乳腺癌病人绝经前后血清25羟维生素D及骨钙素水平与乳腺密度相关性研究

Correlation between serum 25-OH vitamin D and osteocalcin and breast density in patients with breast cancer before and after menopause

目的通过评估乳腺癌病人乳腺密度与25羟维生素D(25 hydroxyvitamin D,25-OH-VD)和骨钙素浓度之间的关系,为乳腺癌病人风险性评估提供科学依据。方法采用病例对照方法,纳入2017年6月至2018年12月在上海市宝山区罗店医院确诊乳腺癌病人108例,其中绝经前病人53例,绝经后病人55例,按Wolfe方法分为低风险和高风险组,以高风险组乳腺癌病人为病例组,低风险组病人为对照组,收集病人基本信息、血清25-OH-VD及骨钙素等资料,分析绝经前后不同风险组乳腺癌病人血清学指标间相关性。结果绝经前、后病人的25-OH-VD和骨钙素分别是(49.41±3.84)nmol/L,(29.04±4.18)nmol/L和(4.27±1.65)μg/L,(14.35±2.42)μg/L,两组间25-OH-VD和骨钙素均差异有统计学意义(均P<0.001);绝经后病人中,低、高风险组25-OH-VD和骨钙素分别是(40.15±4.64)nmol/L,(25.92±3.72)nmol/L和(10.52±2.51)μg/L,(17.67±2.48)μg/L,两组间25-OH-VD和骨钙素均差异有统计学意义(均P<0.001);logistic回归分析显示,乳腺癌病人影像学风险模式与25-OH-VD(β=−0.547,P=0.004)和骨钙素水平有关(β=0.180,P=0.002);相关性分析显示,25-OH-VD和骨钙素在绝经前(r=−0.280)和绝经后(r=−0.557)的相关性均差异有统计学意义(均P<0.05)。结论25-OH-VD和骨钙素与绝经后乳腺癌病人发病风险有关,可作为乳腺癌风险评估的参考指标。

Objective To provide a scientific basis for risk assessment of breast cancer patients by evaluating the relationship between breast density and 25-hydroxyvitamin D (25-OH-VD) and osteocalc in concentrations in breast cancer patients.Methods Using the case control method,108 cases of breast cancer were diagnosed in Luodian Hospital of Baoshan District from June 2017 to December2018,including 53 cases of premenopausal patients and 55 cases of postmenopausal patients.They were assigned into low-risk and highrisk groups according to the Wolfe method,with high-risk breast cancer patients as the case group and low-risk group as the control group.The basic information about patients,serum 25 hydroxy vitamin D and osteocalcin and other data were collected to analyze the correlation between serological indicators of breast cancer patients in different risk groups before and after menopause.Results 25 hydroxy vitamin D and osteocalcin in premenopausal and post-menopausal patients were (49.41±3.84) nmol/L,(29.04±4.18) nmol/L and(4.27±1.65)μg/L,(14.35±2.42) ng/ml,respectively.There were statistically significant between 25-hydroxyvitamin D and osteocalcin(both P<0.001).Among postmenopausal patients,25-hydroxyvitamin D and osteocalcin in the low-risk group and the high-risk group were (40.15±4.64) nmol/L,(25.92±3.72) nmol/L and (10.52±2.51) ng/ml,(17.67±2.48) ng/ml,respectively.There were statistically significant between the low-risk group and the high-risk group for 25-hydroxyvitamin D and osteocalcin (both P<0.001).Logistical regression analysis showed that mammograms in patients with high-risk patterns were associated with 25-hydroxyvitamin D (β=-0.547,P=0.004) and osteocalcin levels (β=0.180,P=0.002),and correlation analysis showed the correlation between 25-hydroxyvitamin D and osteocalcin in premenopausal (r=-0.280) and postmenopausal (r=-0.557) was statistically significant (both P<0.05).Conclusion 25-hydroxyvitamin D and osteocalcin are associated with the risk of postmenopausal breast cancer and can be used as a reference for breast cancer risk assessment.