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初诊时非转移性乳腺癌女性患者中代谢相关脂肪性肝病的患病率及影响:一项中国的横断面研究

Prevalence and impact of metabolic associated fatty liver disease in non-metastatic breast cancer women at initial diagnosis: a cross-sectional study in China.

作者信息

Jiang Zhi-Yu, Liang Xin-Yu, Hu Lei, Ran Liang, She Rui-Ling, Ma Chen-Yu, Feng Jun-Han, Song Jing-Yu, Li Zhao-Xing, Qu Xiu-Quan, Peng Bai-Qing, Wu Kai-Nan, Kong Ling-Quan

机构信息

Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.

Information Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.

出版信息

Clin Transl Oncol. 2025 Apr;27(4):1586-1596. doi: 10.1007/s12094-024-03665-4. Epub 2024 Sep 14.

Abstract

PURPOSE

The epidemiologic data of metabolic associated fatty liver disease (MAFLD) in breast cancer (BC) patients remains limited. We aimed to investigate the prevalence and clinicopathological characteristics of hepatic steatosis (HS) and MAFLD in Chinese BC women at initial diagnosis.

METHODS

3217 non-metastatic primary BC women with MAFLD evaluation indexes at initial diagnosis and 32,170 age-matched (in a 1:10 ratio) contemporaneous health check-up women were enrolled.

RESULTS

The prevalence of HS (21.5% vs. 19.7%, p = 0.013) and MAFLD (20.8% vs. 18.6%, p = 0.002) were significantly higher in BC women than in health check-ups, respectively. Meanwhile, the prevalence of HS/MAFLD among elderly BC women (≥ 60 years) was significantly higher than the health check-ups (38.7%/37.6% vs 31.9%/30.8%), respectively. In BC women with HS/MAFLD, the prevalence of overweight/obesity was up to 85.7%/88.6%, dyslipidemia and elevated blood pressure were 63.2%/63.7% and 59.7%/61.7%, respectively. No statistical significance of the expressions of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor 2 (HER-2) and Ki67 were found between BC women with HS/MAFLD and BC women without HS/MAFLD. After adjustment, BC women with HS showed significantly higher risk of lymph node metastasis than BC women without HS. Subjects with HS/MAFLD had higher risks of overweight/obesity, dyslipidemia, elevated blood pressure, hyperuricemia, and elevated enzymes than those without HS/MAFLD.

CONCLUSIONS

Compared with health check-ups, BC patients have higher prevalence of HS/MAFLD. HS/MAFLD coexist with high prevalence of metabolic complications, and the risk of lymph node metastasis was significantly higher in BC women with HS than in BC women without HS.

摘要

目的

乳腺癌(BC)患者中代谢相关脂肪性肝病(MAFLD)的流行病学数据仍然有限。我们旨在调查中国初诊BC女性中肝脂肪变性(HS)和MAFLD的患病率及临床病理特征。

方法

纳入3217例初诊时有MAFLD评估指标的非转移性原发性BC女性以及32170例年龄匹配(1:10比例)的同期健康体检女性。

结果

BC女性中HS(21.5%对19.7%,p = 0.013)和MAFLD(20.8%对18.6%,p = 0.002)的患病率分别显著高于健康体检者。同时,老年BC女性(≥60岁)中HS/MAFLD的患病率分别显著高于健康体检者(38.7%/37.6%对31.9%/30.8%)。在患有HS/MAFLD的BC女性中,超重/肥胖的患病率高达85.7%/88.6%,血脂异常和血压升高分别为63.2%/63.7%和59.7%/61.7%。在患有HS/MAFLD的BC女性和未患有HS/MAFLD的BC女性之间,雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子2(HER-2)和Ki67的表达无统计学差异。调整后,患有HS的BC女性发生淋巴结转移的风险显著高于未患有HS的BC女性。与未患有HS/MAFLD的受试者相比,患有HS/MAFLD的受试者超重/肥胖、血脂异常、血压升高、高尿酸血症和酶升高的风险更高。

结论

与健康体检者相比,BC患者中HS/MAFLD的患病率更高。HS/MAFLD与高患病率的代谢并发症共存,且患有HS的BC女性发生淋巴结转移的风险显著高于未患有HS的BC女性。

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