Central obesity and breast cancer risk: a systematic review.
Central obesity and breast cancer risk: a systematic review.
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DOI：
10.1046/j.1467-789x.2003.00108.x
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发表时间：
2003-08-01
期刊：
影响因子：
--
通讯作者：
Howell, A H
中科院分区：
文献类型：
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作者：
Harvie, M;Hooper, L;Howell, A H
中枢性肥胖而不是全身性肥胖对乳腺癌风险的具体影响尚不清楚。本综述使用所有可用的队列和病例对照数据研究绝经前后妇女腰围和腰臀比（WHR）与乳腺癌风险之间的关系。检索科克伦图书馆、Medline、Cancer Lit和Embase的数据库，直至2002年10月。纳入了在绝经前和/或绝经后女性中进行单独分析的相关队列和病例对照研究。进行随机效应荟萃分析，按绝经前或绝经后状态和队列或病例对照设计进行亚组。还进行了敏感性分析。纳入了5项队列研究，观察人数为72,1705人年（453例绝经前和2684例绝经后病例），以及3项病例对照研究，包括276例绝经前病例和758例绝经前对照，390例绝经后病例和1071例绝经后对照。使用最多校正数据[但未校正体重或体重指数（BMI）]的队列研究的汇总结果表明，腰围最小的绝经后妇女患乳腺癌的风险降低39%（与腰围最大的妇女相比），腰围最小的妇女患乳腺癌的风险降低24%。然而，在绝经前妇女中，汇总结果表明腰围或WHR的测量对乳腺癌的风险几乎没有影响。BMI的调整消除了腰围或WHR与绝经后乳腺癌风险之间的关系，但在绝经前妇女中引入了这种关系。腰围或腰臀比较小与绝经后乳腺癌风险较低之间的关系似乎与BMI相关。在绝经前妇女中，中心性（非全身性）肥胖可能与乳腺癌风险增加特别相关。
The specific effect of central rather than general obesity on breast cancer risk is not clear. This review examines the relationship between waist and waist-hip ratio (WHR) and risk of breast cancer in pre- and post-menopausal women using all available cohort and case-control data. The databases of the Cochrane Library, Medline, Cancer Lit and Embase were searched until October 2002. Relevant cohort and case-control studies with separate analyses in pre- and/or post-menopausal women were included. Random effects meta-analyses were carried out, subgrouped by pre- or post-menopausal status and cohort or case-control design. Sensitivity analyses were also performed. Five cohort studies with 72,1705 person years of observation (453 pre-menopausal and 2684 post-menopausal cases), and three case-control studies comprising 276 pre-menopausal cases with 758 pre-menopausal controls and 390 post-menopausal cases with 1071 post-menopausal controls were included. Pooled results from cohort studies using the most adjusted data [but without adjustment for weight or body mass index (BMI)] suggest a 39% lower risk of breast cancer in post-menopausal women with the smallest waist (compared with the largest) and a 24% lower risk in women with the smallest WHR. In pre-menopausal women, however, pooled results suggest that measurement of waist or WHR have little effect on risk of breast cancer. Adjustment for BMI abolished the relationship between waist or WHR and risk of post-menopausal breast cancer, but introduced such a relationship amongst pre-menopausal women. The relationship between a smaller measurement of waist or WHR and lower risk of post-menopausal breast cancer appears to result from the associated correlation with BMI. Amongst pre-menopausal women, central (not general) obesity may be specifically associated with an increased risk of breast cancer.