Lin Jing, Tu Rongzu, Lu Zhai'e
Health Management Center, Ningbo Women and Children's Hospital, Ningbo, China.
Department of Internal Medicine, Ningbo Women and Children's Hospital, Ningbo, China.
Front Oncol. 2023 Sep 18;13:1238845. doi: 10.3389/fonc.2023.1238845. eCollection 2023.
Diabetes has been related to a higher risk of breast cancer (BC) in women. However, it remains unknown whether the incidence of BC is increased in women with prediabetes. A systematic review and meta-analysis was therefore performed to evaluate the relationship between prediabetes and risk of BC.
Observational studies with longitudinal follow-up relevant to the objective were found via searching Medline, Embase, Cochrane Library, and Web of Science. A fixed- or random-effects model was used to pool the results depending on heterogeneity.
Eight prospective cohort studies and two nest case-control studies were included. A total of 1069079 community women were involved, and 72136 (6.7%) of them had prediabetes at baseline. During a mean duration follow-up of 9.6 years, 9960 (0.93%) patients were diagnosed as BC. Pooled results with a fixed-effects model showed that women with prediabetes were not associated with a higher incidence of BC as compared to those with normoglycemia (risk ratio: 0.99, 95% confidence interval: 0.93 to 1.05, p = 0.72) with mild heterogeneity (p for Cochrane Q test = 0.42, I 3%). Subgroup analyses showed that study characteristics such as study design, menopausal status of the women, follow-up duration, diagnostic criteria for prediabetes, methods for validation of BC cases, and study quality scores did not significantly affect the results (p for subgroup analyses all > 0.05).
Women with prediabetes may not be associated with an increased risk of BC as compared to women with normoglycemia.
糖尿病与女性患乳腺癌(BC)的较高风险相关。然而,糖尿病前期女性的乳腺癌发病率是否增加仍不清楚。因此,进行了一项系统评价和荟萃分析,以评估糖尿病前期与乳腺癌风险之间的关系。
通过检索Medline、Embase、Cochrane图书馆和科学网,找到与该目标相关的具有纵向随访的观察性研究。根据异质性,使用固定效应或随机效应模型汇总结果。
纳入了八项前瞻性队列研究和两项巢式病例对照研究。总共涉及1069079名社区女性,其中72136名(6.7%)在基线时患有糖尿病前期。在平均9.6年的随访期间,9960名(0.93%)患者被诊断为乳腺癌。固定效应模型的汇总结果显示,与血糖正常的女性相比,糖尿病前期女性的乳腺癌发病率没有更高(风险比:0.99,95%置信区间:0.93至1.05,p = 0.72),异质性较轻(Cochrane Q检验的p值 = 0.42,I² = 3%)。亚组分析表明,研究设计、女性绝经状态、随访持续时间、糖尿病前期诊断标准、乳腺癌病例验证方法和研究质量评分等研究特征对结果没有显著影响(亚组分析 p值均> 0.05)。
与血糖正常的女性相比,糖尿病前期女性可能与乳腺癌风险增加无关。