Serum lipids, lipid-lowering drugs, and the risk of breast cancer
Serum lipids, lipid-lowering drugs, and the risk of breast cancer
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DOI：
10.1001/archinte.165.19.2264
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发表时间：
2005-10-24
影响因子：
--
通讯作者：
Hankinson, SE
中科院分区：
文献类型：
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作者：
Eliassen, AH;Colditz, GA;Hankinson, SE
背景：实验证据表明他汀类药物通过阻断细胞周期进程和促进细胞凋亡来预防乳腺癌的发生。在人类身上的证据有限且不一致。血清胆固醇水平与乳腺癌风险之间的关系本身尚不清楚；因为胆固醇是性类固醇激素的前体，较高的水平可能会增加风险。方法：在护士健康研究中评估他汀类药物、一般降脂药物和报告的胆固醇水平与乳腺癌风险的关系，随访6至12年。共有79994名年龄在42岁至69岁之间且无癌症的妇女被前瞻性随访长达12年。目前他汀类药物的使用情况，包括持续时间，于2000年对75828名女性进行了回顾性评估。在1990年至2000年间，对71921名妇女自我报告的血清胆固醇水平进行前瞻性评估。结果：总的来说，我们记录了3177例浸润性乳腺癌。与不使用降脂药物的人相比，目前使用降脂药物的人患乳腺癌的风险相似（多变量相对危险度[RR]， 0.99； 95%可信区间[CI]， 0.86-1.13）。目前他汀类药物的使用也与乳腺癌风险无显著相关（RR, 0.91; 95% CI, 0.76-1.08）。当前使用时间的关联同样为零。与低于180 mg/dL （< 4.66 mmol/L）的绝经后妇女相比，自我报告的血清胆固醇水平为240 mg/dL或更高（>= 6.22 mmol/L）的妇女与乳腺癌风险无关（RR, 1.04; 95% CI, 0.91-1.17）。结论：总的来说，这些数据表明，血清胆固醇水平和一般降脂药物的使用，特别是他汀类药物的使用，与乳腺癌的风险没有实质性的联系。
Background: Experimental evidence suggests that statins protect against breast carcinogenesis by interrupting cell cycle progression and promoting apoptosis. Evidence in humans is limited and inconsistent. The relation between serum cholesterol levels and breast cancer risk is itself unclear; because cholesterol is the precursor to sex steroid hormones, higher levels could plausibly increase risk.Methods: The associations of statins, general lipid-lowering drugs, and reported cholesterol levels with breast cancer risk were assessed in the Nurses' Health Study, with 6 to 12 years of follow-up. A total of 79 994 women aged 42 to 69 years and free of cancer were followed prospectively for up to 12 years. Current statin use, including duration, was assessed retrospectively in 2000 in 75 828 women. Self-reported serum cholesterol level was assessed prospectively between 1990 and 2000 in 71921 women.Results: Overall, we documented 3177 incident cases of invasive breast cancer. Compared with nonusers, current lipid-lowering drug users experienced similar breast cancer risk (multivariate relative risk [RR], 0.99; 95% confidence interval [CI], 0.86-1.13). Current use of statins also was not significantly associated with breast cancer risk (RR, 0.91; 95% CI, 0.76-1.08). Associations by duration of current use were similarly null. Self-reported serum cholesterol levels were not associated with breast cancer risk in postmenopausal women with levels of 240 mg/dL or higher (>= 6.22 mmol/L) compared with less than 180 mg/dL (< 4.66 mmoUL) (RR, 1.04; 95% CI, 0.91-1.17).Conclusion: Overall, these data suggest that serum cholesterol levels and the use of lipid-lowering drugs in general and of statins in particular are not substantially associated with breast cancer risk.