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Serum high-density lipoprotein cholesterol, metabolic profile, and breast cancer risk.
J Natl Cancer Inst 2004; 96(15):1152-60JNCI

Abstract

BACKGROUND

The prevalence of metabolic syndrome (obesity, glucose intolerance, low serum high-density lipoprotein cholesterol [HDL-C], high serum triglycerides, hypertension) is high and increasing in parallel with an increasing breast cancer incidence worldwide. HDL-C represents an important aspect of the syndrome, yet its role in breast cancer is still undefined.

METHODS

In two population-based screening surveys during 1977-1983 and 1985-1987, serum HDL-C was assayed enzymatically among 38,823 Norwegian women aged 17-54 years at entry. Height, weight, blood pressure, serum lipids, fat and energy intake, physical activity, parity, oral contraceptive use, hormone therapy use, alcohol intake, and tobacco use were also assessed. We used Cox proportional hazards modeling to estimate the relative risk (RR) of breast cancer associated with serum HDL-C levels and to adjust for potential confounding variables. We performed stratified analyses to evaluate effect modification by body mass index (BMI) and menopausal status. All statistical tests were two-sided.

RESULTS

During a median follow-up of 17.2 years, we identified 708 cases of invasive breast cancer. In multivariable analysis, the risk of postmenopausal breast cancer was inversely related to quartile of HDL-C (P(trend) =.02). Among women with HDL-C above 1.64 mmol/L (highest quartile) versus below 1.20 mmol/L (lowest quartile), the relative risk was 0.75 (95% confidence interval [CI] = 0.58 to 0.97). The HDL-C association was confined to women in the heavier subgroup (BMI > or =25 kg/m2), for whom the relative risk of postmenopausal breast cancer in those with HDL-C above 1.64 mmol/L versus below 1.20 mmol/L was 0.43 (95% CI = 0.28 to 0.67; P(trend)<.001; P(interaction) =.001).

CONCLUSION

Low HDL-C, as part of the metabolic syndrome, is associated with increased postmenopausal breast cancer risk.

Authors+Show Affiliations

Section of Epidemiology and Medical Statistics, Institute of Community Medicine, Faculty of Medicine, University of Tromsø, Tromsø, Norway. anne-sofie.furberg@ism.uit.noNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15292387

Citation

Furberg, Anne-Sofie, et al. "Serum High-density Lipoprotein Cholesterol, Metabolic Profile, and Breast Cancer Risk." Journal of the National Cancer Institute, vol. 96, no. 15, 2004, pp. 1152-60.
Furberg AS, Veierød MB, Wilsgaard T, et al. Serum high-density lipoprotein cholesterol, metabolic profile, and breast cancer risk. J Natl Cancer Inst. 2004;96(15):1152-60.
Furberg, A. S., Veierød, M. B., Wilsgaard, T., Bernstein, L., & Thune, I. (2004). Serum high-density lipoprotein cholesterol, metabolic profile, and breast cancer risk. Journal of the National Cancer Institute, 96(15), pp. 1152-60.
Furberg AS, et al. Serum High-density Lipoprotein Cholesterol, Metabolic Profile, and Breast Cancer Risk. J Natl Cancer Inst. 2004 Aug 4;96(15):1152-60. PubMed PMID: 15292387.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum high-density lipoprotein cholesterol, metabolic profile, and breast cancer risk. AU - Furberg,Anne-Sofie, AU - Veierød,Marit Bragelien, AU - Wilsgaard,Tom, AU - Bernstein,Leslie, AU - Thune,Inger, PY - 2004/8/5/pubmed PY - 2004/8/13/medline PY - 2004/8/5/entrez SP - 1152 EP - 60 JF - Journal of the National Cancer Institute JO - J. Natl. Cancer Inst. VL - 96 IS - 15 N2 - BACKGROUND: The prevalence of metabolic syndrome (obesity, glucose intolerance, low serum high-density lipoprotein cholesterol [HDL-C], high serum triglycerides, hypertension) is high and increasing in parallel with an increasing breast cancer incidence worldwide. HDL-C represents an important aspect of the syndrome, yet its role in breast cancer is still undefined. METHODS: In two population-based screening surveys during 1977-1983 and 1985-1987, serum HDL-C was assayed enzymatically among 38,823 Norwegian women aged 17-54 years at entry. Height, weight, blood pressure, serum lipids, fat and energy intake, physical activity, parity, oral contraceptive use, hormone therapy use, alcohol intake, and tobacco use were also assessed. We used Cox proportional hazards modeling to estimate the relative risk (RR) of breast cancer associated with serum HDL-C levels and to adjust for potential confounding variables. We performed stratified analyses to evaluate effect modification by body mass index (BMI) and menopausal status. All statistical tests were two-sided. RESULTS: During a median follow-up of 17.2 years, we identified 708 cases of invasive breast cancer. In multivariable analysis, the risk of postmenopausal breast cancer was inversely related to quartile of HDL-C (P(trend) =.02). Among women with HDL-C above 1.64 mmol/L (highest quartile) versus below 1.20 mmol/L (lowest quartile), the relative risk was 0.75 (95% confidence interval [CI] = 0.58 to 0.97). The HDL-C association was confined to women in the heavier subgroup (BMI > or =25 kg/m2), for whom the relative risk of postmenopausal breast cancer in those with HDL-C above 1.64 mmol/L versus below 1.20 mmol/L was 0.43 (95% CI = 0.28 to 0.67; P(trend)<.001; P(interaction) =.001). CONCLUSION: Low HDL-C, as part of the metabolic syndrome, is associated with increased postmenopausal breast cancer risk. SN - 1460-2105 UR - https://www.unboundmedicine.com/medline/citation/15292387/Serum_high_density_lipoprotein_cholesterol_metabolic_profile_and_breast_cancer_risk_ L2 - https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djh216 DB - PRIME DP - Unbound Medicine ER -