Type 2 diabetes and subsequent incidence of breast cancer in the Nurses' Health Study
Type 2 diabetes and subsequent incidence of breast cancer in the Nurses' Health Study
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DOI：
10.2337/diacare.26.6.1752
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发表时间：
2003-06-01
期刊：
影响因子：
16.2
通讯作者：
Manson, JE
中科院分区：
文献类型：
--
作者：
Michels, KB;Solomon, CG;Manson, JE
目的-高胰岛素血症可能促进乳腺癌的发生。胰岛素抵抗与乳腺癌风险增加有关，也是2型糖尿病的特征。研究设计和方法-共有116，488名年龄在30-55岁且在1976年无癌症的女护士，随访至1996年2型糖尿病的发生和1908年侵袭性乳腺癌的发生，结果-在230万人-年的随访中，我们确定了6,220名2型糖尿病妇女和5,189例浸润性乳腺癌。2型糖尿病妇女乳腺癌发病率适度升高（风险比）。[HR]= 1.17; 95%CI 1.01-1.35）与非糖尿病女性相比，与年龄、肥胖、乳腺癌家族史、良性乳腺疾病史、生殖因素、体力活动和饮酒无关。这种关联在绝经后妇女中明显（1.16; 0.98-1.62），但在绝经前妇女中不明显（0.83; 0.48-1.42）。雌激素受体阳性的乳腺癌患者中，这种相关性占主导地位（1.22; 1.01-1.47）。结论：2型糖尿病患者患乳腺癌的风险可能略有增加。
OBJECTIVE - Hyperinsulinemia may promote mammary carcinogenesis. Insulin resistance has been linked to an increased risk of breast cancer and is also characteristic of type 2 diabetes. We prospectively evaluated the association between type 2 diabetes and invasive breast cancer incidence in the Nurses' Health Study.RESEARCH DESIGN AND METHODS - A total of 116,488 female nurses who were 30-55 years old and free of cancer in 1976 were followed through 1996 for the occurrence of type 2 diabetes and through 1908 for incident invasive breast cancer, verified by medical records and pathology reports.RESULTS - During 2.3 miltion person-years of follow-up, we identified 6,220 women with type 2 diabetes and 5,189 incident cases of invasive breast cancer. Women with type 2 diabetes had a modestly elevated incidence of breast cancer (hazard ratio. [HR] = 1.17; 95% CI 1.01-1.35) compared with women without diabetes, independent of age, obesity, family history of breast cancer, history of benign breast disease, reproductive factors, physical activity, and alcohol consumption. This association was apparent among postmenopausal women (1.16; 0.98-1.62) but not premenopausal women (0.83; 0.48-1.42). The association was predominant among women with estrogen receptor-positive breast cancer (1.22; 1.01-1.47).CONCLUSIONS - Women with type 2 diabetes may have a slightly increased risk of breast cancer.