甲状腺激素敏感性指标与乳腺癌风险的相关性研究  

Association between thyroid hormone sensitivity indicators and breast cancer risk

作　　者：刘皓然 方子豪 廖定君 陈学彰[1] LIU Hao-ran;FANG Zi-hao;LIAO Ding-jun;CHEN Xue-zhang(The Eighth Clinical Medical School of Guangzhou University of Chinese Medicine,Foshan,Guangdong 528000,China)

机构地区：[1]广州中医药大学第八临床医学院,广东广州510405

出　　处：《现代预防医学》2024年第20期3829-3835,共7页Modern Preventive Medicine

基　　金：广东省中医药局面上项目(202305041559305920)。

摘　　要：目的研究对象来自NHANES 2007—2012年收集的2892例成人,其中乳腺癌患者83例;计算获得中枢性甲状腺激素敏感性指标,包括甲状腺反馈分位数指数(TFQI_(FT4)、TFQI_(FT3))、促甲状腺激素T4抵抗指数(TT4RI)、促甲状腺激素T3抵抗指数(TT3RI)和TSH指数(TSHI),以及外周甲状腺激素敏感性指标FT3/FT4。利用多因素logistic回归模型研究乳腺癌与甲状腺系统的相关性。使用平滑曲线拟合及分层分析研究甲状腺激素敏感性指标与乳腺癌之间是否存阈值效应,并对年龄进行亚组分析和交互作用检验。结果模型3表明,促甲状腺激素(TSH)(OR=1.33,95%CI:1.08~1.63)、TFQI_(FT4)(OR=2.61,95%CI:1.25~5.45)、TFQI_(FT3)(OR=3.15,95%CI:1.18~8.44)、TT4RI(OR=1.03,95%CI:1.01~1.05)、TT3RI(OR=1.10,95%CI:1.03~1.18)以及TSHI(OR=1.68,95%CI:1.14~2.50)与乳腺癌风险呈显著正相关。当TFQI_(FT3)≥0.7、TSHI≥2.4、TT4RI<50时,与乳腺癌之间存在线性关系(P<0.05)。TFQI_(FT4)则显示出阈值效应(对数似然比检验=0.040),当TFQI_(FT4)<0.25时,TFQI_(FT4)与乳腺癌的关系不显著(OR=1.07,95%CI:0.36~3.15),当TFQI_(FT4)≥0.25时,与乳腺癌风险升高显著相关(OR=12.79,95%CI:2.50~65.40)。亚组分析进一步揭示,在55岁以上的女性中,中枢性甲状腺激素敏感性指标的升高与乳腺癌风险相关(P<0.05)。结论中枢性甲状腺激素敏感性指标升高与乳腺癌风险显著相关,未来可能是检测乳腺癌的有效指标。Objective To analyze whether there is a threshold effect between thyroid hormone sensitivity indexes and breast cancer,and to analyze the subgroup analysis and interaction test of age.Methods 2892 adults from NHANES were collected between 2007 and 2012,including 83 breast cancer patients.Central thyroid hormone sensitivity indices were calculated,including Thyroid Feedback Quantile Index for T4(TFQIFT4)and T3(TFQIFT3),Thyroid Stimulating Hormone T4 Resistance Index(TT4RI),Thyroid Stimulating Hormone T3 Resistance Index(TT3RI),and TSH Index(TSHI),as well as peripheral thyroid hormone sensitivity index FT3/FT4.The association between breast cancer and the thyroid system was investigated using a multivariable logistic regression model.Smooth curve fitting and stratified analysis were used too,and subgroup analysis and interaction tests were performed based on age.Results Model3 showed that Thyroid Stimulating Hormone(TSH)(OR=1.33,95%CI:1.08-1.63),TFQIFT4(OR=2.61,95%CI:1.25-5.45),TFQIFT3(OR=3.15,95%CI:1.18-8.44),TT4RI(OR=1.03,95%CI:1.01-1.05),TT3RI(OR=1.10,95%CI:1.03-1.18),and TSHI(OR=1.68,95%CI:1.14-2.50)were significantly positively associated with the risk of breast cancer.A linear relationship with breast cancer was observed when TFQIFT3≥0.7,TSHI≥2.4,and TT4RI<50(P<0.05).TFQIFT4 showed a threshold effect(likelihood ratio test=0.040)when TFQIFT4<0.25.The relationship between TFQIFT4 and breast cancer was not significant(OR=1.07,95%CI:0.36-3.15),but when TFQIFT4≥0.25,it was significantly associated with an increased risk of breast cancer(OR=12.79,95%CI:2.50-65.40).Subgroup analysis further revealed that in women over 55 years old,increased central thyroid hormone sensitivity indices were associated with breast cancer risk(P<0.05).Conclusion Increased central thyroid hormone sensitivity indices are significantly associated with the risk of breast cancer,which may be a potential indicator for breast cancer detection in the future.

关 键 词：乳腺癌 甲状腺激素敏感性 横断面研究 甲状腺反馈分位数指数 

分 类 号：R737.9[医药卫生—肿瘤]