Department of Epidemiology and Population Health Albert Einstein College of Medicine, Bronx, New York.
Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington.
Cancer Prev Res (Phila). 2022 Apr 1;15(4):255-264. doi: 10.1158/1940-6207.CAPR-21-0467.
Obesity and obesity-related metabolic disorders, such as diabetes and chronic inflammation, have been positively associated both with postmenopausal breast cancer and with resting energy expenditure (REE). However, there is limited epidemiologic evidence on the associations between REE and risk of postmenopausal breast cancer. We used multivariable Cox proportional hazards models to examine the association between predicted REE (calculated using the Ikeda, Livingston, and Mifflin equations) and risk of postmenopausal breast cancer overall and by subtypes, and by level of body fat) among 137,283 postmenopausal women in the Women's Health Initiative (WHI). All predicted REEs were positively associated with risk of invasive breast cancer [HRq5 vs. q1 = 1.69; 95% confidence interval (CI), 1.57-1.81; HR = 1.69; 95% CI, 1.57-1.82; and HR = 1.68; 95% CI, 1.56-1.80 for Ikeda, Livingston, and Mifflin, respectively]. These positive associations were observed irrespective of the hormone receptor subtype, grade, and stage of the tumors, but were most pronounced for estrogen receptor-positive/progesterone receptor-positive tumors. After additional adjustment for body mass index (BMI), the associations were mostly attenuated and remained statistically significant for most of the outcomes. We also observed an interaction between the predicted REEs and BMI, with the associations being somewhat stronger among normal weight and overweight women than among obese women (Pinteractions < 0.05). Our findings indicate that relatively high REE is associated with increased risk of invasive breast cancer among postmenopausal women (particularly for the obesity-related tumor subtypes), irrespective of the equation used. Further studies using more objective measures of REE are, however, needed to confirm our findings.
This study showed that higher resting energy expenditure (REE) was associated with higher postmenopausal breast cancer risk. REE provides energy to support cancer-associated disorders such as obesity and inflammation. Thus, studies on its association with breast cancer can help to improve our understanding of the pathophysiology of breast cancer.
肥胖和与肥胖相关的代谢紊乱，如糖尿病和慢性炎症，与绝经后乳腺癌和静息能量消耗 (REE) 均呈正相关。然而，关于 REE 与绝经后乳腺癌风险之间的关联，流行病学证据有限。我们使用多变量 Cox 比例风险模型来研究预测 REE（使用 Ikeda、Livingston 和 Mifflin 方程计算）与绝经后乳腺癌总体风险以及乳腺癌亚型风险、体脂水平之间的关系，共纳入了妇女健康倡议（WHI）中的 137283 名绝经后妇女。所有预测的 REE 与浸润性乳腺癌的风险呈正相关[q5 与 q1 的 HR = 1.69；95%置信区间（CI）为 1.57-1.81；HR = 1.69；95%CI 为 1.57-1.82；和 HR = 1.68；95%CI 为 1.56-1.80，分别用于 Ikeda、Livingston 和 Mifflin]。这些正相关关系在肿瘤的激素受体亚型、分级和分期方面均存在，但在雌激素受体阳性/孕激素受体阳性肿瘤中最为明显。在进一步调整体重指数（BMI）后，这些关联大多减弱，但大多数结果仍具有统计学意义。我们还观察到预测 REE 与 BMI 之间存在交互作用，在正常体重和超重女性中，这种关联比肥胖女性更强（P 交互 < 0.05）。我们的研究结果表明，绝经后女性较高的 REE 与浸润性乳腺癌风险增加相关（尤其是与肥胖相关的肿瘤亚型），与使用的方程无关。然而，需要使用更客观的 REE 测量方法进行进一步研究，以证实我们的研究结果。
本研究表明，较高的静息能量消耗（REE）与绝经后乳腺癌风险增加相关。REE 为支持肥胖和炎症等与癌症相关的疾病提供能量。因此，对其与乳腺癌之间关系的研究可以帮助我们更好地理解乳腺癌的病理生理学。
