A longitudinal study of the metabolic syndrome and risk of postmenopausal breast cancer.
A longitudinal study of the metabolic syndrome and risk of postmenopausal breast cancer.
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DOI：
10.1158/1055-9965.epi-09-0235
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发表时间：
2009-07
期刊：
影响因子：
--
通讯作者：
Rohan TE
中科院分区：
文献类型：
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作者：
Kabat GC;Kim M;Chlebowski RT;Khandekar J;Ko MG;McTiernan A;Neuhouser ML;Parker DR;Shikany JM;Stefanick ML;Thomson CA;Rohan TE
代谢综合征的特征是腹型肥胖、高血糖水平、糖耐量受损、血脂异常和高血压，与2型糖尿病和冠心病的风险增加有关。几项研究已经研究了代谢综合征的个体成分与乳腺癌的关系；然而，到目前为止，还没有研究评估代谢综合征本身与乳腺癌风险的关系。此外，以前的研究仅依赖于对综合征组成部分的基线评估。因此，我们评估了代谢综合征与绝经后乳腺癌风险的相关性，在妇女健康倡议临床试验中，有6%的样本受试者在随访期间反复测量了代谢综合征的组成部分。在基线和时间依赖分析中，我们使用COX比例风险模型来估计乳腺癌风险与代谢综合征及其组成部分的相关性的风险比和95%的可信区间。排除患有糖尿病的女性后，在4888名有基线测量的女性中，在中位数8.0年的随访中，确定了165例乳腺癌病例。基线时代谢综合征的存在与风险改变无关。在基线测量的个体成分中，舒张压与乳腺癌呈边缘正相关。然而，在与时间相关的协变量分析中，某些情景表明代谢综合征与乳腺癌之间存在正相关，这主要是由于与血糖、血清甘油三酯和舒张压呈正相关。
The metabolic syndrome, characterized by abdominal obesity, high blood glucose levels, impaired glucose tolerance, dyslipidemia, and hypertension, is associated with increased risk of type 2 diabetes and coronary heart disease. Several studies have examined the association of individual components of the metabolic syndrome with breast cancer; however, to date, no study has assessed the metabolic syndrome per se in relation to breast cancer risk. Furthermore, previous studies have relied only on baseline assessment of components of the syndrome. Therefore, we assessed the association of the metabolic syndrome with risk of postmenopausal breast cancer among women in the 6% sample of subjects in the Women’s Health Initiative clinical trial who had repeated measurements of the components of the syndrome during follow up. We used Cox proportional hazards models to estimate hazard ratios and 95% confidence intervals for the association of breast cancer risk with presence of the metabolic syndrome, as well as its components, at baseline and in time-dependent analyses. After exclusion of women with diabetes, among 4,888 women with baseline measurements, 165 incident cases of breast cancer were ascertained over a median of 8.0 years of follow-up. Presence of the metabolic syndrome at baseline was not associated with altered risk. Of the individual components measured at baseline, diastolic blood pressure showed a borderline positive association with breast cancer. In time-dependent covariate analyses, however, certain scenarios indicated a positive association between the metabolic syndrome and breast cancer, due primarily to positive associations with serum glucose, serum triglycerides, and diastolic blood pressure.