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| 心脏代谢指数与乳腺癌患病风险的关联性研究 |
| Association between cardiometabolic index and risk of breast cancer |
| 投稿时间：2024-08-30 修订日期：2024-11-01 |
| DOI： |
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| 中文关键词: 心脏代谢指数 乳腺癌 病例对照研究 |
| 英文关键词:cardiometabolic index breast cancer case-control study |
| 基金项目:世界癌症研究基金会课题“中国人群超重、肥胖与女性癌症关系的研究”项目（WCRF 2011/RFA/473） |
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| 中文摘要: |
| [目的] 探索心脏代谢指数（cardiometabolic index, CMI）与乳腺癌患病风险的关联。[方法] 基于在江苏省无锡市开展的女性乳腺癌病例对照研究，病例组为2013年11月~2014年11月确诊的原发型乳腺癌患者，对照组为来自同一地区、年龄±5岁、未有癌症病史的妇女。本研究共纳入1726名参与者（796例乳腺癌病例，930例健康对照）。按照绝经状态进行分层，采用多因素条件Logistic回归模型分析总人群、未绝经和已绝经女性中CMI与乳腺癌患病风险的关联，并计算比值比（odds ratio, OR）及其95%置信区间（confidence interval, CI）。采用4个节点的限制性立方样条（restricted cubic spline, RCS）分别拟合CMI与乳腺癌患病风险的剂量反应关系。运用似然比检验分析CMI与年龄、体力活动等分层变量之间的交互作用。[结果] 研究对象的中位年龄为53岁，65.6%已绝经。多因素条件Logistic回归分析结果显示，在调整混杂因素后，CMI水平每增加一个单位，总人群、未绝经和已绝经妇女中乳腺癌患病风险分别增加133%（OR=2.33, 95% CI: 1.92~2.86）、177%（OR=2.77, 95% CI: 1.86~4.30）和117%（OR=2.17, 95% CI: 1.75~2.73）。CMI水平与乳腺癌患病风险之间存在非线性正向剂量反应关系（均P总趋势<0.001，P非线性<0.001）。分层分析结果显示，CMI与乳腺癌患病风险的关联在年龄≤60岁和低体力活动水平亚组中更强。[结论] 研究发现CMI水平升高与乳腺癌患病风险增加有关，未来仍需在前瞻性研究中予以验证。 |
| 英文摘要: |
| [Objective] To analyze the association between cardiometabolic index and risk of breast cancer. [Methods] This study utilized a case-control study conducted in Wuxi, Jiangsu Province. The case group consisted of primary breast cancer cases diagnosed between November 2013 and November 2014. The control group included women from the same region as the case group, aged within ±5 years old, and without history of cancers. A total of 1,726 participants were included in current study (796 breast cancer cases and 930 healthy controls). The multivariate conditional Logistic regression models were applied to explore the association between CMI and breast cancer risk in the total participants, premenopausal and postmenopausal women, respectively. The restricted cubic spline analysis was used to assess the dose-response relationship between CMI and breast cancer risk. The likelihood ratio test was used to analyze the interaction between CMI and stratified variables such as age and physical activity. [Results] The median age of the participants was 53 years old and 65.6% participants were postmenopausal women. The results of multivariate conditional Logistic regression analysis showed that after adjusting for confounding factors, the risk of breast cancer increased by 133% (OR=2.330, 95% CI: 1.919~2.861), 177% (OR=2.768, 95% CI: 1.861~4.302), and 117% (OR=2.166, 95% CI: 1.745~2.729) for each one-unit increase in CMI levels in the overall participants, premenopausal and postmenopausal women, respectively (all P trend < 0.001). There was a positive nonlinear dose-response relationship between CMI and breast cancer risk (all P for overall < 0.001, P for nonlinearity < 0.001). The association between CMI and breast cancer was stronger in the subgroups of individuals aged < 60 years and with low levels of physical activity. [Conclusion] Our findings indicated that elevated CMI levels were associated with a higher risk of breast cancer. |
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