Prenatal and infant exposures and age at menarche.
Prenatal and infant exposures and age at menarche.
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DOI：
10.1097/ede.0b013e31828062b7
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发表时间：
2013-03
期刊：
影响因子：
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通讯作者：
Sandler DP
中科院分区：
文献类型：
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作者：
D'Aloisio AA;DeRoo LA;Baird DD;Weinberg CR;Sandler DP
月经初潮早与乳腺癌风险增加有关。导致初潮提前的既定因素数量有限。我们在一个全国范围内有乳腺癌家族史的妇女队列中研究了产前和婴儿暴露与初潮年龄的关系。该研究包括姐妹研究中的33，501名女性，基线年龄为35-59岁（2003-2009）。我们使用多分类logistic回归来估计自我报告暴露与≤10、11、14和≥15岁初潮相对于12-13岁初潮的相关性的独立相对风险比（rRR）和95%置信区间（CI）。月经初潮早（≤10或11岁）与出生体重低、母亲未成年、是头胎以及特定的母体产前暴露相关：吸烟、DES（己烯雌酚）、孕前糖尿病和妊娠相关高血压疾病。与初潮极早（≤10年）相关性最强的产前暴露是DES（RR = 1.56 [95% CI = 1.24-1.96]）、母体孕前糖尿病（2.24 [1.37-3.68]）和妊娠相关高血压疾病（1.45 [1.18-1.79]）。大豆配方奶粉与极早月经初潮（1.21 [0.94-1.54]）和晚月经初潮（14岁：1.17 [0.98-1.40]或≥15岁：1.28 [1.06-1.56]）相关。虽然初潮只是青春期发育的一个标志，但它是一个常用的替代指标。所观察到的产前DES和大豆配方暴露与初潮年龄的关联与外源性雌激素和青春期时间的动物数据一致。早期生活暴露可能混淆初潮年龄与成人月经依赖性结局之间的关联。
Early menarche is related to increased risk of breast cancer. The number of established factors that contribute to early menarche is limited. We studied prenatal and infant exposures in relation to age at menarche in a nationwide cohort of women who have a family history of breast cancer. The study comprised 33,501 women in the Sister Study who were aged 35-59 years at baseline (2003-2009). We used polytomous logistic regression to estimate separate relative risk ratios (rRRs) and 95% confidence intervals (CIs) for associations of self-reported exposures with menarche at ≤10, 11, 14, and ≥15 years relative to menarche at 12-13 years. Early menarche (≤10 or 11 years) was associated with having low birth weight, having had a teenage mother, being firstborn, and specific maternal prenatal exposures: smoking, DES (diethylstilbestrol), pre-pregnancy diabetes, and pregnancy-related hypertensive disorder. Prenatal exposures most strongly associated with very early menarche (≤10 years) were DES (rRR = 1.56 [95% CI = 1.24-1.96]), maternal pre-pregnancy diabetes (2.24 [1.37-3.68]), and pregnancy-related hypertensive disorder (1.45 [1.18-1.79]). Soy formula was associated with both very early menarche (1.21 [0.94-1.54]) and late menarche (14 years: 1.17 [0.98-1.40] or ≥15 years: 1.28 [1.06-1.56]). Although menarche is only one marker of pubertal development, it is a commonly used surrogate. The observed associations of prenatal DES and soy formula exposure with age at menarche are consistent with animal data on exogenous estrogens and pubertal timing. Early-life exposures may confound associations between age at menarche and hormonally dependent outcomes in adults.