Obesity, body size, and risk of postmenopausal breast cancer: the Women's Health Initiative (United States)
Obesity, body size, and risk of postmenopausal breast cancer: the Women's Health Initiative (United States)
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DOI：
10.1023/a:1020239211145
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发表时间：
2002-10-01
影响因子：
2.3
通讯作者：
McTiernan, A
中科院分区：
文献类型：
--
作者：
Morimoto, LM;White, E;McTiernan, A
目的：体型是乳腺癌的一个重要的可改变危险因素。虽然肥胖通常被发现与绝经后乳腺癌风险增加有关，但关于身体脂肪分布的作用、终生体重史以及特定女性亚群的影响仍然存在疑问。方法：我们评估了参与妇女健康倡议观察性研究的 85,917 名 50-79 岁女性的几种人体测量指标与绝经后乳腺癌风险的关系。 1993 年至 1998 年间，美国 40 家诊所招募了女性，到 2000 年 4 月，已有 1030 名女性患上浸润性乳腺癌。入组后，训练有素的临床中心工作人员测量了每位女性的身高、体重、腰围和臀围。结果：在曾经使用过激素替代疗法 (HRT) 的女性中，人体测量因素与乳腺癌无关。在未使用 HRT 的女性中，与较瘦的女性（基线 BMI 小于或等于 22.6）相比，较重的女性（基线体重指数 (BMI) > 31.1）患绝经后乳腺癌的风险较高（相对风险 (RR) = 2.52；95% 置信区间 (CI) = 1.62-3.93）。与体重指数增加相关的风险升高似乎在年轻的绝经后女性中最为明显。 18 岁以来 BMI 的变化、最大 BMI 和体重也与不使用 HRT 的乳腺癌相关。虽然腰围和臀围都与乳腺癌风险相关，但它们的比率（衡量脂肪分布的指标）却无关（RR = 1.33；95% CI = 0.88-2.01）。结论：我们的研究证实了之前报道的发现，即全身性肥胖是绝经后乳腺癌的重要危险因素，但仅限于从未接受过 HRT 的女性。终生体重增加也是乳腺癌的有力预测因素。腰臀比（衡量体重分布的指标）似乎与绝经后乳腺癌风险无关。
Objective: Body size is an important modifiable risk factor for breast cancer. Although obesity has generally been found to be associated with increased risk for postmenopausal breast cancer, there remain questions concerning the role of body fat distribution, lifetime weight history, and effects within specific subgroups of women.Methods: We assessed the relationship of several anthropometric measures and risk of postmenopausal breast cancer in 85,917 women aged 50-79 at entry in the Women's Health Initiative Observational Study. Women were enrolled during 1993-1998 at 40 clinics in the US and 1030 developed invasive breast cancer by April 2000. Upon entry, trained clinical center staff measured each woman's height, weight, and waist and hip circumference.Results: Anthropometric factors were not associated with breast cancer among women who had ever used hormone replacement therapy (HRT). Among HRT non-users, heavier women (baseline body mass index (BMI) > 31.1) had an elevated risk of postmenopausal breast cancer (relative risk (RR) = 2.52; 95% confidence interval (CI) = 1.62-3.93), compared to slimmer women (baseline BMI less than or equal to 22.6). The elevation in risk associated with increasing BMI appeared to be most pronounced among younger postmenopausal women. Change in BMI since age 18, maximum BMI, and weight were also associated with breast cancer in HRT non-users. While both waist and hip circumference were associated with breast cancer risk, their ratio, a measure of fat distribution, was not (RR = 1.33; 95% CI = 0.88-2.01).Conclusions: Our study confirms previously reported findings that generalized obesity is an important risk factor for postmenopausal breast cancer, but only among women who have never taken HRT. Lifetime weight gain is also a strong predictor of breast cancer. Waist to hip ratio, a measure of weight distribution, does not appear to be related to postmenopausal breast cancer risk.