Petridou E, Syrigou E, Toupadaki N, Zavitsanos X, Willett W, Trichopoulos D
Department of Hygiene and Epidemiology, Athens University Medical School, Greece.
Int J Cancer. 1996 Oct 9;68(2):193-8. doi: 10.1002/(SICI)1097-0215(19961009)68:2<193::AID-IJC9>3.0.CO;2-T.
Age at menarche is one of the few established risk factors for breast cancer; identification of its exogenous determinants could throw light on the origins of breast cancer. We have undertaken an epidemiologic study in Greece to ascertain whether: 1) energy intake, an indicator of physical activity, is associated with later age at menarche; 2) energy-adjusted fat intake is related to earlier age at menarche; and 3) other macronutrients and anthropometric variables are predictors of age at menarche. Anthropometric, socio-economic, familiar, nutritional and lifestyle predictors of age at menarche were studied by interviewing in person 345 female students 9 to 16 years old attending 8 schools of Greater Athens. Menarche was the outcome variable in a proportional hazards model assessing the mutually adjusted incidence rate ratio by a series of predictor variables. In a complementary analysis, age at menarche was the dependent variable among menstruating girls. Consistent results were derived from the main and the complementary analysis. Increased height and body mass index accelerate the occurrence of menarche. Maternal and daughter's ages at menarche are correlated, but there is no evidence of an association with paternal education. Various measures of moderate physical activity as well as increased total energy intake were associated with a delay in age at menarche. Energy-adjusted macronutrients were not associated with age at menarche. It appears that an alteration of energy balance in early life through increased physical activity could delay age at menarche and reduce the risk for breast cancer in later life.
初潮年龄是为数不多已确定的乳腺癌风险因素之一；确定其外部决定因素有助于揭示乳腺癌的起源。我们在希腊开展了一项流行病学研究，以确定：1）能量摄入作为身体活动的一个指标，是否与初潮年龄较晚有关；2）能量调整后的脂肪摄入是否与初潮年龄较早有关；3）其他常量营养素和人体测量变量是否是初潮年龄的预测因素。通过对雅典大区8所学校的345名9至16岁女学生进行面对面访谈，研究了初潮年龄的人体测量、社会经济、家族、营养和生活方式预测因素。在一个比例风险模型中，初潮情况是结果变量，该模型通过一系列预测变量评估相互调整后的发病率比。在一项补充分析中，初潮年龄是月经初潮女孩中的因变量。主要分析和补充分析得出了一致的结果。身高和体重指数增加会加速初潮的发生。母亲和女儿的初潮年龄相关，但没有证据表明与父亲的教育程度有关。各种适度身体活动的衡量指标以及总能量摄入增加与初潮年龄延迟有关。能量调整后的常量营养素与初潮年龄无关。看来，通过增加身体活动在生命早期改变能量平衡可能会延迟初潮年龄，并降低晚年患乳腺癌的风险。
