Circulating Hormones and Mammographic Density in Premenopausal Women
Circulating Hormones and Mammographic Density in Premenopausal Women
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DOI：
10.1007/s12672-017-0321-6
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发表时间：
2018-04-01
影响因子：
3
通讯作者：
Tamimi, Rulla M.
中科院分区：
文献类型：
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作者：
Bertrand, Kimberly A.;Eliassen, A. Heather;Tamimi, Rulla M.
先前的研究表明，绝经前妇女的几种内源性激素与乳腺癌的风险有关;然而，很少有研究评估绝经前妇女内源性激素与乳腺摄影密度（MD）的关系。我们在护士健康研究II中对634名无癌症的绝经前妇女进行了一项与MD相关的血浆激素水平的横断面研究。我们使用计算机辅助方法从筛查乳房X线照片中测量MD百分比。我们分析了雌二醇，雌酮，硫酸雌酮在血液样本定时在卵泡早期和中期黄体期的月经周期，以及睾酮，雄烯二酮，孕酮，脱氢表雄酮（DHEA），硫酸脱氢表雄酮，性激素结合球蛋白（SHBG），和抗苗勒管激素在黄体或不定时的样本。我们使用多变量线性回归来量化%MD与每种激素的四分位数的相关性，调整年龄，体重指数和乳腺癌风险因素。卵泡雌二醇水平最高四分位数的女性与卵泡雌二醇水平最低四分位数的女性相比，其%MD显著更高[差异，6.7个百分点; 95%置信区间（CI）2.2，11.3; p趋势< 0.001]。卵泡游离雌二醇也有类似的相关性，但黄体期雌二醇没有。此外，游离睾酮水平最高（与最低）四分位数的女性的%MD显著较低（差异，-4.7; 95% CI - 8.7，-0.8; p趋势= 0.04）。较高的SHBG与较高的MD百分比显著相关（差异，4.8; 95% CI 1.1，8.6; p趋势= 0.002）。MD百分比与其他测量的激素没有很强的相关性。排除无排卵周期妇女的分析结果相似。我们的研究结果表明，卵泡雌二醇和SHBG可能在绝经前百分比MD中起重要作用。
Prior research suggests that several endogenous hormones in premenopausal women are associated with breast cancer risk; however, few studies have evaluated associations of endogenous hormones with mammographic density (MD) in premenopausal women. We conducted a cross-sectional study of plasma hormone levels in relation to MD among 634 cancer-free premenopausal women in the Nurses' Health Study II. We measured percent MD from screening mammograms using a computer-assisted method. We assayed estradiol, estrone, and estrone sulfate in blood samples timed in early follicular and mid-luteal phases of the menstrual cycle as well as testosterone, androstenedione, progesterone, dehydroepiandrosterone (DHEA), DHEA sulfate, sex hormone-binding globulin (SHBG), and anti-Mullerian hormone in luteal or untimed samples. We used multivariable linear regression to quantify the association of %MD with quartiles of each hormone, adjusting for age, body mass index, and breast cancer risk factors. Women in the highest quartile of follicular estradiol levels had significantly greater %MD compared to those in the lowest quartile [difference, 6.7 percentage points; 95% confidence interval (CI) 2.2, 11.3; p-trend < 0.001]. Similar associations were observed for follicular free estradiol but not luteal-phase estradiol. Also, women in the top (vs. bottom) quartile of free testosterone had significantly lower %MD (difference, - 4.7; 95% CI - 8.7, - 0.8; p-trend = 0.04). Higher SHBG was significantly associated with higher percent MD (difference, 4.8; 95% CI 1.1, 8.6; p-trend = 0.002). Percent MD was not strongly associated with other measured hormones. Results were similar in analyses that excluded women with anovulatory cycles. Our findings suggest that follicular estradiol and SHBG may play an important role in premenopausal percent MD.