Ennour-Idrissi Kaoutar, Laforest Sofia, Tchernof André, Durocher Francine, Diorio Caroline
Département de Médecine Sociale et Préventive, Faculté de Médecine, Université Laval, Québec, QC, Canada.
Département Biologie Moléculaire, Biochimie Médicale et Pathologie, Faculté de Médecine, Université Laval, Québec, QC, Canada.
Int J Obes (Lond). 2025 May 29. doi: 10.1038/s41366-025-01814-5.
Mammary adipocyte size reflects both local excess of adiposity and adipose tissue dysfunction relevant to breast cancer biology.
To identify modifiable factors that are associated with both traditional adiposity indicators and mammary adipocyte size in women with breast cancer, and to compare the individual and simultaneous effect of these factors.
Data were collected prospectively from 160 consecutive breast cancer patients (biobank of a breast cancer reference center): factors that may influence body weight and composition (telephone interview), dietary intakes (DHQ-I) and adiposity measurements (anthropometric indices and mammary adipocyte size). Relationships between determinants of adiposity identified in the literature were summarized in a directed acyclic graph. Principal component analysis was conducted to capture dietary intakes from major nutrient intakes. Robust univariate and multivariable linear regression models were used to estimate the associations.
Menopausal status, ever smoking, tumour grade and higher weight at 18 years old were consistently associated with higher adiposity. Higher animal fat intakes was consistently associated with higher body mass index (BMI). High educational attainment was consistently associated with lower BMI and waist-to-height ratio. Higher physical activity was associated with lower adiposity and adipocyte cell size, whereas higher age was associated with higher adiposity and adipocyte cell size only in univariate models. Only menopausal status was consistently associated with higher mammary adipocyte size.
While excess adiposity is a complex condition that cannot be attributed to a single factor, menopausal status seems to be the main determinant of excess adiposity in women with breast cancer and the only independent determinant of mammary adipocyte size. Among lifestyle factors, ever smoking was the strongest independent determinant of higher adiposity, followed by high intakes of fats, particularly animal fats. If targeted efficiently, some of these modifiable factors could reduce the burden among breast cancer patients.
乳腺脂肪细胞大小既反映了局部脂肪过多，也反映了与乳腺癌生物学相关的脂肪组织功能障碍。
确定与乳腺癌女性传统肥胖指标和乳腺脂肪细胞大小均相关的可改变因素，并比较这些因素的个体和综合影响。
前瞻性收集了160例连续乳腺癌患者（一家乳腺癌参考中心的生物样本库）的数据：可能影响体重和组成的因素（电话访谈）、饮食摄入（DHQ-I）和肥胖测量指标（人体测量指数和乳腺脂肪细胞大小）。文献中确定的肥胖决定因素之间的关系总结在一个有向无环图中。进行主成分分析以从主要营养素摄入中获取饮食摄入情况。使用稳健的单变量和多变量线性回归模型来估计关联。
绝经状态、曾经吸烟、肿瘤分级和18岁时较高体重始终与较高肥胖程度相关。较高的动物脂肪摄入量始终与较高的体重指数（BMI）相关。高学历始终与较低的BMI和腰高比相关。较高的身体活动与较低的肥胖程度和脂肪细胞大小相关，而仅在单变量模型中，较高年龄与较高的肥胖程度和脂肪细胞大小相关。只有绝经状态始终与较高的乳腺脂肪细胞大小相关。
虽然肥胖过多是一种复杂情况，不能归因于单一因素，但绝经状态似乎是乳腺癌女性肥胖过多的主要决定因素，也是乳腺脂肪细胞大小的唯一独立决定因素。在生活方式因素中，曾经吸烟是较高肥胖程度的最强独立决定因素，其次是高脂肪摄入，尤其是动物脂肪。如果有效针对这些可改变因素中的一些，可能会减轻乳腺癌患者的负担。
