Metabolic syndrome and breast cancer prognosis
Metabolic syndrome and breast cancer prognosis
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DOI：
10.1007/s10549-014-3076-6
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发表时间：
2014-08-01
影响因子：
3.8
通讯作者：
Pasanisi, Patrizia
中科院分区：
文献类型：
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作者：
Berrino, Franco;Villarini, Anna;Pasanisi, Patrizia
代谢综合征(MS)，传统上定义为至少五种代谢异常特征中的三种(腹型肥胖、高血压、低血浆高密度脂蛋白-胆固醇、高血糖和高甘油三酯)，与包括乳腺癌(BC)在内的几种与年龄相关的慢性疾病的风险增加有关。这可能会对BC幸存者的预后产生影响。2,092名年龄35-70岁的早期BC幸存者在手术治疗后0-5年(平均1.74岁)在11个意大利中心招募，平均随访2.8年以上，以了解其他BC相关事件，包括BC特异性死亡、远处转移、局部复发和对侧BC。在重新招募时，20%的患者患有MS，采用Logistic回归模型对与MS相关的新BC事件进行OR和95%的可信区间(CI)，调整基线病理预后因素。164例患者发生了新的BC事件，其中包括89例远处转移。患有多发性硬化症的女性与没有任何多发性硬化症特征的女性相比，调整后的整体OR值为2.17(CI 1.31-3.60)，而远处转移的调整OR值为2.45(CI 1.24-4.82)。仅有一个或两个MS特征的女性发生新的BC事件的OR为1.40(CI为0.91-2.16)。所有MS性状与新的BC事件呈正相关，低高密度脂蛋白和高甘油三酯与此显著相关。MS是影响BC预后的重要因素。由于多发性硬化通过生活方式的改变是可逆的，因此应该在BC诊所实施减少BC患者多发性硬化症特征的干预措施。
Metabolic syndrome (MS), conventionally defined by the presence of at least three out of five dysmetabolic traits (abdominal obesity, hypertension, low plasma HDL-cholesterol, high plasma glucose and high triglycerides), has been associated with an increased risk of several age-related chronic diseases, including breast cancer (BC). This may have prognostic implications for BC survivors. 2,092 early stage BC survivors aged 35-70, recruited in eleven Italian centres 0-5 years after surgical treatment (1.74 years on average), were followed-up over 2.8 years on average for additional BC-related events, including BC-specific mortality, distant metastasis, local recurrences and contralateral BC. At recruitment, 20 % of the patients had MS. Logistic regression models were carried out to generate OR and 95 % confidence intervals (CI) for new BC events associated with MS, adjusting for baseline pathological prognostic factors. New BC events occurred in 164 patients, including 89 distant metastases. The adjusted ORs for women with MS versus women without any MS traits were 2.17 (CI 1.31-3.60) overall, and 2.45 (CI 1.24-4.82) for distant metastasis. The OR of new BC events for women with only one or two MS traits was 1.40 (CI 0.91-2.16). All MS traits were positively associated with new BC events, and significantly so for low HDL and high triglycerides. MS is an important prognostic factor in BC. As MS is reversible through lifestyle changes, interventions to decrease MS traits in BC patients should be implemented in BC clinics.