Bone mineral density and risk of breast cancer in older women - The study of osteoporotic fractures
Bone mineral density and risk of breast cancer in older women - The study of osteoporotic fractures
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DOI：
10.1001/jama.276.17.1404
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发表时间：
1996-11-06
影响因子：
120.7
通讯作者：
Cummings, SR
中科院分区：
文献类型：
--
作者：
Cauley, JA;Lucas, FL;Cummings, SR
客观。-为了检验骨矿物质密度（BMD）与老年妇女患乳腺癌风险相关的假设。前瞻性队列研究，平均（SD）随访3.2（1.6）年。四个临床中心，分别位于以下地区：马里兰州的巴尔的摩、明尼苏达州的明尼阿波利斯、俄勒冈州的波特兰和宾夕法尼亚州的莫农加希拉山谷。共有6854名65岁或以上的非黑人女性参加了骨质疏松性骨折的研究。基线时用单光子吸收法测量桡骨和跟骨BMD; 2年后用双能X线吸收法测量髋部和脊柱BMD。乳腺癌确诊的医疗记录审查。共有97名妇女患上了乳腺癌。在多变量模型中，校正年龄、肥胖程度和其他重要协变量后，BMD每增加1 SD，乳腺癌风险增加约30%至50（相对危险度，桡骨远端BMD=1.50; 95%置信区间，1.16-1.95），在桡骨远端BMD最低四分位数的女性中，每1000人-年的年龄调整乳腺癌发病率为2.46，而在骨密度最高的女性中，这一比例为5.99。BMD高于第25百分位数的女性患乳腺癌的风险是低于第25百分位数的女性的2.0至2.5倍。结果是一致的所有骨密度网站。骨密度可预测老年妇女患乳腺癌的风险。相关性的程度与BMD和所有骨折之间观察到的相似。我们的研究结果表明，影响女性健康的两种最常见的疾病之间存在联系，确定这些疾病的共同点应该能大大提高我们对其病因和预防的理解。
Objective.-To test the hypothesis that bone mineral density (BMD) is associated with the risk of developing breast cancer in older women.Design.-Prospective cohort study with mean (SD) follow-up of 3.2 (1.6) years.Setting.-Four clinical centers, one each located in the following areas: Baltimore, Md; Minneapolis, Minn; Portland, Ore; and the Monongahela Valley in Pennsylvania.Participants.-A total of 6854 nonblack women who were 65 years of age or older and enrolled in the Study of Osteoporotic Fractures.Measurements.-Radius and calcaneus BMD by single photon absorptiometry at baseline; hip and spine BMD by dual-energy x-ray absorptiometry 2 years later.Main Outcome Measure.-Breast cancer confirmed by medical record review.Results.-A total of 97 women developed breast cancer. In the multivariate model, adjusting for age, the degree of obesity, and other important covariates, the risk of breast cancer was about 30% to 50% higher per 1 SD increase in BMD (relative risk, distal radius BMD=1.50; 95% confidence interval, 1.16-1.95), The age-adjusted incidence rate of breast cancer per 1000 person-years among women in the lowest quartile of distal radius BMD was 2.46, compared with 5.99 among women with the highest BMD. Women with BMD above the 25th percentile were at 2.0 to 2.5 times increased risk of breast cancer compared with women below the 25th percentile. Results were consistent across all BMD sites.Conclusions.-Bone mineral density predicts the risk of breast cancer in older women. The magnitude of the association is similar to that observed between BMD and all fractures. Our findings suggest a link between 2 of the most common conditions affecting a woman's health, Identifying a common denominator for these conditions should substantially improve our understanding of their etiology and prevention.