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特定领域的体力活动模式与 MCC-Spain 研究中乳腺癌亚型的风险。

Domain-specific patterns of physical activity and risk of breast cancer sub-types in the MCC-Spain study.

机构信息

Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Ronda de Levante 11, 30008, Murcia, Spain.

CIBER Epidemiología Y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain.

出版信息

Breast Cancer Res Treat. 2019 Oct;177(3):749-760. doi: 10.1007/s10549-019-05358-x. Epub 2019 Jul 17.

Abstract

PURPOSE

Literature on the separate effects of physical activities (PA) on risk of breast cancer (BC) sub-types is heterogeneous. We investigated domain-specific associations between PA and BC risk by menopausal status and molecular subtype.

METHODS

1389 histologically confirmed invasive BC cases and 1712 controls from the MCC-Spain study were included (age: 20-85 years). Questionnaire information on PA at work, at home, and during leisure time, including recreational PA and sedentary time, and data on reproductive history, anthropometry, family history of BC, diet, and lifestyles were obtained through face-to-face interviews. Information on the expression of oestrogen (ER), progesterone (PR), and HER2 receptors was available for > 95% of the cases. Mixed-effects multivariable logistic regression models were used to estimate odds ratios (OR) of BC sub-types.

RESULTS

Occupational PA (OPA) intensity was associated with higher BC risk. Associations were stronger for pre-menopausal (OR 1.89; 95% confidence interval (CI) 1.22, 2.91) and ER+/PR+, HER2- tumours (OR 1.80; 95% CI 1.28, 2.53). Sedentary time was associated with higher risk of post-menopausal BC (OR 1.69; 95% CI 1.22, 2.32). Moderate-to-high-intensity household (HPA) and recreational PA (RPA) were inversely associated with BC occurrence in pre- and post-menopausal women, with estimated 14-33% lower risks (P for trend < 0.001) above 1000 MET·min/week.

CONCLUSIONS

Higher levels of HPA and RPA were associated with lower risk of BC, with heterogeneity by molecular type, whereas sitting time was a consistent independent risk factor of BC risk. The positive association found for OPA with ER+/PR+ BC deserves further investigation.

摘要

目的

关于体力活动(PA)对乳腺癌(BC)亚型风险的单独影响的文献存在异质性。我们通过绝经状态和分子亚型研究了 PA 与 BC 风险之间的特定领域关联。

方法

本研究纳入了 1389 例组织学确诊的浸润性 BC 病例和 1712 例对照(年龄:20-85 岁),来自 MCC-Spain 研究。通过面对面访谈获得了关于工作、家庭和休闲时间的 PA、包括娱乐性 PA 和久坐时间、以及生殖史、人体测量学、BC 家族史、饮食和生活方式的数据。超过 95%的病例可获得雌激素(ER)、孕激素(PR)和 HER2 受体的表达信息。使用混合效应多变量逻辑回归模型估计了 BC 亚型的比值比(OR)。

结果

职业性体力活动(OPA)强度与 BC 风险增加相关。对于绝经前(OR 1.89;95%置信区间(CI)1.22-2.91)和 ER+/PR+、HER2-肿瘤(OR 1.80;95%CI 1.28-2.53),相关性更强。久坐时间与绝经后 BC 风险增加相关(OR 1.69;95%CI 1.22-2.32)。中高强度的家务(HPA)和娱乐性 PA(RPA)与绝经前和绝经后女性的 BC 发生呈负相关,每周超过 1000 MET·min 的风险降低 14-33%(P 趋势 <0.001)。

结论

较高水平的 HPA 和 RPA 与 BC 风险降低相关,且与分子类型存在异质性,而久坐时间是 BC 风险的一致独立危险因素。OPA 与 ER+/PR+ BC 之间的正相关关系值得进一步研究。

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