Serum high-density lipoprotein cholesterol, metabolic profile, and breast cancer risk
Serum high-density lipoprotein cholesterol, metabolic profile, and breast cancer risk
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DOI：
10.1093/jnci/djh216
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发表时间：
2004-08-04
期刊：
影响因子：
--
通讯作者：
Thune, I
中科院分区：
文献类型：
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作者：
Furberg, AS;Veierod, MB;Thune, I
背景：代谢综合征（肥胖、葡萄糖耐受不良、低血清高密度脂蛋白胆固醇（HDL-C）、高血清甘油三酯、高血压）的患病率很高，并且随着全球乳腺癌发病率的增加而增加。高密度脂蛋白- c代表了该综合征的一个重要方面，但其在乳腺癌中的作用仍不明确。方法：在1977-1983年和1985-1987年两次以人群为基础的筛查调查中，对38823名17-54岁的挪威妇女进行了血清HDL-C酶学检测。还评估了身高、体重、血压、血脂、脂肪和能量摄入、体力活动、胎次、口服避孕药使用、激素治疗使用、酒精摄入和烟草使用。我们使用Cox比例风险模型来估计与血清HDL-C水平相关的乳腺癌的相对风险（RR），并调整潜在的混杂变量。我们进行了分层分析，以评估体重指数（BMI）和绝经状态对效果的影响。所有统计检验均为双侧检验。结果：在17.2年的中位随访期间，我们发现了708例浸润性乳腺癌。在多变量分析中，绝经后乳腺癌的风险与HDL-C的四分位数呈负相关（p趋势= 0.02）。在HDL-C高于1.64 mmol/L（最高四分位数）和低于1.20 mmol/L（最低四分位数）的女性中，相对风险为0.75（95%置信区间[CI] = 0.58至0.97）。HDL-C的关联仅限于较重亚组（BMI大于或等于25 kg/m）的女性，其中HDL-C高于1.64 mmol/L与低于1.20 mmol/L的绝经后乳腺癌的相对风险为0.43 （95% CI = 0.28至0.67；p趋势< 0.001；p相互作用= 0.001）。结论：低HDL-C作为代谢综合征的一部分，与绝经后增高有关；乳腺癌风险。
Background: The prevalence of metabolic syndrome (obesity, glucose intolerance, low serum high-density lipoprotein cholesterol [HDL-C], high serum triglycerides, hypertension) is high and increasing in parallel with an increasing breast cancer incidence worldwide. HDL-C represents an important aspect of the syndrome, yet its role in breast cancer is still undefined. Methods: In two population-based screening surveys during 1977-1983 and 1985-1987, serum HDL-C was assayed enzymatically among 38 823 Norwegian women aged 17-54 years at entry. Height, weight, blood pressure, serum lipids, fat and energy intake, physical activity, parity, oral contraceptive use, hormone therapy use, alcohol intake, and tobacco use were also assessed. We used Cox proportional hazards modeling to estimate the relative risk (RR) of breast cancer associated with serum HDL-C levels and to adjust for potential confounding variables. We performed stratified analyses to evaluate effect modification by body mass index (BMI) and menopausal status. All statistical tests were two-sided. Results: During a median follow-up of 17.2 years, we identified 708 cases of invasive breast cancer. In multivariable analysis, the risk of postmenopausal breast cancer was inversely related to quartile of HDL-C (P-trend = .02). Among women with HDL-C above 1.64 mmol/L (highest quartile) versus below 1.20 mmol/L (lowest quartile), the relative risk was 0.75 (95% confidence interval [CI] = 0.58 to 0.97). The HDL-C association was confined to women in the heavier subgroup (BMI greater than or equal to25 kg/m(2)), for whom the relative risk of postmenopausal breast cancer in those with HDL-C above 1.64 mmol/L versus below 1.20 mmol/L was 0.43 (95% CI = 0.28 to 0.67; P-trend < .001; P-interaction = .001). Conclusion: Low HDL-C, as part of the metabolic syndrome, is associated with increased postmenopausal ;breast cancer risk.