable tool to assess cardiometabolic health in women attending mammographic screening.
近年来，在常规乳房 X 光片中发现的微钙化与女性的心血管代谢疾病有关。在这里，我们旨在系统地评估微钙化和其他乳房 X 光特征与心血管代谢疾病风险和死亡率在大型筛查队列中的关联，并了解潜在的遗传贡献。
这项研究包括来自瑞典前瞻性乳房 X 光筛查队列（KARMA）的 57867 名女性和 49583 名姐妹。通过与瑞典人口登记处的链接提取心血管代谢疾病的诊断和死亡率以及药物治疗信息，几乎没有缺失数据。在心血管代谢表型全基因组关联研究中，我们发现微钙化数量越多，多种心血管代谢疾病的风险就越高，特别是在患有心血管代谢疾病的女性中。相比之下，致密的乳房与心血管代谢疾病的发病率较低有关。重要的是，我们在 KARMA 女性的姐妹中观察到了类似的关联，表明乳房特征和心血管代谢特征之间存在潜在的遗传重叠。最后，我们观察到在患有心血管代谢疾病的女性中，微钙化的存在与心血管代谢死亡率的增加相关（风险比和 95%置信区间：1.79 [1.24-2.58]，P = 0.002），而在没有心血管代谢疾病的女性中，我们没有发现这种影响。
我们发现乳房特征与心血管代谢风险和死亡率有关。我们的结果进一步证实了这样一种观点，即乳房特征与其他乳腺癌风险因素的结合可能是一种新颖且经济实惠的工具，可以评估参加乳房 X 光筛查的女性的心血管代谢健康状况。
