Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.
Danish Cancer Society Research Center, Copenhagen, Denmark.
Eur J Pediatr. 2022 Aug;181(8):3023-3030. doi: 10.1007/s00431-021-04363-x. Epub 2022 Jun 2.
A high childhood body mass index (BMI) may be protective against benign breast disease (BBD), but little is known about the effects of other early life body size measures. Thus, we examined associations between birthweight, childhood BMI, height, and pubertal timing and BBD risks. We included 171,272 girls, born from 1930 to 1996, from the Copenhagen School Health Records Register, which contains information on birthweight, childhood anthropometry (7-13 years), age at onset of the growth spurt (OGS), and peak height velocity (PHV). During follow-up, 9361 BBD cases (15-50 years) were registered in the Danish National Patient Register. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated by Cox regressions. At all childhood ages, BMI was inversely but non-linearly associated with BBD. The association was slightly stronger in magnitude for BMI z-scores above 0 (HR = 0.86; 95%CI: 0.83-0.90 per z-score) than below 0 (HR = 0.95; 95%CI 0.91-0.99 per z-score). Associations between childhood height and BBD differed by age; at 7 years the association was an inverted U-shape, whereas at 13 years height was not associated with BBD. Ages at OGS and PHV were positively associated with BBD. Low and high birthweights were associated with lower BBD risks. Conclusion: A high childhood BMI, a short or tall stature at young childhood ages, an early pubertal onset, and low or high birthweights are associated with reduced risks of BBD. These complex associations suggest that the role of these factors in breast tissue development during early life warrants further investigation in relation to BBD etiology. What is Known: • Benign breast disease (BBD) is common and may be an intermediary marker of breast cancer risks. • Early life body size may relate to the development of BBD, but currently little is known. What is New: • Girls with a high body mass index at school ages or with an early pubertal timing have decreased risks of BBD. • Short and tall heights at young childhood ages and low and high birthweights are associated with lower BBD risks.
儿童时期较高的体重指数（BMI）可能对良性乳腺疾病（BBD）有保护作用，但对于其他早期生命体型指标的影响知之甚少。因此，我们研究了出生体重、儿童时期 BMI、身高和青春期开始时间与 BBD 风险之间的关系。我们纳入了 1930 年至 1996 年期间出生于哥本哈根学校健康记录登记处的 171272 名女孩，该登记处包含了出生体重、儿童期人体测量（7-13 岁）、生长突增开始年龄（OGS）和峰值身高速度（PHV）的信息。在随访期间，丹麦国家患者登记处登记了 9361 例 BBD 病例（15-50 岁）。通过 Cox 回归估计危险比（HR）和 95%置信区间（CI）。在所有儿童时期，BMI 与 BBD 呈负相关，但呈非线性关系。BMI z 分数大于 0（HR=0.86；每 z 分数增加 0.83-0.90）的关联比 BMI z 分数小于 0（HR=0.95；每 z 分数增加 0.91-0.99）的关联略强。儿童时期身高与 BBD 的关系因年龄而异；7 岁时呈倒 U 型，而 13 岁时身高与 BBD 无关。OGS 和 PHV 年龄与 BBD 呈正相关。低出生体重和高出生体重与较低的 BBD 风险相关。结论：儿童时期较高的 BMI、幼儿时期身材矮小或高大、青春期较早开始以及低出生体重或高出生体重与 BBD 风险降低相关。这些复杂的关联表明，这些因素在生命早期对乳腺组织发育的作用值得进一步研究，以了解 BBD 的病因。已知：•良性乳腺疾病（BBD）很常见，可能是乳腺癌风险的中间标志物。•早期生命体型可能与 BBD 的发展有关，但目前知之甚少。新内容：•在学校年龄时体重指数较高或青春期开始较早的女孩患 BBD 的风险较低。•幼儿时期身材矮小或高大以及低出生体重和高出生体重与较低的 BBD 风险相关。
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