Sellers T A, Gapstur S M, Potter J D, Kushi L H, Bostick R M, Folsom A R
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55454-1015.
Am J Epidemiol. 1993 Nov 15;138(10):799-803. doi: 10.1093/oxfordjournals.aje.a116783.
The authors recently published data from a prospective cohort study of postmenopausal women (N Engl J Med 1992;326:1323-9) which suggested that a high waist/hip ratio was associated with a significantly increased risk of breast cancer in women with a positive family history of breast cancer. Since families with aggregations of breast and ovarian cancer demonstrate more consistent genetic linkage to markers on chromosome 17q than do families with breast cancer alone, the authors performed additional analyses to examine whether the previously observed associations with waist/hip ratio differed when family history of breast cancer was partitioned according to whether or not ovarian cancer was also present in a close relative. Between 1986 and 1990, 620 incident cases of breast cancer were identified in a cohort of 37,105 postmenopausal Iowa women. A family history of breast cancer in first-degree relatives was associated with a relative risk of 1.34 (95% confidence interval (CI) 1.07-1.69); a family history of both breast cancer and ovarian cancer was associated with a relative risk of 2.36 (95% CI 1.12-4.98). Consistent with the authors' findings after 4 years of follow-up, a high waist/hip ratio (> or = 80th percentile vs. < 80th percentile) was associated with increased risk of breast cancer in the presence of a family history of breast cancer (relative risk (RR) = 2.10, 95% CI 1.43-3.09) but not in the absence of a family history of breast cancer (RR = 1.12). The combination of a high waist/hip ratio with a family history of breast and ovarian cancer was associated with 4.83-fold increased risk (95% CI 1.55-15.1). Neither a family history of breast cancer nor a family history of ovarian cancer was associated with significantly increased risk in the absence of a high waist/hip ratio.
作者最近发表了一项针对绝经后女性的前瞻性队列研究数据（《新英格兰医学杂志》1992年；326:1323 - 9），该研究表明，在有乳腺癌家族史的女性中，高腰臀比与乳腺癌风险显著增加相关。由于乳腺癌和卵巢癌聚集的家族与单独患有乳腺癌的家族相比，在17号染色体q臂上的标记显示出更一致的遗传连锁，作者进行了额外分析，以检验根据近亲中是否也存在卵巢癌对乳腺癌家族史进行划分时，之前观察到的与腰臀比的关联是否不同。1986年至1990年期间，在爱荷华州37105名绝经后女性队列中确定了620例乳腺癌新发病例。一级亲属中有乳腺癌家族史与相对风险1.34相关（95%置信区间（CI）1.07 - 1.69）；乳腺癌和卵巢癌家族史与相对风险2.36相关（95% CI 1.12 - 4.98）。与作者4年随访后的发现一致，在有乳腺癌家族史的情况下，高腰臀比（≥第80百分位数与＜第80百分位数相比）与乳腺癌风险增加相关（相对风险（RR）= 2.10，95% CI 1.43 - 3.09），但在无乳腺癌家族史的情况下则不然（RR = 1.12）。高腰臀比与乳腺癌和卵巢癌家族史相结合与风险增加4.83倍相关（95% CI 1.55 - 15.1）。在没有高腰臀比的情况下，乳腺癌家族史和卵巢癌家族史均与风险显著增加无关。
