Nagrani R, Mhatre S, Rajaraman P, Soerjomataram I, Boffetta P, Gupta S, Parmar V, Badwe R, Dikshit R
Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, 400 012, India.
Center for Global Health, U.S. National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA.
Eur J Cancer. 2016 Oct;66:153-61. doi: 10.1016/j.ejca.2016.07.022. Epub 2016 Aug 27.
Current evidence suggests that the relationship between obesity and breast cancer (BC) risk may vary between ethnic groups.
A total of 1633 BC cases and 1504 controls were enrolled in hospital-based case-control study in Mumbai, India, from 2009 to 2013. Along with detailed questionnaire, we collected anthropometric measurements on all participants. We used unconditional logistic regression models to estimate odds ratios (ORs) and 95% confidence interval (CI) for BC risk associated with anthropometry measurements, stratified on tumour subtype and menopausal status.
Waist-to-hip ratio (WHR) of ≥0.95 was strongly associated with risk of BC compared to WHR ≤0.84 in both premenopausal (OR = 4.3; 95% CI: 2.9-6.3) and postmenopausal women (OR = 3.4; 95% CI: 2.4-4.8) after adjustment for body mass index (BMI). Premenopausal women with a BMI ≥30 were at lower risk compared to women with normal BMI (OR = 0.5; 95% CI: 0.4-0.8). A similar protective effect was observed in women who were postmenopausal for <10 years (OR = 0.6; 95% CI: 0.4-0.9) but not in women who were postmenopausal for ≥10 years (OR = 1.8; 95% CI: 1.1-3.3). Overweight and obese women (BMI: 25-29.9 and ≥ 30 kg/m(2), respectively) were at increased BC risk irrespective of menopausal status if their WHR ≥0.95. Central obesity (measured in terms of WC and WHR) increased the risk of both premenopausal and postmenopausal BCs irrespective of hormone receptor (HR) status.
Central obesity appears to be a key risk factor for BC irrespective of menopausal or HR status in Indian women with no history of hormone replacement therapy.
目前的证据表明,肥胖与乳腺癌(BC)风险之间的关系在不同种族群体中可能有所不同。
2009年至2013年期间,在印度孟买开展了一项基于医院的病例对照研究,共纳入1633例BC病例和1504例对照。除详细问卷外,我们还收集了所有参与者的人体测量数据。我们使用无条件逻辑回归模型来估计与人体测量相关的BC风险的比值比(OR)和95%置信区间(CI),并按肿瘤亚型和绝经状态进行分层。
在调整体重指数(BMI)后,绝经前(OR = 4.3;95% CI:2.9 - 6.3)和绝经后女性(OR = 3.4;95% CI:2.4 - 4.8)中,腰臀比(WHR)≥0.95与BC风险的关联均显著高于WHR≤0.84。BMI≥30的绝经前女性相比BMI正常的女性风险更低(OR = 0.5;95% CI:0.4 - 0.8)。在绝经<10年的女性中也观察到类似的保护作用(OR = 0.6;95% CI:0.4 - 0.9),但在绝经≥10年的女性中未观察到(OR = 1.8;95% CI:1.1 - 3.3)。超重和肥胖女性(BMI分别为25 - 29.9和≥30 kg/m²),若其WHR≥0.95,则无论绝经状态如何,BC风险均增加。中心性肥胖(以腰围和腰臀比衡量)增加了绝经前和绝经后BC的风险,与激素受体(HR)状态无关。
在没有激素替代疗法病史的印度女性中,无论绝经状态或HR状态如何,中心性肥胖似乎都是BC的关键危险因素。