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Adult weight gain, fat distribution and mammographic density in Spanish pre- and post-menopausal women (DDM-Spain).

Pollán M, Lope V, Miranda-García J, García M, Casanova F, Sánchez-Contador C, Santamariña C, Moreo P, Vidal C, Peris M, Moreno MP, Vázquez-Carrete JA, Collado F, Pedraz-Pingarrón C, Ascunce N, Salas-Trejo D, Aragonés N, Pérez-Gómez B, Ruiz-Perales F, DDM-Spa - Breast Cancer Res. Treat. (2012)

Bottom Line: We investigated the influence of abdominal fat distribution and adult weight gain on MD, taking age, BMI and other confounders into account.Waist-to-hip ratio was inversely associated with MD, and the effect was more pronounced in pre-menopausal (OR = 0.53 per 0.1 units; 95 % CI = 0.42-0.66) than in post-menopausal women (OR = 0.73; 95 % CI = 0.65-0.82) (P of heterogeneity = 0.010).MD was also evaluated using Wolfe's and Tabár's classifications, with similar results being obtained.

View Article: PubMed Central - PubMed

Affiliation: Cancer Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Monforte de Lemos 5, 28029 Madrid, Spain. mpollan@isciii.es

ABSTRACT
High mammographic density (MD) is a phenotype risk marker for breast cancer. Body mass index (BMI) is inversely associated with MD, with the breast being a fat storage site. We investigated the influence of abdominal fat distribution and adult weight gain on MD, taking age, BMI and other confounders into account. Because visceral adiposity and BMI are associated with breast cancer only after menopause, differences in pre- and post-menopausal women were also explored. We recruited 3,584 women aged 45-68 years within the Spanish breast cancer screening network. Demographic, reproductive, family and personal history data were collected by purpose-trained staff, who measured current weight, height, waist and hip circumferences under the same protocol and with the same tools. MD was assessed in the left craniocaudal view using Boyd's Semiquantitative Scale. Association between waist-to-hip ratio, adult weight gain (difference between current weight and self-reported weight at 18 years) and MD was quantified by ordinal logistic regression, with random center-specific intercepts. Models were adjusted for age, BMI, breast size, time since menopause, parity, family history of breast cancer and hormonal replacement therapy use. Natural splines were used to describe the shape of the relationship between these two variables and MD. Waist-to-hip ratio was inversely associated with MD, and the effect was more pronounced in pre-menopausal (OR = 0.53 per 0.1 units; 95 % CI = 0.42-0.66) than in post-menopausal women (OR = 0.73; 95 % CI = 0.65-0.82) (P of heterogeneity = 0.010). In contrast, adult weight gain displayed a positive association with MD, which was similar in both groups (OR = 1.17 per 6 kg; 95 % CI = 1.11-1.23). Women who had gained more than 24 kg displayed higher MD (OR = 2.05; 95 % CI = 1.53-2.73). MD was also evaluated using Wolfe's and Tabár's classifications, with similar results being obtained. Once BMI, fat distribution and other confounders were considered, our results showed a clear dose-response gradient between the number of kg gained during adulthood and the proportion of dense tissue in the breast.

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Related in: MedlinePlus

The effect of adult weight gain and waist-to-hip ratio on MD, estimated separately for groups of women defined by observed BMI quintile
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Fig1: The effect of adult weight gain and waist-to-hip ratio on MD, estimated separately for groups of women defined by observed BMI quintile

Mentions: All anthropometric variables were strongly and statistically significantly correlated with BMI, with Pearson’s correlation coefficients equal to or >0.80 for all of these, except bra size (0.63) and waist-to-hip ratio (0.43). To avoid a multi-colinearity problem, we decided to use waist-to-hip ratio as an indicator of fat distribution in subsequent analyses, because it was the measure showing the least correlation with BMI. Figure 1 graphically shows the effect of adult weight gain and waist-to-hip ratio on MD, separately estimated for groups of women defined by observed BMI quintile. For each subgroup of women, the corresponding quartiles of the two variables, weight gain and waist-to-hip ratio, were considered in these analyses. Imputed values for weight at age 18 years and bra size were used to prevent the exclusion of a substantial number of women (564) from the analysis. ORs were adjusted for all the abovementioned variables except hormonal replacement therapy. In all BMI categories, a positive dose–response gradient was observed for adult weight gain in relation to MD, even though the trend was not statistically significant in more obese women. For fat distribution, the inverse association between MD and waist-to-hip ratio was confirmed in all BMI groups.Fig. 1


Adult weight gain, fat distribution and mammographic density in Spanish pre- and post-menopausal women (DDM-Spain).

Pollán M, Lope V, Miranda-García J, García M, Casanova F, Sánchez-Contador C, Santamariña C, Moreo P, Vidal C, Peris M, Moreno MP, Vázquez-Carrete JA, Collado F, Pedraz-Pingarrón C, Ascunce N, Salas-Trejo D, Aragonés N, Pérez-Gómez B, Ruiz-Perales F, DDM-Spa - Breast Cancer Res. Treat. (2012)

The effect of adult weight gain and waist-to-hip ratio on MD, estimated separately for groups of women defined by observed BMI quintile
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3401511&req=5

Fig1: The effect of adult weight gain and waist-to-hip ratio on MD, estimated separately for groups of women defined by observed BMI quintile
Mentions: All anthropometric variables were strongly and statistically significantly correlated with BMI, with Pearson’s correlation coefficients equal to or >0.80 for all of these, except bra size (0.63) and waist-to-hip ratio (0.43). To avoid a multi-colinearity problem, we decided to use waist-to-hip ratio as an indicator of fat distribution in subsequent analyses, because it was the measure showing the least correlation with BMI. Figure 1 graphically shows the effect of adult weight gain and waist-to-hip ratio on MD, separately estimated for groups of women defined by observed BMI quintile. For each subgroup of women, the corresponding quartiles of the two variables, weight gain and waist-to-hip ratio, were considered in these analyses. Imputed values for weight at age 18 years and bra size were used to prevent the exclusion of a substantial number of women (564) from the analysis. ORs were adjusted for all the abovementioned variables except hormonal replacement therapy. In all BMI categories, a positive dose–response gradient was observed for adult weight gain in relation to MD, even though the trend was not statistically significant in more obese women. For fat distribution, the inverse association between MD and waist-to-hip ratio was confirmed in all BMI groups.Fig. 1

Bottom Line: We investigated the influence of abdominal fat distribution and adult weight gain on MD, taking age, BMI and other confounders into account.Waist-to-hip ratio was inversely associated with MD, and the effect was more pronounced in pre-menopausal (OR = 0.53 per 0.1 units; 95 % CI = 0.42-0.66) than in post-menopausal women (OR = 0.73; 95 % CI = 0.65-0.82) (P of heterogeneity = 0.010).MD was also evaluated using Wolfe's and Tabár's classifications, with similar results being obtained.

View Article: PubMed Central - PubMed

Affiliation: Cancer Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Monforte de Lemos 5, 28029 Madrid, Spain. mpollan@isciii.es

ABSTRACT
High mammographic density (MD) is a phenotype risk marker for breast cancer. Body mass index (BMI) is inversely associated with MD, with the breast being a fat storage site. We investigated the influence of abdominal fat distribution and adult weight gain on MD, taking age, BMI and other confounders into account. Because visceral adiposity and BMI are associated with breast cancer only after menopause, differences in pre- and post-menopausal women were also explored. We recruited 3,584 women aged 45-68 years within the Spanish breast cancer screening network. Demographic, reproductive, family and personal history data were collected by purpose-trained staff, who measured current weight, height, waist and hip circumferences under the same protocol and with the same tools. MD was assessed in the left craniocaudal view using Boyd's Semiquantitative Scale. Association between waist-to-hip ratio, adult weight gain (difference between current weight and self-reported weight at 18 years) and MD was quantified by ordinal logistic regression, with random center-specific intercepts. Models were adjusted for age, BMI, breast size, time since menopause, parity, family history of breast cancer and hormonal replacement therapy use. Natural splines were used to describe the shape of the relationship between these two variables and MD. Waist-to-hip ratio was inversely associated with MD, and the effect was more pronounced in pre-menopausal (OR = 0.53 per 0.1 units; 95 % CI = 0.42-0.66) than in post-menopausal women (OR = 0.73; 95 % CI = 0.65-0.82) (P of heterogeneity = 0.010). In contrast, adult weight gain displayed a positive association with MD, which was similar in both groups (OR = 1.17 per 6 kg; 95 % CI = 1.11-1.23). Women who had gained more than 24 kg displayed higher MD (OR = 2.05; 95 % CI = 1.53-2.73). MD was also evaluated using Wolfe's and Tabár's classifications, with similar results being obtained. Once BMI, fat distribution and other confounders were considered, our results showed a clear dose-response gradient between the number of kg gained during adulthood and the proportion of dense tissue in the breast.

Show MeSH
Related in: MedlinePlus