Early-Life Exposures and Early-Onset Uterine Leiomyomata in Black Women in the Sister Study
Early-Life Exposures and Early-Onset Uterine Leiomyomata in Black Women in the Sister Study
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DOI：
10.1289/ehp.1103620
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发表时间：
2012-03-01
影响因子：
10.4
通讯作者：
Sandler, Dale P.
中科院分区：
文献类型：
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作者：
D'Aloisio, Aimee A.;Baird, Donna D.;Sandler, Dale P.
背景：子宫平滑肌瘤（肌瘤）是一种对子宫有反应的肿瘤，但其危险因素知之甚少。早期接触可能会影响子宫发育和成年后对激素的反应。早期对参加姐妹研究的非西班牙裔白色妇女的分析发现了几种早期生活因素与早发性肌瘤之间的关联。结论：我们评估了黑人妇女早期生活和儿童期暴露与早发性肌瘤的关联，并将结果与白色妇女的结果进行了比较。我们分析了3，534名35-59岁的黑人女性的基线数据，这些女性在姐妹研究（一个全国性的姐妹被诊断患有乳腺癌的女性队列）中自我报告了有关早期生活和儿童期暴露的信息。早发性子宫肌瘤是根据30岁时医生诊断子宫肌瘤的自我报告进行评估的（n = 561）。我们估计风险比（RR）和95%的置信区间（CI）从对数二项回归模型。结果：与早发性子宫肌瘤最密切相关的因素是子宫内己烯雌酚（DES; RR = 2.02; 95% CI：1.28，3.18），母体孕前糖尿病或妊娠期糖尿病（RR = 1.54; 95% CI：0.95，2.49）和单卵多胎（RR = 1.94; 95% CI：1.26，2.99）。我们还发现，10岁时比同龄人更高或更瘦与早期生活因素有正相关，这些因素包括青少年母亲的第一个孩子、母亲高血压疾病、早产和喂养大豆配方奶粉。除了同卵多胎和母体高血压疾病外，黑人妇女早发性子宫肌瘤的早期风险因素与白色妇女相似。然而，与白人相比，黑人儿童期的身高和体重与早发性肌瘤相关，而不是低社会经济地位指标。黑人和白色妇女的早期生活发现的一般一致性支持早期生活因素在纤维瘤发展中的可能作用。
BACKGROUND: Uterine leiomyomata (fibroids) are hormonally responsive tumors, but little is known about risk factors. Early-life exposures may influence uterine development and subsequent response to hormones in adulthood. An earlier analysis of non-Hispanic white women who participated in the Sister Study found associations between several early-life factors and early-onset fibroids.OBJECTIVES: We evaluated associations of early-life and childhood exposures with early-onset fibroids among black women and compared the results with those found among white women.METHODS: We analyzed baseline data from 3,534 black women, 35-59 years of age, in the Sister Study (a nationwide cohort of women who had a sister diagnosed with breast cancer) who self-reported information on early-life and childhood exposures. Early-onset fibroids were assessed based on self-report of a physician diagnosis of fibroids by the age of 30 years (n = 561). We estimated risk ratios (RR) and 95% confidence intervals (Cl) from log-binomial regression models.RESULTS: Factors most strongly associated with early-onset fibroids were in utero diethylstilbestrol (DES; RR = 2.02; 95% Cl: 1.28, 3.18), maternal prepregnancy diabetes or gestational diabetes (RR = 1.54; 95% CI: 0.95, 2.49), and monozygotic multiple birth (RR = 1.94; 95% CI: 1.26, 2.99). We also found positive associations with having been taller or thinner than peers at the age of 10 years and with early-life factors that included being the firstborn child of a teenage mother, maternal hypertensive disorder, preterm birth, and having been fed soy formula.CONCLUSIONS: With the exception of monozygotic multiple birth and maternal hypertensive disorder, early-life risk factors for early-onset fibroids for black women were similar to those found for white women. However, in contrast to whites, childhood height and weight, but not low socioeconomic status indicators, were associated with early-onset fibroids in blacks. The general consistency of early-life findings for black and white women supports a possible role of early-life factors in fibroid development.