Department of Endocrinology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.
Clinical Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.
Obes Facts. 2023;16(4):356-363. doi: 10.1159/000529834. Epub 2023 Mar 7.
Obesity is a risk factor for both the development of and mortality from breast cancer in postmenopausal but not in premenopausal women. However, which part of the fat mass is associated with risk remains unclear, and whether the difference in the risk for breast cancer is associated with discrepancy in the distribution of fat with menstrual status requires further study.
A dataset from the UK Biobank, which included 245,009 female participants and 5,402 females who developed breast cancer during a mean follow-up of 6.6 years, was analyzed. Body fat mass was measured according to bioelectrical impedance at baseline by trained technicians. Age- and multivariable-adjusted hazard ratios and corresponding 95% confidence intervals for associations between body fat distribution and the risk for breast cancer were estimated using Cox proportional-hazards regression. Height, age, education level, ethnicity, index of multiple deprivation, alcohol intake, smoking, physical activity, fruit consumption, age at menarche, age at first birth, number of births, hormone replacement therapy, family history of breast cancer, hysterectomy, and ovariotomy were adjusted for potential confounders.
Fat distribution differed between pre- and postmenopausal women. After menopause, there was an increase in fat mass in different body segments (arms, legs, and trunk). After age- and multivariable adjustment, fat mass in different segments, BMI, and waist circumference were significantly associated with the risk for breast cancer among postmenopausal but not premenopausal women.
Postmenopausal women exhibited more fat in different body segments, which are associated with increased risk for breast cancer, compared to premenopausal women. Fat mass control throughout the body may be beneficial in mitigating the risk for breast cancer and was not limited to abdominal fat alone among postmenopausal women.
肥胖是绝经后女性乳腺癌发生和死亡的一个危险因素,但不是绝经前女性乳腺癌发生和死亡的一个危险因素。然而,与风险相关的脂肪质量的哪一部分仍不清楚,并且乳腺癌风险的差异是否与月经状态下脂肪分布的差异有关,还需要进一步研究。
对英国生物银行的一个数据集进行了分析,该数据集包括 245009 名女性参与者和 5402 名在平均 6.6 年的随访期间发生乳腺癌的女性。基线时,由经过培训的技术人员根据生物电阻抗法测量体脂肪量。使用 Cox 比例风险回归估计体脂分布与乳腺癌风险之间的关联,并使用年龄和多变量调整后的风险比及其相应的 95%置信区间。调整了身高、年龄、教育水平、种族、多重剥夺指数、酒精摄入量、吸烟、体力活动、水果摄入量、初潮年龄、初产年龄、生育次数、激素替代疗法、乳腺癌家族史、子宫切除术和卵巢切除术等潜在混杂因素。
绝经前后女性的脂肪分布不同。绝经后,不同身体部位(手臂、腿部和躯干)的脂肪量增加。在年龄和多变量调整后,不同部位的脂肪量、BMI 和腰围与绝经后女性的乳腺癌风险显著相关,但与绝经前女性的乳腺癌风险无关。
与绝经前女性相比,绝经后女性不同身体部位的脂肪量增加,这与乳腺癌风险增加有关。绝经后女性,全身脂肪量的控制可能有助于降低乳腺癌风险,并且不仅限于腹部脂肪。