医学
腰围
体质指数
人体测量学
调解
内科学
腰臀比
乳腺癌
人口学
危险系数
队列
睾酮(贴片)
内分泌学
性激素结合球蛋白
肥胖
肿瘤科
风险因素
队列研究
生理学
癌症
置信区间
激素
雄激素
社会学
法学
政治学
作者
Amina Amadou,Heinz Freisling,Anja M. Sedlmeier,Patricia Bohmann,Emma Fontvieille,Andrea Hillreiner,Julian Konzok,Michael J. Stein,Laia Peruchet‐Noray,Anna Jansana,Hwayoung Noh,Mathilde His,Quan Gan,Hansjörg Baurecht,Béatrice Fervers
标识
DOI:10.1007/s44197-024-00226-4
摘要
Abstract Body shape phenotypes combining multiple anthropometric traits have been linked to postmenopausal breast cancer (BC). However, underlying biological pathways remain poorly understood. This study investigated to what extent the associations of body shapes with postmenopausal BC risk is mediated by biochemical markers. The study included 176,686 postmenopausal women from UK Biobank. Four body shape phenotypes were derived from principal component (PC) analysis of height, weight, body mass index, waist and hip circumferences, and waist-to-hip ratio (WHR). The four-way decomposition of the total effect was used to estimate mediation and interaction effects simultaneously as well as the mediated proportions. After 10.9 years median follow-up, 6,396 incident postmenopausal BC were diagnosed. There was strong evidence of positive associations between PC1 (general obesity) and PC2 (tall, low WHR), and BC risk. The association of PC1 with BC risk was positively mediated by testosterone and negatively by insulin-like growth factor-1 (IGF-1), with the overall proportion mediated (sum of the mediated interaction and pure indirect effect (PIE)) accounting for 11.4% (95% confidence intervals: 5.1 to 17.8%) and -12.2% (-20.5% to -4.0%) of the total effect, respectively. Small proportions of the association between PC2 and BC were mediated by IGF-1 (PIE: 2.8% (0.6 to 4.9%)), and sex hormone-binding globulin (SHBG) (PIE: -6.1% (-10.9% to -1.3%)). Our findings are consistent with differential pathways linking different body shapes with BC risk, with a suggestive mediation through testosterone and IGF-1 in the relationship of a generally obese body shape and BC risk, while IGF-1 and SHBG may mediate a tall/lean body shape-BC risk association.
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