Sun exposure, vitamin D receptor genetic variants, and risk of breast cancer in the Agricultural Health Study.
Sun exposure, vitamin D receptor genetic variants, and risk of breast cancer in the Agricultural Health Study.
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DOI：
10.1289/ehp.1206274
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发表时间：
2014-02
影响因子：
10.4
通讯作者：
Alavanja MC
中科院分区：
文献类型：
--
作者：
Engel LS;Satagopan J;Sima CS;Orlow I;Mujumdar U;Coble J;Roy P;Yoo S;Sandler DP;Alavanja MC
背景：流行病学证据表明，阳光暴露与乳腺癌风险呈负相关。假想的机制是阳光诱导皮肤合成维生素D。目的：我们的目标是研究阳光暴露及其与维生素D受体(VDR)基因变异的相互作用对乳腺癌风险的影响。方法：我们调查了31021名私人农药施用者的妻子的阳光暴露和乳腺癌发病率，其中包括578例，登记在前瞻性农业健康研究队列中，平均跟踪时间为8.6年。我们在一项包含293例病例和586例匹配对照的嵌套病例对照研究中估计了日光照射、VDR变异和乳腺癌之间的相互作用。在队列登记时，通过问卷调查获得有关阳光暴露的信息。对队列数据使用COX比例风险回归，对嵌套病例对照数据使用条件Logistic回归估计相对风险。结果：我们观察到，在所有参与者中，在开始随访的10年前，与通常的≥暴露1小时/天(与1小时/天)有关的乳腺癌风险略有降低[风险比(HR)=0.8；95%CI：0.6，1.0]。雌激素受体阳性肿瘤(HR=0.7；95%CI：0.5，0.9)的相关性似乎略强于雌激素受体阴性肿瘤(HR=1.1；95%CI：0.6，2.1)。如果每一次单独暴露的HR为负值，则联合暴露≥1小时/天和一种VDR单倍型的HR低于预期(交互作用p值=0.07)。结论：我们的结果表明，阳光照射可能与乳腺癌风险降低有关，但我们没有发现VDR变异体修饰的明确证据。有必要进行更大规模的研究，特别是在那些可以更准确地描述日常阳光暴露水平较低的人群中。引文：Engel LS，Satagopan J，Sima CS，Orlow I，Mujudar U，Coble J，Roy P，Yoo S，Sandler DP，Alavanja MC。2014年。农业健康研究中的阳光暴露、维生素D受体基因变异和乳腺癌风险。环境健康展望122:165–171； http://dx.doi.org/10.1289/ehp.1206274
Background: Epidemiologic evidence suggests a negative relation between sunlight exposure and breast cancer risk. The hypothesized mechanism is sunlight-induced cutaneous synthesis of vitamin D. Objectives: Our goal was to examine sun exposure and its interaction with vitamin D receptor (VDR) gene variants on breast cancer risk. Methods: We examined sun exposure and breast cancer incidence among 31,021 private pesticide applicators’ wives, including 578 cases, enrolled in the prospective Agricultural Health Study cohort and followed 8.6 years on average. We estimated interactions between sun exposure, VDR variants, and breast cancer in a nested case–control study comprising 293 cases and 586 matched controls. Information on sun exposure was obtained by questionnaire at cohort enrollment. Relative risks were estimated using Cox proportional hazards regression for the cohort data and conditional logistic regression for the nested case–control data. Results: We observed a small decrease in breast cancer risk in association with usual sun exposure of ≥ 1 hr/day (versus < 1 hr/day) 10 years before the start of follow-up among all participants [hazard ratio (HR) = 0.8; 95% CI: 0.6, 1.0]. The association appeared to be slightly stronger in relation to estrogen receptor–positive tumors (HR = 0.7; 95% CI: 0.5, 0.9) than estrogen receptor–negative tumors (HR = 1.1; 95% CI: 0.6, 2.1). The HR for joint exposure ≥ 1 hr/day of sunlight and one VDR haplotype was less than expected given negative HRs for each individual exposure (interaction p-value = 0.07). Conclusion: Our results suggest that sun exposure may be associated with reduced risk of breast cancer, but we did not find clear evidence of modification by VDR variants. Larger studies are warranted, particularly among populations in whom low levels of usual sun exposure can be more precisely characterized. Citation: Engel LS, Satagopan J, Sima CS, Orlow I, Mujumdar U, Coble J, Roy P, Yoo S, Sandler DP, Alavanja MC. 2014. Sun exposure, vitamin D receptor genetic variants, and risk of breast cancer in the Agricultural Health Study. Environ Health Perspect 122:165–171; http://dx.doi.org/10.1289/ehp.1206274
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