不同肥胖测量指标对血浆C反应蛋白与乳腺癌患病风险关系的影响  

Influence of different obesity measurement indexes on the relationship between plasma C-reactive protein and breast cancer risk

作　　者：张小凡 刁莎[1] 李旭 李佳圆[1] ZHANG Xiao-fan;DIAO Sha;LI Xu;LI Jia-yuan(West China School of Public Health and West China Fourth Hospital,Sichuan University,Chengdu,Sichuan Province 610041,China)

机构地区：[1]四川大学华西公共卫生学院,四川大学华西第四医院,四川省成都610041

出　　处：《中国慢性病预防与控制》2021年第4期254-258,共5页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：国家自然科学基金(81874282);四川省科技厅项目(2017SZ0005);四川省卫生健康委项目(20PJ093)。

摘　　要：目的探讨血浆C反应蛋白(CRP)在不同肥胖测量指标的影响下与乳腺癌患病风险的关系,为针对性预防乳腺癌并识别高危人群提供科学依据。方法于2014年4月至2015年5月序贯收集经四川省肿瘤医院和华西医院组织病理学确诊的原发性乳腺癌新发病例312例为乳腺癌组,同期按年龄频数1∶1匹配,选取在四川省人民医院和成都双流妇幼保健院参加乳腺癌筛查的312名健康体检者作为对照组。采用标准方法进行现场问卷调查、体格测量和实验室检测。以体质指数(BMI)和腰臀比(WHR)分别作为超重和中心性肥胖的评价指标,分别按BMI、WHR及其联合指标对研究人群进行分层。采用SPSS 20.0软件进行t检验、χ^(2)检验和多因素logistic回归分析。结果乳腺癌组CRP中位数为2.9 mg/L(P25~P75:1.2~7.5 mg/L)高于对照组[1.6 mg/L(P25~P75:0.7~4.5 mg/L)],差异有统计学意义(P<0.01)。多因素logistic回归分析结果显示,在体重正常者(OR=2.25,95%CI:1.19~4.27)、超重者(OR=4.21,95%CI:1.63~10.85)和中心性肥胖者(OR=3.59,95%CI:1.75~7.34)中,相较于CRP<0.7 mg/L组,CRP>4.5 mg/L组乳腺癌患病风险上升,均有统计学意义(P<0.01)。按联合指标分层,在体重正常且中心性肥胖者(OR=3.46,95%CI:1.34~8.93)和超重且中心性肥胖者(OR=7.21,95%CI:1.93~26.96)中,相较于CRP<0.7 mg/L组,CRP>4.5 mg/L组乳腺癌患病风险上升,均有统计学意义(P<0.01)。经自然对数转换后的CRP与中心性肥胖对乳腺癌的相乘交互作用有统计学意义(P<0.05),Ln(CRP)每上升1个单位,体重正常和超重的中心性肥胖者患乳腺癌的风险分别增加43.0%、78.0%,均有统计学意义(P<0.01)。结论 CRP升高可增加乳腺癌的患病风险,无论体重正常或超重,CRP高水平且伴有中心性肥胖的女性可能是乳腺癌的高危人群。Objective To explore the relationship between plasma C-reactive protein (CRP) and the risk of breast cancer under the influence of different obesity measurement indexes,and to provide the scientific basis for preventing breast cancer and recognizing the people with high risk.Methods From April 2014 to May 2015,312 new female cases with primary breast cancer confirmed by histopathology in Sichuan Cancer Hospital and West China Hospital were collected as the breast cancer group;312 age-matched healthy women who took part in breast cancer screening in Sichuan Provincial People’s Hospital and Shuangliu Maternal and Child Health Hospital of Chengdu were selected as the control group.The investigation was performed with the questionnaire,physical examination and laboratory test.The body mass index (BMI) and waist-to-hip ratio (WHR) served as the indexes of overweight and central obesity,respectively.The subjects were stratified by BMI,WHR or combined indexes of BMI and WHR.The t test,χ^(2) test and multivariate logistic regression analysis were used to analyze the data.The used software was SPSS20.0.Results The median CRP of breast cancer group was 2.9 mg/L (P25-P75:1.2-7.5 mg/L),which was significantly higher than that[1.6 mg/L (P25-P75:0.7-4.5 mg/L)]of control group (P<0.01).Multivariate logistic regression analysis showed that the breast cancer risk of normal weight group (OR=2.25,95%CI:1.19-4.27),overweigh group (OR=4.21,95%CI:1.63-10.85) and central obesity group (OR=3.59,95%CI:1.75-7.34) with CRP>4.5 mg/L was significantly higher than that of such groups,with CRP<0.7mg/L (P<0.01).According to the stratification of combined indexes,the breast cancer risk of normal weight with central obesity group (OR=3.46,95%CI:1.34-8.93) and overweight with central obesity group (OR=7.21,95%CI:1.93-26.96) with CRP>4.5mg/L was significantly higher than that of such groups with CRP<0.7 mg/L (P<0.01).Multiplicative interaction between natural logarithm transformed CRP and central obesity had statistical significance (P<0.05),whe

关 键 词：C反应蛋白 乳腺癌 体质指数 腰臀比 

分 类 号：R737.9[医药卫生—肿瘤]