Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK.
Department of Inflammation Biology, School of Immunology & Microbial Sciences, King's College London, London, UK.
BMC Cancer. 2023 Jun 19;23(1):562. doi: 10.1186/s12885-023-11056-1.
Associations of body shape with breast cancer risk, independent of body size, are unclear because waist and hip circumferences are correlated strongly positively with body mass index (BMI).
We evaluated body shape with the allometric "a body shape index" (ABSI) and hip index (HI), which compare waist and hip circumferences, correspondingly, among individuals with the same weight and height. We examined associations of ABSI, HI, and BMI (per one standard deviation increment) with breast cancer overall, and according to menopausal status at baseline, age at diagnosis, and oestrogen and progesterone receptor status (ER+/-PR+/-) in multivariable Cox proportional hazards models using data from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.
During a mean follow-up of 14.0 years, 9011 incident breast cancers were diagnosed among 218,276 women. Although there was little evidence for association of ABSI with breast cancer overall (hazard ratio HR = 0.984; 95% confidence interval: 0.961-1.007), we found borderline inverse associations for post-menopausal women (HR = 0.971; 0.942-1.000; n = 5268 cases) and breast cancers diagnosed at age ≥ 55 years (HR = 0.976; 0.951-1.002; n = 7043) and clear inverse associations for ER + PR- subtypes (HR = 0.894; 0.822-0.971; n = 726) and ER-PR- subtypes (HR = 0.906; 0.835-0.983 n = 759). There were no material associations with HI. BMI was associated strongly positively with breast cancer overall (HR = 1.074; 1.049-1.098), for post-menopausal women (HR = 1.117; 1.085-1.150), for cancers diagnosed at age ≥ 55 years (HR = 1.104; 1.076-1.132), and for ER + PR + subtypes (HR = 1.122; 1.080-1.165; n = 3101), but not for PR- subtypes.
In the EPIC cohort, abdominal obesity evaluated with ABSI was not associated with breast cancer risk overall but was associated inversely with the risk of post-menopausal PR- breast cancer. Our findings require validation in other cohorts and with a larger number of PR- breast cancer cases.
由于腰围和臀围与体重指数（BMI）呈强正相关，因此身体形状与乳腺癌风险之间的关联，独立于体型大小，尚不清楚。
我们使用比例身材指数（ABSI）和髋指数（HI）评估体型，这两种指数在相同体重和身高的个体中比较腰围和臀围。我们使用欧洲癌症与营养前瞻性调查（EPIC）队列的数据，在多变量 Cox 比例风险模型中，根据基线时的绝经状态、诊断时的年龄以及雌激素和孕激素受体状态（ER+/PR+/-），评估了 ABSI、HI 和 BMI（每标准偏差增加）与乳腺癌整体的相关性。
在平均 14.0 年的随访期间，218276 名女性中有 9011 例发生乳腺癌。尽管 ABSI 与乳腺癌整体相关性的证据很少（危险比 HR=0.984；95%置信区间：0.961-1.007），但我们发现绝经后女性（HR=0.971；0.942-1.000；n=5268 例）和诊断年龄≥55 岁的乳腺癌（HR=0.976；0.951-1.002；n=7043）存在边缘负相关，而 ER+/PR-亚型（HR=0.894；0.822-0.971；n=726）和 ER-PR-亚型（HR=0.906；0.835-0.983；n=759）存在明显的负相关。HI 与乳腺癌无明显相关性。BMI 与乳腺癌整体呈强正相关（HR=1.074；1.049-1.098），与绝经后女性（HR=1.117；1.085-1.150）、诊断年龄≥55 岁的癌症（HR=1.104；1.076-1.132）以及 ER+/PR+ 亚型（HR=1.122；1.080-1.165；n=3101）相关，但与 PR-亚型无关。
在 EPIC 队列中，用 ABSI 评估的腹型肥胖与乳腺癌风险无相关性，但与绝经后 PR-乳腺癌风险呈负相关。我们的研究结果需要在其他队列中并通过更多的 PR-乳腺癌病例进行验证。
