Body mass index and survival after breast cancer diagnosis in Japanese women.
Body mass index and survival after breast cancer diagnosis in Japanese women.
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DOI：
10.1186/1471-2407-12-149
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发表时间：
2012-04-17
期刊：
影响因子：
3.8
通讯作者：
Kakugawa Y
中科院分区：
文献类型：
--
作者：
Kawai M;Minami Y;Nishino Y;Fukamachi K;Ohuchi N;Kakugawa Y
体重指数（BMI）可能是影响乳腺癌预后的重要因素。主要在西方国家进行的研究报告了较高的BMI与乳腺癌女性全因死亡或乳腺癌特异性死亡风险较高之间的关系，但迄今为止在日本只有少数研究报告。在目前的前瞻性研究中，我们调查了BMI与乳腺癌患者的全因和乳腺癌特异性死亡风险之间的关系，以及绝经状态和激素受体状态。该研究包括1997年至2005年期间在日本一家医院住院的653名乳腺癌患者。使用自填问卷评估BMI。患者随访至2008年12月。根据BMI类别的四分位点分别估计风险比（HR）和95%置信区间（CI）：<21.2、≥21.2至<23.3（参考）、≥23.3至<25.8和≥25.8 kg/m2。在随访期间，观察到136例全因死亡和108例乳腺癌特异性死亡。在调整临床和混杂因素后，绝经前患者中较高的BMI与全因死亡风险增加相关（HR = 2.61; 95%CI：BMI ≥25.8 vs. ≥21.2至<23.3 kg/m2的患者为1.01-6.78）。根据激素受体状态，BMI ≥25.8 kg/m2与乳腺癌特异性死亡相关（HR = 4.95; 95% CI：1.05-23.35）和BMI <21.2 kg/m2与全因ER +或PgR +肿瘤患者中乳腺癌特异性死亡（HR = 2.91; 95% CI：1.09-7.77）和乳腺癌特异性死亡（HR = 7.23; 95% CI：1.57-33.34）。激素受体状态分析还显示，在ER +或PgR +肿瘤患者和BMI ≥21.2 kg/m2的患者中，BMI与死亡风险呈正相关（趋势p：全因死亡和乳腺癌特异性死亡分别为0.020和0.031）。我们的研究结果表明，较高的BMI和较低的BMI都与死亡风险增加有关，特别是在绝经前患者或激素受体阳性肿瘤患者中。乳腺癌患者应被告知在确诊后保持适当体重的潜在重要性。
Body mass index (BMI) may be an important factor affecting breast cancer outcome. Studies conducted mainly in Western countries have reported a relationship between higher BMI and a higher risk of all-cause death or breast cancer-specific death among women with breast cancer, but only a few studies have been reported in Japan so far. In the present prospective study, we investigated the associations between BMI and the risk of all-cause and breast cancer-specific death among breast cancer patients overall and by menopausal status and hormone receptor status. The study included 653 breast cancer patients admitted to a single hospital in Japan, between 1997 and 2005. BMI was assessed using a self-administered questionnaire. The patients were completely followed up until December, 2008. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated according to quartile points of BMI categories, respectively: <21.2, ≥21.2 to <23.3 (reference), ≥23.3 to <25.8 and ≥25.8 kg/m2. During the follow-up period, 136 all-cause and 108 breast cancer-specific deaths were observed. After adjustment for clinical and confounding factors, higher BMI was associated with an increased risk of all-cause death (HR = 2.61; 95% CI: 1.01–6.78 for BMI ≥25.8 vs. ≥21.2 to <23.3 kg/m2) among premenopausal patients. According to hormonal receptor status, BMI ≥25.8 kg/m2 was associated with breast cancer-specific death (HR = 4.95; 95% CI: 1.05–23.35) and BMI <21.2 kg/m2 was associated with all-cause (HR = 2.91; 95% CI: 1.09–7.77) and breast cancer-specific death (HR = 7.23; 95% CI: 1.57–33.34) among patients with ER + or PgR + tumors. Analysis by hormonal receptor status also showed a positive association between BMI and mortality risk among patients with ER + or PgR + tumors and with BMI ≥21.2 kg/m2 (p for trend: 0.020 and 0.031 for all-cause and breast cancer-specific death, respectively). Our results suggest that both higher BMI and lower BMI are associated with an increased risk of mortality, especially among premenopausal patients or among patients with hormonal receptor positive tumors. Breast cancer patients should be informed of the potential importance of maintaining an appropriate body weight after they have been diagnosed.
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影响因子：
3.8
作者：
Loi, S;Milne, RL;Phillips, KA
通讯作者：
Phillips, KA
影响因子：
5.7
作者：
Minami, Y;Tateno, H
通讯作者：
Tateno, H
影响因子：
8.4
作者：
HOLMBERG, L;LUND, E;MEIRIK, O
通讯作者：
MEIRIK, O
影响因子：
50.5
作者：
Berclaz, G;Li, S;International Breast Cancer Study Grp
通讯作者：
International Breast Cancer Study Grp
影响因子：
2.2
作者：
ABE, R;KUMAGAI, N;NAKAMURA, T
通讯作者：
NAKAMURA, T