Longitudinal study on the role of body size in premenopausal breast cancer
Longitudinal study on the role of body size in premenopausal breast cancer
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DOI：
10.1001/archinte.166.21.2395
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发表时间：
2006-11-27
影响因子：
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通讯作者：
Willett, Walter C.
中科院分区：
文献类型：
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作者：
Michels, Karin B.;Terry, Kathryn L.;Willett, Walter C.
背景：高体重指数（BMI）与绝经前妇女乳腺癌风险降低有关。这种关联的机制尚未阐明。方法：我们探讨了影响排卵的因素是否可以解释BMI（计算为体重公斤除以平方米的高度）和乳腺癌之间的负相关性在113 - 130绝经前参与者的护士健康研究II。在1989年至2003年的1225520人年的前瞻性随访中，诊断出1398例浸润性乳腺癌。在整个随访过程中，对体重、身高、排卵性不孕症、月经周期模式和大量协变量进行了评估。使用考克斯比例风险回归计算风险比和95%置信区间（CI）。我们观察到当前BMI和乳腺癌发病率之间存在显著的线性反比趋势（P < .001）不能用月经周期特征或排卵障碍引起的不孕来解释（BMI >= 30 vs 20.0-22.4的女性乳腺癌的协变量调整风险比，0.81; 95% CI，0.68-0.96）。我们发现18岁时的BMI是乳腺癌发病率的最强预测因子（18岁时BMI>= 27.5 vs 20.0-22.4，0.57; 95%CI，0.41-0.81）。成年早期的身体大小似乎对绝经前乳腺癌的发展特别重要。不排卵以外的因素可能介导高BMI所赋予的保护作用。
Background: A high body mass index (BMI) has been related to a reduced risk of breast cancer in premenopausal women. The mechanisms underlying this association have not been elucidated.Methods: We explored whether factors affecting ovulation may explain the inverse association between BMI ( calculated as weight in kilograms divided by the square of height in meters) and breast cancer in 113 130 premenopausal participants in the Nurses' Health Study II. During 1 225 520 person-years of prospective follow-up between 1989 and 2003, 1398 incident cases of invasive breast cancer were diagnosed. Weight, height, ovulatory infertility, menstrual cycle patterns, and a multitude of covariates were assessed throughout follow-up. Cox proportional hazards regression was used to compute hazard ratios and 95% confidence intervals (CIs).Results: We observed a significant linear inverse trend between current BMI and breast cancer incidence (P < .001) that was not explained by menstrual cycle characteristics or infertility due to an ovulatory disorder (covariate-adjusted hazard ratio for breast cancer in women with a BMI >= 30 vs 20.0-22.4, 0.81; 95% CI, 0.68-0.96). We found BMI at age 18 years to be the strongest predictor of breast cancer incidence (covariate-adjusted hazard ratio for breast cancer in women with a BMI at age 18 years >= 27.5 vs 20.0-22.4, 0.57; 95% CI, 0.41-0.81).Conclusions: Body size during the early phases of adult life seems to be particularly important in the development of premenopausal breast cancer. Factors other than anovulation are likely to mediate the protection conferred by a high BMI.