胆固醇与乳腺癌风险：基于医疗保险理赔和健康检查数据库的队列研究。
Cholesterol and breast cancer risk: a cohort study using health insurance claims and health checkup databases.
机构信息
Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan.
Department of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
出版信息
Breast Cancer Res Treat. 2023 Jun;199(2):315-322. doi: 10.1007/s10549-023-06917-z. Epub 2023 Mar 30.
PURPOSE
This study aimed to investigate the association between serum cholesterol and triglyceride levels and breast cancer risk in Japanese women.
METHODS
We retrospectively evaluated the association between the levels of low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TGs) and the incidence of breast cancer in a cohort study by using the health insurance claims and health checkup data from a database provided by JMDC Inc. We included 956,390 women who were insured between April 2008 and June 2019, identified breast cancer cases by using validated definitions, and estimated the risk of breast cancer by using multivariable Cox proportional hazards regression models adjusted for potential confounders.
RESULTS
During the 2,832,277 person-years observation period (median 2.4 years), 6284 participants were diagnosed with breast cancer. There was marginally significant association between LDL-C and breast cancer risk when comparing the highest and lowest quintiles and at the clinical cutoff values for diagnosing hyperlipidemia. HDL-C was not associated with breast cancer. However, when stratified by age groups (< 50 and ≥ 50), HDL-C was inversely associated with breast cancer risk in women over 50 years old. TG was not associated with breast cancer risk.
CONCLUSION
In this population, there was a modest association of LDL-C at the clinical cutoff values for diagnosing hyperlipidemia (140 mg/mL), and there were no associations of HDL-C and TG with breast cancer risk.
目的
本研究旨在探讨日本女性血清胆固醇和甘油三酯水平与乳腺癌风险之间的关系。
方法
我们通过使用 JMDC 公司提供的数据库中的健康保险索赔和健康检查数据，对一项队列研究中 LDL-C、HDL-C 和甘油三酯（TGs）水平与乳腺癌发病之间的关系进行了回顾性评估。我们纳入了 956390 名在 2008 年 4 月至 2019 年 6 月期间参保的女性，使用经过验证的定义确定乳腺癌病例，并使用多变量 Cox 比例风险回归模型调整潜在混杂因素来估计乳腺癌风险。
结果
在 2832277 人年的观察期内（中位数 2.4 年），有 6284 名参与者被诊断患有乳腺癌。当比较最高和最低五分位组以及诊断高脂血症的临床切点值时，LDL-C 与乳腺癌风险之间存在边缘显著关联。HDL-C 与乳腺癌无关。然而，按年龄组（<50 岁和≥50 岁）分层时，在 50 岁以上的女性中，HDL-C 与乳腺癌风险呈负相关。TG 与乳腺癌风险无关。
结论
在本人群中，诊断高脂血症的临床切点值（140mg/dL）时 LDL-C 有适度关联，而 HDL-C 和 TG 与乳腺癌风险无关联。
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