Cauley J A, Lucas F L, Kuller L H, Vogt M T, Browner W S, Cummings S R
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA 15261, USA.
JAMA. 1996 Nov 6;276(17):1404-8.
To test the hypothesis that bone mineral density (BMD) is associated with the risk of developing breast cancer in older women.
Prospective cohort study with mean (SD) follow-up of 3.2 (1.6) years.
Four clinical centers, one each located in the following areas: Baltimore, Md; Minneapolis, Minn; Portland, Ore; and the Monongahela Valley in Pennsylvania.
A total of 6854 nonblack women who were 65 years of age or older and enrolled in the Study of Osteoporotic Fractures.
Radius and calcaneus BMD by single photon absorptiometry at baseline; hip and spine BMD by dual-energy x-ray absorptiometry 2 years later.
Breast cancer confirmed by medical record review.
A total of 97 women developed breast cancer. In the multivariate model, adjusting for age, the degree of obesity, and other important covariates, the risk of breast cancer was about 30% to 50% higher per 1 SD increase in BMD (relative risk, distal radius BMD=1.50; 95% confidence interval, 1.16-1.95). The age-adjusted incidence rate of breast cancer per 1000 person-years among women in the lowest quartile of distal radius BMD was 2.46, compared with 5.99 among women with the highest BMD. Women with BMD above the 25th percentile were at 2.0 to 2.5 times increased risk of breast cancer compared with women below the 25th percentile. Results were consistent across all BMD sites.
Bone mineral density predicts the risk of breast cancer in older women. The magnitude of the association is similar to that observed between BMD and all fractures. Our findings suggest a link between 2 of the most common conditions affecting a woman's health. Identifying a common denominator for these conditions should substantially improve our understanding of their etiology and prevention.
检验骨矿物质密度（BMD）与老年女性患乳腺癌风险相关这一假设。
前瞻性队列研究，平均（标准差）随访3.2（1.6）年。
四个临床中心，分别位于以下地区：马里兰州巴尔的摩；明尼苏达州明尼阿波利斯；俄勒冈州波特兰；以及宾夕法尼亚州的莫农加希拉山谷。
共有6854名65岁及以上的非黑人女性，她们参与了骨质疏松性骨折研究。
基线时通过单光子吸收法测量桡骨和跟骨的骨密度；两年后通过双能X线吸收法测量髋部和脊柱的骨密度。
通过病历审查确诊的乳腺癌。
共有97名女性患乳腺癌。在多变量模型中，校正年龄、肥胖程度和其他重要协变量后，骨密度每增加1个标准差，患乳腺癌的风险约高出30%至50%（相对风险，桡骨远端骨密度=1.50；95%置信区间，1.16 - 1.95）。桡骨远端骨密度处于最低四分位数的女性中，年龄校正后的每1000人年乳腺癌发病率为2.46，而骨密度最高的女性中这一发病率为5.99。骨密度高于第25百分位数的女性患乳腺癌的风险是低于第25百分位数女性的2.0至2.5倍。所有骨密度测量部位的结果均一致。
骨矿物质密度可预测老年女性患乳腺癌的风险。这种关联的程度与骨密度和所有骨折之间观察到的相似。我们的研究结果表明，影响女性健康的两种最常见病症之间存在联系。确定这些病症的共同因素应能大幅增进我们对其病因和预防的理解。
