Wei Linlin, Han Ning, Sun Shichen, Ma Xinchi, Zhang Yaotian
Department of Radiotherapy, Cancer Hospital of China Medical University, Shenyang, China.
Int J Clin Pract. 2021 Nov;75(11):e14793. doi: 10.1111/ijcp.14793. Epub 2021 Sep 17.
Sleep-disordered breathing (SDB) has been related to a higher risk of breast cancer whereas the results of previous studies are inconsistent. We, therefore, performed a meta-analysis to evaluate the association between SDB and subsequent risk of breast cancer in women.
Cohort studies that investigated the temporal relationship between SDB and breast cancer incidence were obtained via search of PubMed, Embase and Web of Science from inception to 30 January 2021. Only studies with multivariate analyses were included. A fixed or a randomised effect model was applied according to the heterogeneity.
Eight cohort studies with 1 398 113 women were included. Pooled results with a randomised-effect model showed that compared with women without SDB at baseline, women with SDB had a significantly increased risk of breast cancer (risk ratio [RR]: 1.36, 95% confidence interval [CI]: 1.08 to 1.71, P = .01) with significant heterogeneity (P for Cochrane's Q test < .001, I = 95%). Subgroup analyses showed that SDB seemed to confer a more remarkably increased risk of breast cancer in elderly women (RR: 3.00, 95% CI: 1.33 to 6.76, P = .008) than that in non-elderly women (RR: 1.15, 95% CI: 1.02 to 1.29, P = .02; P for subgroup difference = .04). However, the association was not significantly affected by country of the study, study design, diagnostic strategy for SDB or adjustment of obesity (P for subgroup analyses all > .05).
SDB may be an independent risk factor for breast cancer in women, particularly in elderly females.
睡眠呼吸紊乱（SDB）与乳腺癌风险较高有关，而先前研究的结果并不一致。因此，我们进行了一项荟萃分析，以评估女性SDB与后续患乳腺癌风险之间的关联。
通过检索PubMed、Embase和Web of Science数据库，获取从建库至2021年1月30日期间调查SDB与乳腺癌发病率之间时间关系的队列研究。仅纳入进行了多变量分析的研究。根据异质性应用固定效应模型或随机效应模型。
纳入了八项队列研究，共1398113名女性。随机效应模型的汇总结果显示，与基线时无SDB的女性相比，患有SDB的女性患乳腺癌的风险显著增加（风险比[RR]：1.36，95%置信区间[CI]：1.08至1.71，P = 0.01），且存在显著异质性（Cochrane Q检验P < 0.001，I² = 95%）。亚组分析显示，SDB在老年女性中（RR：3.00，95% CI：1.33至6.76，P = 0.008）似乎比在非老年女性中（RR：1.15，95% CI：1.02至1.29，P = 0.02；亚组差异P = 0.04）更显著地增加患乳腺癌的风险。然而，该关联未受到研究国家、研究设计、SDB诊断策略或肥胖调整的显著影响（亚组分析的P值均> 0.05）。
SDB可能是女性乳腺癌的独立危险因素，尤其是在老年女性中。
