循环炎症生物标志物、脂肪因子与乳腺癌风险——一项嵌套于欧洲癌症与营养前瞻性调查（EPIC）队列中的病例对照研究
Circulating inflammatory biomarkers, adipokines and breast cancer risk-a case-control study nested within the EPIC cohort.
作者信息
Cairat Manon, Rinaldi Sabina, Navionis Anne-Sophie, Romieu Isabelle, Biessy Carine, Viallon Vivian, Olsen Anja, Tjønneland Anne, Fournier Agnès, Severi Gianluca, Kvaskoff Marina, Fortner Renée T, Kaaks Rudolf, Aleksandrova Krasimira, Schulze Matthias B, Masala Giovanna, Tumino Rosario, Sieri Sabina, Grasso Chiara, Mattiello Amalia, Gram Inger T, Olsen Karina Standahl, Agudo Antonio, Etxezarreta Pilar Amiano, Sánchez Maria-Jose, Santiuste Carmen, Barricarte Aurelio, Monninkhof Evelyn, Hiensch Anouk E, Muller David, Merritt Melissa A, Travis Ruth C, Weiderpass Elisabete, Gunter Marc J, Dossus Laure
机构信息
Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, 150 cours Albert Thomas, 69372, Lyon, CEDEX 08, France.
National Institute of Public Health, Centre for Population Health Research, Cuernavaca, Morelos, Mexico City, Mexico.
出版信息
BMC Med. 2022 Apr 18;20(1):118. doi: 10.1186/s12916-022-02319-y.
BACKGROUND
Inflammation has been hypothesized to play a role in the development and progression of breast cancer and might differently impact breast cancer risk among pre and postmenopausal women. We performed a nested case-control study to examine whether pre-diagnostic circulating concentrations of adiponectin, leptin, c-reactive protein (CRP), tumour necrosis factor-α, interferon-γ and 6 interleukins were associated with breast cancer risk, overall and by menopausal status.
METHODS
Pre-diagnostic levels of inflammatory biomarkers were measured in plasma from 1558 case-control pairs from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. We used conditional logistic regression to estimate the odds ratios (ORs) of breast cancer at blood collection, per one standard deviation increase in biomarker concentration.
RESULTS
Cases were diagnosed at a mean age of 61.4 years on average 8.6 years after blood collection. No statistically significant association was observed between inflammatory markers and breast cancer risk overall. In premenopausal women, borderline significant inverse associations were observed for leptin, leptin-to-adiponectin ratio and CRP [OR= 0.89 (0.77-1.03), OR= 0.88 (0.76-1.01) and OR= 0.87 (0.75-1.01), respectively] while positive associations were observed among postmenopausal women [OR= 1.16 (1.05-1.29), OR= 1.11 (1.01-1.23), OR= 1.10 (0.99-1.22), respectively]. Adjustment for BMI strengthened the estimates in premenopausal women [leptin: OR = 0.83 (0.68-1.00), leptin-to-adiponectin ratio: OR = 0.80 (0.66-0.97), CRP: OR = 0.85 (0.72-1.00)] but attenuated the estimates in postmenopausal women [leptin: OR = 1.09 (0.96-1.24), leptin-to-adiponectin ratio: OR = 1.02 (0.89-1.16), CRP: OR = 1.04 (0.92-1.16)].
CONCLUSIONS
Associations between CRP, leptin and leptin-to-adiponectin ratio with breast cancer risk may represent the dual effect of obesity by menopausal status although this deserves further investigation.
背景
有假说认为炎症在乳腺癌的发生和发展中起作用，并且可能对绝经前和绝经后女性的乳腺癌风险产生不同影响。我们进行了一项巢式病例对照研究，以检验诊断前血浆中脂联素、瘦素、C反应蛋白（CRP）、肿瘤坏死因子-α、干扰素-γ和6种白细胞介素的循环浓度与乳腺癌风险之间的关联，总体情况以及按绝经状态分层的情况。
方法
在欧洲癌症与营养前瞻性调查（EPIC）队列的1558对病例对照研究对象的血浆中测量了诊断前炎症生物标志物的水平。我们使用条件逻辑回归来估计采血时生物标志物浓度每增加一个标准差，患乳腺癌的比值比（OR）。
结果
病例确诊时的平均年龄为61.4岁，平均在采血后8.6年。总体上未观察到炎症标志物与乳腺癌风险之间存在统计学显著关联。在绝经前女性中，观察到瘦素、瘦素与脂联素比值和CRP存在临界显著的负相关[OR分别为0.89（0.77 - 1.03）、0.88（0.76 - 1.01）和0.87（0.75 - 1.01）]，而在绝经后女性中观察到正相关[OR分别为1.16（1.05 - 1.29）、1.11（1.01 - 1.23）、1.10（0.99 - 1.22）]。对体重指数（BMI）进行调整后，绝经前女性的估计值增强了[瘦素：OR = 0.83（0.68 - 1.00），瘦素与脂联素比值：OR = 0.80（0.66 - 0.97），CRP：OR = 0.85（0.72 - 1.00）]，但绝经后女性的估计值减弱了[瘦素：OR = 1.09（0.96 - 1.24），瘦素与脂联素比值：OR = 1.02（0.89 - 1.16），CRP：OR = 1.04（0.92 - 1.16）]。
结论
CRP、瘦素和瘦素与脂联素比值与乳腺癌风险之间的关联可能代表了肥胖按绝经状态产生的双重影响，尽管这值得进一步研究。
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