代谢综合征组分与乳腺癌发生风险研究

Correlation between factors for metabolic syndrome and risk of breast cancer

目的评估中国女性代谢综合征组分与乳腺癌的相关性。方法 2011-2012年,我科在北京的4个城市社区进行了一项大规模流行病学调查,其中资料完整且诊断明确的乳腺癌病例共116例,并从同期行调查的人群中按照年龄和绝经情况进行3∶1匹配,随机抽取无乳腺癌348例作为对照。对体质量指数(body mass index,BMI)、腰围(waist circumference,WC)、血清空腹血糖(fasting blood glucose,FBG)、口服75 g葡萄糖耐量试验(oral glucose tolerance test,OGTT)2 h血糖、糖化血红蛋白(hemoglobin A1c,HbA1c)、甘油三酯(triglyceride,TG)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、血压进行评估。结果乳腺癌组OGTT 2 h血糖(9.46±3.88)mmol/L,与对照组(8.44±3.55)mmol/L相比明显升高(P=0.01);乳腺癌组HbA1c(6.33±1.07)%,与对照组(6.07±0.88)%相比也偏高;随着OGTT 2 h血糖和HbA1c水平的升高,乳腺癌的发生风险增加(OR值分别为1.07和1.30)。乳腺癌组OGTT 2 h血糖≥7.8 mmol/L及HbA1c≥6.5%的人数比例分别为57%和29%,与对照组41%和20%相比明显升高,其校正后OR值为1.80(P=0.008)和1.83(P=0.01)。结论代谢综合征有增加乳腺癌发生风险的趋势,其中以OGTT 2 h血糖和HbA1c水平的影响更加显著。

Objective To assess the correlation between factors for metabolic syndrome and risk of breast cancer in Chinese women.Methods A large scale epidemiology investigation of breast cancer was carried out in communities of 4 Beijing districts by our department from 2011 to 2012.One hundred and sixteen breast cancer patients served as a breast cancer group and 348 age-matched non-breast cancer subjects served as a control group in this study.Their BMI,WC,serum levels of FBG,OGTT 2h blood glucose,HbAlc,TG,HDL-C,and blood pressure were measured.Results The serum levels of OGTT 2 h blood glucose and HbA1c were significantly higher in breast cancer group than in control group （9.46 ± 3.88 mmol/L vs 8.44 ± 3.55 mmol/L,6.33% ± 1.07% vs 6.07% ± 0.88%,P=0.01）.The risk of breast cancer increased with elevated serum OGTT 2 h blood glucose and HbA1c levels （OR=1.07,OR=1.30）.The proportion of breast cancer patients with their OGTT 2 h blood glucose ≥ 7.8 mmol/L and HbA1c ≥ 6.5% was significantly higher than that of controls （57% and 29% vs 41% and 20%,OR=1.80,OR=1.83,P=0.008,P=0.01）.Conclusion Metabolic syndrome,especially the OGTT 2 h blood glucose and HbA 1 c level,increases the risk of breast cancer.