PDF(Pubmed)
Abstract：
UNASSIGNED: Epidemiologic data suggest an association of obesity with breast cancer (BC); however, obesity\'s contribution to early onset and risk of diagnosis with specific molecular subtypes by race is uncertain.
UNASSIGNED: To examine the race-specific association of body mass index with early onset and diagnosis of specific molecular subtypes.
UNASSIGNED: This retrospective cohort study included patients with BC diagnosed between October 1, 2017, and March 31, 2022, at 3 University of South Alabama Mitchell Cancer Institute clinics. Participants were also prospectively enrolled for serum leptin measurement.
UNASSIGNED: The primary outcome was age at BC onset and specific subtype diagnosis. The secondary outcome was race-specific differences. Odds ratios (ORs) for associations of body mass index with age at onset and subtype were estimated using the Fisher exact test. Race was self-reported.
UNASSIGNED: Of the 1085 study patients, 332 (30.6%) were Black with a median age of 58 (IQR, 50-66) years, and 753 (69.4%) were White with a median age of 63 (IQR, 53-71) years. A total of 499 patients (46.0%) had obesity, with Black women with obesity receiving more frequent BC diagnosis than their White counterparts (OR, 2.40; 95% CI, 1.87-3.15; P < .001). In addition, Black women had a significantly higher incidence of early-onset disease (OR, 1.95; 95% CI, 1.33-2.86; P = .001) than White women, and obesity increased this risk significantly in Black women (OR, 2.92; 95% CI, 1.35-6.22; P = .006). Black women with obesity also had a significantly higher risk of luminal A BC (OR, 2.53; 95% CI, 1.81-3.56; P < .001) and triple-negative BC (TNBC) (OR, 2.48; 95% CI, 1.43-4.22; P = .002) diagnosis than White counterparts. Black women, with or without BC, had significantly higher serum leptin levels (median [IQR], 55.3 [40.3-66.2] ng/mL and 29.1 [21.1-46.5] ng/mL, respectively, P < .001) than White women (median [IQR], 33.4 [18.9-47.7] ng/mL and 16.5 [10.0-22.9] ng/mL, respectively), which was associated with higher odds of luminal A disease (OR, 5.25; 95% CI, 1.69-14.32, P = .003). Higher odds of early-onset disease (OR, 3.50; 95% CI, 0.43-23.15; P = .33 for trend), and TNBC diagnosis (OR, 6.00; 95% CI, 0.83-37.27; P = .14 for trend) were also seen, although these outcomes were not statistically significant.
UNASSIGNED: In this cohort study of patients with BC, obesity and high serum leptin levels were associated with an enhanced risk of early-onset BC and diagnosis of luminal A and TNBC subtypes in Black women. These findings should help in developing strategies to narrow the existing disparity gaps.
UNASSIGNED: To examine the race-specific association of body mass index with early onset and diagnosis of specific molecular subtypes.
UNASSIGNED: This retrospective cohort study included patients with BC diagnosed between October 1, 2017, and March 31, 2022, at 3 University of South Alabama Mitchell Cancer Institute clinics. Participants were also prospectively enrolled for serum leptin measurement.
UNASSIGNED: The primary outcome was age at BC onset and specific subtype diagnosis. The secondary outcome was race-specific differences. Odds ratios (ORs) for associations of body mass index with age at onset and subtype were estimated using the Fisher exact test. Race was self-reported.
UNASSIGNED: Of the 1085 study patients, 332 (30.6%) were Black with a median age of 58 (IQR, 50-66) years, and 753 (69.4%) were White with a median age of 63 (IQR, 53-71) years. A total of 499 patients (46.0%) had obesity, with Black women with obesity receiving more frequent BC diagnosis than their White counterparts (OR, 2.40; 95% CI, 1.87-3.15; P < .001). In addition, Black women had a significantly higher incidence of early-onset disease (OR, 1.95; 95% CI, 1.33-2.86; P = .001) than White women, and obesity increased this risk significantly in Black women (OR, 2.92; 95% CI, 1.35-6.22; P = .006). Black women with obesity also had a significantly higher risk of luminal A BC (OR, 2.53; 95% CI, 1.81-3.56; P < .001) and triple-negative BC (TNBC) (OR, 2.48; 95% CI, 1.43-4.22; P = .002) diagnosis than White counterparts. Black women, with or without BC, had significantly higher serum leptin levels (median [IQR], 55.3 [40.3-66.2] ng/mL and 29.1 [21.1-46.5] ng/mL, respectively, P < .001) than White women (median [IQR], 33.4 [18.9-47.7] ng/mL and 16.5 [10.0-22.9] ng/mL, respectively), which was associated with higher odds of luminal A disease (OR, 5.25; 95% CI, 1.69-14.32, P = .003). Higher odds of early-onset disease (OR, 3.50; 95% CI, 0.43-23.15; P = .33 for trend), and TNBC diagnosis (OR, 6.00; 95% CI, 0.83-37.27; P = .14 for trend) were also seen, although these outcomes were not statistically significant.
UNASSIGNED: In this cohort study of patients with BC, obesity and high serum leptin levels were associated with an enhanced risk of early-onset BC and diagnosis of luminal A and TNBC subtypes in Black women. These findings should help in developing strategies to narrow the existing disparity gaps.
摘要：
■流行病学数据表明肥胖与乳腺癌（BC）有关；然而，肥胖对早期发病的贡献以及特定分子亚型的种族诊断风险尚不确定。
■研究体重指数与特定分子亚型的早期发作和诊断的种族特异性关联。
这项回顾性队列研究包括2017年10月1日至2022年3月31日在南阿拉巴马大学米切尔癌症研究所3个诊所诊断的BC患者。参与者也被前瞻性纳入血清瘦素测量。
■主要结果是BC发病时的年龄和特定亚型诊断。次要结果是种族特异性差异。使用Fisher精确检验估计体重指数与发病年龄和亚型的关联的几率（OR）。种族是自我报告的。
■在1085名研究患者中，332人(30.6%)为黑人，中位年龄为58岁(IQR，50-66）年，753人(69.4%)为白人，中位年龄为63岁(IQR，53-71）年。共有499名患者(46.0%)患有肥胖症,肥胖的黑人女性比白人女性接受更频繁的BC诊断(或，2.40；95%CI，1.87-3.15；P<.001）。此外,黑人妇女早发性疾病的发病率明显较高（OR，1.95；95%CI，1.33-2.86；P=0.001）比白人女性，肥胖显著增加了黑人女性的这种风险(或者，2.92；95%CI，1.35-6.22；P=.006）。肥胖的黑人女性也有明显更高的管腔ABC风险(OR，2.53；95%CI，1.81-3.56；P<.001）和三阴性BC（TNBC）（OR，2.48；95%CI，1.43-4.22；P=.002）诊断优于怀特同行。黑人女性,不管有没有BC,血清瘦素水平明显较高(中位数[IQR]，55.3[40.3-66.2]ng/mL和29.1[21.1-46.5]ng/mL，分别,P<.001）比白人女性（中位数[IQR]，33.4[18.9-47.7]ng/mL和16.5[10.0-22.9]ng/mL，分别)，与管腔A疾病的较高几率相关(OR，5.25；95%CI，1.69-14.32，P=.003）。早发疾病的几率更高(OR，3.50；95%CI，0.43-23.15；趋势P=0.33），和TNBC诊断（或，6.00；95%CI，0.83-37.27；趋势P=.14）也被看到，尽管这些结局没有统计学意义.
■在这项BC患者的队列研究中，肥胖和高血清瘦素水平与黑人女性早发性BC的风险增加以及腔内A和TNBC亚型的诊断相关.这些发现应有助于制定缩小现有差距的战略。
■研究体重指数与特定分子亚型的早期发作和诊断的种族特异性关联。
这项回顾性队列研究包括2017年10月1日至2022年3月31日在南阿拉巴马大学米切尔癌症研究所3个诊所诊断的BC患者。参与者也被前瞻性纳入血清瘦素测量。
■主要结果是BC发病时的年龄和特定亚型诊断。次要结果是种族特异性差异。使用Fisher精确检验估计体重指数与发病年龄和亚型的关联的几率（OR）。种族是自我报告的。
■在1085名研究患者中，332人(30.6%)为黑人，中位年龄为58岁(IQR，50-66）年，753人(69.4%)为白人，中位年龄为63岁(IQR，53-71）年。共有499名患者(46.0%)患有肥胖症,肥胖的黑人女性比白人女性接受更频繁的BC诊断(或，2.40；95%CI，1.87-3.15；P<.001）。此外,黑人妇女早发性疾病的发病率明显较高（OR，1.95；95%CI，1.33-2.86；P=0.001）比白人女性，肥胖显著增加了黑人女性的这种风险(或者，2.92；95%CI，1.35-6.22；P=.006）。肥胖的黑人女性也有明显更高的管腔ABC风险(OR，2.53；95%CI，1.81-3.56；P<.001）和三阴性BC（TNBC）（OR，2.48；95%CI，1.43-4.22；P=.002）诊断优于怀特同行。黑人女性,不管有没有BC,血清瘦素水平明显较高(中位数[IQR]，55.3[40.3-66.2]ng/mL和29.1[21.1-46.5]ng/mL，分别,P<.001）比白人女性（中位数[IQR]，33.4[18.9-47.7]ng/mL和16.5[10.0-22.9]ng/mL，分别)，与管腔A疾病的较高几率相关(OR，5.25；95%CI，1.69-14.32，P=.003）。早发疾病的几率更高(OR，3.50；95%CI，0.43-23.15；趋势P=0.33），和TNBC诊断（或，6.00；95%CI，0.83-37.27；趋势P=.14）也被看到，尽管这些结局没有统计学意义.
■在这项BC患者的队列研究中，肥胖和高血清瘦素水平与黑人女性早发性BC的风险增加以及腔内A和TNBC亚型的诊断相关.这些发现应有助于制定缩小现有差距的战略。
