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痛风与乳腺癌发病风险的关联:一项包括德国 67598 例初级保健患者的回顾性队列研究。

Association between gout and subsequent breast cancer: a retrospective cohort study including 67,598 primary care patients in Germany.

机构信息

Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps-University Marburg, Baldingerstraße, 35043, Marburg, Germany.

IQVIA, Main Airport Center, Unterschweinstiege 2-14, 60549, Frankfurt, Germany.

出版信息

Breast Cancer Res Treat. 2023 Jun;199(3):545-552. doi: 10.1007/s10549-023-06944-w. Epub 2023 Apr 18.

Abstract

PURPOSE

The aim of this retrospective cohort study was to analyze the cumulative incidence of breast cancer following gout and to investigate the association between gout and subsequent breast cancer in 67,598 primary care patients in Germany.

METHODS

This study included adult female patients (≥ 18 years) with an initial diagnosis of gout in 1284 general practices in Germany between January 2005 and December 2020. Individuals without gout were matched to gout patients using propensity score matching based on average yearly consultation frequency during the follow-up period, diabetes, obesity, chronic bronchitis/COPD diagnoses, and diuretic therapy. The 10-year cumulative incidence of breast cancer in the cohorts with and without gout was also studied using Kaplan-Meier curves, which were then compared using the log-rank test. Finally, a univariable Cox regression analysis was conducted to assess the association between gout and breast cancer.

RESULTS

After up to 10 years of follow-up, 4.5% of gout and 3.7% of non-gout patients were diagnosed with breast cancer. A Cox regression analysis revealed a significant association between gout and subsequent breast cancer in the total population (HR: 1.17; 95% CI: 1.05-1.31). In the age-stratified analyses, gout was only strongly associated with subsequent breast cancer in the age group ≤ 50 (HR: 1.58; 95% CI: 1.10-2.27), but the association was not significant in women over 50 years old.

CONCLUSION

Taken together, the findings of our study provide evidence for the association between gout and subsequent breast cancer diagnosis, particularly in the youngest age group.

摘要

目的

本回顾性队列研究旨在分析痛风患者乳腺癌的累积发病率,并在德国的 67598 名初级保健患者中调查痛风与乳腺癌后续诊断之间的关系。

方法

本研究纳入了 2005 年 1 月至 2020 年 12 月期间德国 1284 家全科诊所中年龄≥18 岁的女性痛风初诊患者。采用倾向评分匹配,根据随访期间的平均每年就诊频率、糖尿病、肥胖、慢性支气管炎/COPD 诊断和利尿剂治疗情况,对无痛风的患者与痛风患者进行匹配。还使用 Kaplan-Meier 曲线研究了有和无痛风的队列的 10 年乳腺癌累积发病率,并使用对数秩检验比较了这些曲线。最后,进行单变量 Cox 回归分析以评估痛风与乳腺癌之间的关联。

结果

在长达 10 年的随访后,4.5%的痛风患者和 3.7%的非痛风患者被诊断患有乳腺癌。Cox 回归分析显示,在总体人群中,痛风与乳腺癌后续诊断之间存在显著关联(HR:1.17;95%CI:1.05-1.31)。在年龄分层分析中,痛风仅与≤50 岁年龄组的乳腺癌后续诊断密切相关(HR:1.58;95%CI:1.10-2.27),但在 50 岁以上女性中,这种关联不显著。

结论

综上所述,本研究的结果为痛风与乳腺癌后续诊断之间的关系提供了证据,特别是在最年轻的年龄组中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb04/10175324/22123c0ac63c/10549_2023_6944_Fig1_HTML.jpg

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