Estrogen Metabolism and Mammographic Density in Postmenopausal Women: A Cross-Sectional Study
Estrogen Metabolism and Mammographic Density in Postmenopausal Women: A Cross-Sectional Study
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DOI：
10.1158/1055-9965.epi-12-0247
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发表时间：
2012-09-01
影响因子：
3.8
通讯作者：
Gierach, Gretchen L.
中科院分区：
文献类型：
--
作者：
Fuhrman, Barbara J.;Brinton, Louise A.;Gierach, Gretchen L.
背景：前瞻性研究一致发现，绝经后乳腺癌风险随着循环雌激素的增加而增加。然而，雌激素和乳房X光密度（MD）（乳腺癌风险的中间标志）的研究结果并不一致。我们调查了尿雌激素及其 2-、4- 和 16- 羟基化代谢物与 MD 的横断面关联。方法：2005 年，纽约州西部的一家诊所招募了年龄 48 至 82 岁、报告目前未使用更年期激素治疗的无乳腺癌绝经后妇女 (n = 194)。使用质量法测量尿雌激素和雌激素代谢物。光谱测定法。使用计算机辅助分析数字化胶片来测量 MD 百分比和致密面积 (cm(2))。使用线性回归模型来估计对数转换的雌激素测量值与 MD 的关联，同时调整年龄、体重指数 (BMI)、产次和过去激素治疗的使用情况。结果：大多数个体雌激素和代谢物的尿液浓度与 MD 无关；然而，在母体雌激素（雌酮和雌二醇）与其代谢物比率的十分位数范围内，MD 增加了 6.8 个百分点 (P = 0.02)，致密面积增加了 10.3 cm(2) (P = 0.03)。在 2-、4-和 16-羟基化途径与母体雌激素的比率的十分位数范围内，MD 分别下降了 6.2 (P = 0.03)、6.4 (P = 0.04) 和 5.7 (P = 0.05) 个百分点。在没有调整 BMI 的模型中，所有关联仍然很明显。结论：在这项针对绝经后妇女的研究中，母体雌激素的广泛羟基化与较高的 MD 相关。影响：雌激素的羟基化可能通过涉及 MD 的途径调节绝经后乳腺癌风险。癌症流行病学生物标志物21（9）； 1582-91。 (C) 2012 年 AACR。
Background: Prospective studies have consistently found that postmenopausal breast cancer risk increases with circulating estrogens; however, findings from studies of estrogens and mammographic density (MD), an intermediate marker of breast cancer risk, have been inconsistent. We investigated the cross-sectional associations of urinary estrogens, and their 2-, 4-, and 16-hydroxylated metabolites with MD.Methods: Postmenopausal women without breast cancer (n = 194), ages 48 to 82 years, and reporting no current menopausal hormone therapy use were enrolled at a clinic in Western NY in 2005. Urinary estrogens and estrogen metabolites were measured using mass spectrometry. Percent MD and dense area (cm(2)) were measured using computer-assisted analyses of digitized films. Linear regression models were used to estimate associations of log-transformed estrogen measures with MD while adjusting for age, body mass index (BMI), parity, and past hormone therapy use.Results: Urinary concentrations of most individual estrogens and metabolites were not associated with MD; however, across the interdecile range of the ratio of parent estrogens (estrone and estradiol) to their metabolites, MD increased by 6.8 percentage points (P = 0.02) and dense area increased by 10.3 cm(2) (P = 0.03). Across the interdecile ranges of the ratios of 2-, 4-, and 16-hydroxylation pathways to the parent estrogens, MD declined by 6.2 (P = 0.03), 6.4 (P = 0.04), and 5.7 (P = 0.05) percentage points, respectively. All associations remained apparent in models without adjustment for BMI.Conclusion: In this study of postmenopausal women, less extensive hydroxylation of parent estrogens was associated with higher MD.Impact: Hydroxylation of estrogens may modulate postmenopausal breast cancer risk through a pathway involving MD. Cancer Epidemiol Biomarkers Prev; 21(9); 1582-91. (C) 2012 AACR.