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[持续性肥胖、人类瘦素基因/瘦素受体基因多态性与乳腺癌分子亚型之间的关联研究]

[Study of the association between polymorphism of persistent obesity, human leptin gene/leptin receptor gene and molecular subtypes of breast cancer].

作者信息

Yuan X L, Xu Z P, Liu C R, Yan L P, Tao P, Xiong P, Li Q, Zhou M, Li H, Zhao M, Li J Y

机构信息

West China School of Public Health, Sichuan University, Chengdu 610041, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2017 Jun 6;51(6):533-538. doi: 10.3760/cma.j.issn.0253-9624.2017.06.015.

Abstract

To explore the association between the polymorphism of persistent obesity and genetic variations in the LEP (human leptin gene, LEP) and LEPR (leptin receptor gene, LEPR) genes and different molecular subtypes of breast cancer. All 703 female patients of breast cancer diagnosed by histopathology in the Sichuan Cancer Hospital or the West China Hospital, excluding patients with metastatic breast cancer or mental disease, were selected as cases from April 2014 to May 2015. At the same time, 805 healthy women received physical examination in medical examination center of Sichuan People Hospital or Shuangliu maternal and child health care hospital, excluding those with therioma, breast disease, and mental disease, were enrolled in control group. A uniform questionnaire was used to collect general information including demographic characteristic, reproductive history height, weight, and so on. And the obesity status in recent 10 years was judged. Time of Flight Mass Spectrometer was used to determine the genotypes of LEP rs7799039, LEPR rs1137100 and LEPR rs1137101, while the multinomial logistic regression analysis was conducted to estimate the effect of risk factors related to breast cancer in different molecular subtypes; and then, the association between polymorphism of persistent obesity, the LEP, LEPR genes and breast cancer of different molecular subtypes was analyzed by binary logistic regression models. The average age of controls was (48.98±8.83) years old, while the age of cases of TNBC, Luminal A, Luminal B, and HER-2+ were (51.43±11.33), (49.94±10.10), (49.73±9.38), (50.50±9.04) years old, respectively. The frequency of genotype LEP rs7799039, LEPR rs1137100 and LEPR rs1137101 in control group was separately 74.8%(1 157/1 546), 83.6%(1 339/1 602) and 88.4%(1 416/1 602); while 77.6% (1 074/1 384), 82.4% (1 155/1 402) and 87.9% (1 232/1 402) respectively in case group. Compared with non-persistent obesity subjects, the persistent obesity ones showed an increased risk in TNBC (3.58, 95% 1.90-6.72), Luminal A (2.65, 95% 1.35-5.21) and Luminal B (1.90, 95% 1.26-2.89) breast cancer. LEP rs7799039-AA was relevant with the upward risk of Luminal B independently (1.30, 95% 1.00-1.69). Besides, persistent obesity was found to have a combined effect on Luminal B (β=3.34, 95% 1.00-11.12) with LEPR rs1137101-GG. Persistent obesity could increase the potential risk of TNBC, Luminal A and Luminal B breast cancer. Women who were suffered from persistent obesity with a genotype of LEPR rs1137101-GG were more susceptible to Luminal B breast cancer.

摘要

探讨持续性肥胖的多态性与LEP(人类瘦素基因,LEP)和LEPR(瘦素受体基因,LEPR)基因的遗传变异以及不同分子亚型乳腺癌之间的关联。选取2014年4月至2015年5月期间在四川省肿瘤医院或四川大学华西医院经组织病理学确诊的703例女性乳腺癌患者作为病例组,排除转移性乳腺癌或精神疾病患者。同时,选取805名在四川省人民医院体检中心或双流妇幼保健院接受体检的健康女性作为对照组,排除患有子宫肌瘤、乳腺疾病和精神疾病的女性。使用统一问卷收集包括人口统计学特征、生育史、身高、体重等在内的一般信息,并判断近10年的肥胖状况。采用飞行时间质谱仪测定LEP rs7799039、LEPR rs1137100和LEPR rs1137101的基因型,同时进行多项逻辑回归分析以评估不同分子亚型中与乳腺癌相关的危险因素的作用;然后,通过二元逻辑回归模型分析持续性肥胖的多态性、LEP和LEPR基因与不同分子亚型乳腺癌之间的关联。对照组的平均年龄为(48.98±8.83)岁,三阴乳腺癌(TNBC)、Luminal A、Luminal B和HER-2+病例组的年龄分别为(51.43±11.33)、(49.94±10.10)、(49.73±9.38)、(50.50±9.04)岁。对照组中LEP rs7799039、LEPR rs1137100和LEPR rs1137101基因型的频率分别为74.8%(1157/1546)、83.6%(1339/1602)和88.4%(1416/1602);病例组中分别为77.6%(1074/1384)、82.4%(1155/1402)和87.9%(1232/1402)。与非持续性肥胖受试者相比,持续性肥胖者患三阴乳腺癌(3.58,95%置信区间1.90 - 6.72)、Luminal A(2.65,95%置信区间1.35 - 5.21)和Luminal B(1.90,95%置信区间1.26 - 2.89)乳腺癌的风险增加。LEP rs7799039 - AA独立地与Luminal B乳腺癌风险升高相关(1.30,95%置信区间1.00 - 1.69)。此外,发现持续性肥胖与LEPR rs1137101 - GG对Luminal B乳腺癌有联合作用(β = 3.34,95%置信区间1.00 - 11.12)。持续性肥胖可能增加三阴乳腺癌、Luminal A和Luminal B乳腺癌的潜在风险。携带LEPR rs1137101 - GG基因型的持续性肥胖女性更易患Luminal B乳腺癌。

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