体质指数与东亚绝经前和绝经后妇女乳腺癌风险：13 项队列研究的汇总分析。
Body mass index and breast cancer risk in premenopausal and postmenopausal East Asian women: a pooled analysis of 13 cohort studies.
机构信息
Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1193, Japan.
Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan.
出版信息
Breast Cancer Res. 2024 Nov 14;26(1):158. doi: 10.1186/s13058-024-01907-5.
BACKGROUND
It has been suggested that the association between body mass index and breast cancer risk differs between Asian women and Western women. We aimed to assess the associations between body mass index and breast cancer incidence in East Asian women.
METHODS
Pooled analyses were performed using individual participant data of 319,189 women from 13 cohort studies in Japan, Korea, and China. Participants' height and weight were obtained by measurement or self-reports at cohort baseline. Breast cancer was defined as code C50.0-C50.9 according to the International Classification. Using a Cox proportional hazards model, hazard ratios of breast cancer were estimated for each body mass index category, with the reference group set as the group with a body mass index of 21 to < 23 kg/m. The hazard ratio for a 5 kg/m increase in body mass index was also calculated.
RESULTS
During a mean 16.6 years of follow-up, 4819 women developed breast cancer. Similar to Westerners, a steady increase in breast cancer risk with increasing body mass index was observed in postmenopausal women, but the slope of the risk increase appeared to slow at a body mass index of 26-28 kg/m. In premenopausal women, the inverse association seen in Westerners was not observed. The risk of developing breast cancer after 50 years of age increased slightly with increasing body mass index, which was more pronounced in the older birth cohort. There was no significant association between body mass index and the risk of developing breast cancer before 50 years of age, but the risk estimates changed from positive to negative as the birth cohort got younger.
CONCLUSIONS
In East Asia, the role of body mass index in breast cancer in premenopausal women may be changing along with the increase in obesity and breast cancer. The increased risk of postmenopausal breast cancer with a higher body mass index was as robust as that of Western women.
背景
有人认为，体重指数与乳腺癌风险之间的关联在亚洲女性和西方女性之间存在差异。我们旨在评估东亚女性的体重指数与乳腺癌发病率之间的关联。
方法
使用来自日本、韩国和中国的 13 项队列研究的 319189 名女性的个体参与者数据进行汇总分析。参与者的身高和体重通过测量或队列基线时的自我报告获得。乳腺癌根据国际分类定义为 C50.0-C50.9 代码。使用 Cox 比例风险模型，估计每个体重指数类别中乳腺癌的风险比，参考组设定为体重指数为 21 至<23kg/m 的组。还计算了体重指数增加 5kg/m 时的风险比。
结果
在平均 16.6 年的随访期间，4819 名女性患上了乳腺癌。与西方人相似，绝经后女性的乳腺癌风险随着体重指数的增加而稳步上升，但风险增加的斜率在体重指数为 26-28kg/m 时似乎放缓。在绝经前女性中，西方人观察到的反比关系并未出现。50 岁以后，随着体重指数的增加，患乳腺癌的风险略有增加，在年龄较大的出生队列中更为明显。50 岁以前，体重指数与乳腺癌风险之间没有显著关联，但随着出生队列越来越年轻，风险估计从阳性变为阴性。
结论
在东亚，体重指数在绝经前女性乳腺癌中的作用可能随着肥胖和乳腺癌的增加而发生变化。较高体重指数与绝经后乳腺癌风险增加的关系与西方女性一样稳健。
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