TIMING OF WEIGHT-GAIN IN RELATION TO BREAST-CANCER RISK
TIMING OF WEIGHT-GAIN IN RELATION TO BREAST-CANCER RISK
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DOI：
10.1093/oxfordjournals.annonc.a059153
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发表时间：
1995-03-01
影响因子：
50.5
通讯作者：
STOLL, BA
中科院分区：
文献类型：
--
作者：
STOLL, BA
女性在荷尔蒙剧烈变化时体重过度增加会导致代谢功能障碍。青春期、怀孕或绝经对乳腺组织“衰老”的代谢/内分泌影响可能比癌症出现时的肥胖程度更与女性乳腺癌风险相关。实验证据表明，乳腺组织对致癌作用的敏感性在成年早期最大，多项研究表明，成年早期体重增加的历史与西方女性乳腺癌风险增加有关。该年龄段的体重过度增加与对胰岛素抵抗具有遗传易感性的个体发生高胰岛素血症有关。胰岛素抵抗综合征可能是西方女性体重增加和乳腺癌风险之间的代谢联系。一些研究表明，在绝经后妇女中，高胰岛素血症与总体肥胖相关性更大，而在绝经前妇女中，高胰岛素血症与腹部脂肪定位相关性更大。这可以解释为什么体重指数增加是绝经后而不是绝经前妇女乳腺癌的风险标志。（具有平均体重指数的绝经前妇女可能具有与高胰岛素血症相关的大腹内脂肪量。）据推测，营养过剩和体育锻炼不足有利于高胰岛素血症的发展，也增加了遗传易感性的妇女患乳腺癌的风险。这一假设可以通过具体的干预研究来检验。
Excessive weight gain in women at the time of intense hormonal change can result in metabolic dysfunction. The metabolic/endocrine effect of puberty, pregnancy or menopause on breast tissue 'aging' is likely to be more relevant to a woman's breast cancer risk than is her degree of obesity at the time when the cancer presents. Experimental evidence suggests that the susceptibility of mammary tissue to carcinogenesis is greatest in early adult life, and multiple studies show that a history of weight gain in early adult Life is associated with increased breast cancer risk in Western women. Excessive weight gain in that age group is associated with the development of hyperinsulinaemia in individuals with genetic susceptibility to insulin resistance.The insulin resistance syndrome may be a metabolic link between weight gain and breast cancer risk in Western women. Some studies suggest that in postmenopausal women, hyperinsulinaemia is related more to overall obesity, whereas in premenopausal women it is related more to abdominal localisation of fat. This may explain why an increased body mass index is a risk marker for breast cancer in postmenopausal but not premenopausal women. (A premenopausal woman with an average body mass index may have a large intra-abdominal fat mass associated with the presence of hyperinsulinaemia.) It is hypothesised that overnutrition and inadequate physical exercise favour the development of hyperinsulinaemia and also increase breast cancer risk in women with a genetic susceptibility to both conditions. The hypothesis can be tested by specific intervention studies.