Stoll B A, Vatten L J, Kvinnsland S
Department of Oncology, St. Thomas' Hospital, London, UK.
Acta Oncol. 1994;33(2):171-6. doi: 10.3109/02841869409098400.
Earlier onset of menarche and tallness in adult women are mainly confirmed as risk markers for breast cancer. Recent disparate case-control studies have reported abdominal-type obesity and higher circulating levels of insulin, testosterone and insulin-like growth factor 1, to be further risk markers for breast cancer. There is evidence that abdominal-type obesity is recognisable in girls even before puberty, and disparate studies have shown it to be correlated with earlier onset of menarche, insulin resistance leading to hyperinsulinaemia, and an abnormal sex steroid profile. The implications are that earlier onset of puberty in a subset of girls can lead to more prolonged exposure of developing breast tissue to an abnormal sex steroid profile and also to a higher circulating level of insulin. It is postulated that these metabolic/endocrine concomitants of abdominal-type obesity could play a role in promoting mammary carcinogenesis at a young age, particularly if genetic predisposition is present.
初潮提前和成年女性身材高大主要被确认为乳腺癌的风险标志物。最近不同的病例对照研究报告称，腹型肥胖以及胰岛素、睾酮和胰岛素样生长因子1的循环水平升高是乳腺癌的进一步风险标志物。有证据表明，腹型肥胖在女孩青春期前就可被识别，不同研究表明其与初潮提前、导致高胰岛素血症的胰岛素抵抗以及异常的性类固醇谱相关。这意味着一部分女孩青春期提前会导致发育中的乳腺组织更长时间暴露于异常的性类固醇谱以及更高的胰岛素循环水平。据推测，腹型肥胖的这些代谢/内分泌伴随因素可能在年轻时促进乳腺癌发生中起作用，特别是在存在遗传易感性的情况下。
