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      Lipid profile among Moroccan overweight women and breast cancer: a case-control study

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          Abstract

          Background

          Breast cancer has become the most common type of cancer in Morocco. In 2005, 127 new cases in women, representing 33.5% of female cancers, were added to the National Center of Oncology registry. The incidence of breast cancer is higher in Morocco than in the three other Maghreb countries, and it is significantly lower than in Western countries where it stands at over 80 cases per 100,000 people.

          Purpose

          This 2-year long case-control study was conducted to assess the causal relationship between the lipid profile of overweight Moroccan women and breast cancer risk.

          Patients and methods

          Overweight female patients with breast cancer (n = 400) were compared to 400 healthy controls at the National Institute of Oncology of Rabat. The epidemiological data on the disease and physical activity were gathered by interviewing the patients who had their lipid profile measured (total cholesterol, triglycerides, high density lipoprotein cholesterol, and low density lipoprotein cholesterol). Body mass index was used to determine if patients were overweight.

          Results

          Univariate analysis revealed a significant association between breast cancer and high body mass index (odds ratio [OR] = 1.31; 95% confidence interval [CI] = 1.25–1.37), menopause (OR = 2.68; 95% CI = 2–3.55), lack of physical activity (OR = 0.26; 95% CI = 0.21–0.31), and triglyceridemia (OR = 3.78; 95% CI = 2.73–5.23). Multivariate analysis revealed that the statistically significant increase in breast cancer risk was associated with a higher body mass index (OR = 1.11; 95% CI = 1.04–1.18), menopause (OR = 9.11; 95% CI = 4.76–17.47), and high triglyceride levels (OR = 4.5; 95% CI = 2.94–6.88). However, a protective effect for physical activity was detected (OR = 0.35; 95% CI = 0.26–0.48).

          Conclusion

          This study suggests that there is a connection between hypertriglyceridemia, obesity, and breast cancer risk and confirms a protective role for physical activity on breast cancer risk.

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          Breast cancer and hormone-replacement therapy in the Million Women Study.

          Valerie Beral (2003)
          Current use of hormone-replacement therapy (HRT) increases the incidence of breast cancer. The Million Women Study was set up to investigate the effects of specific types of HRT on incident and fatal breast cancer. 1084110 UK women aged 50-64 years were recruited into the Million Women Study between 1996 and 2001, provided information about their use of HRT and other personal details, and were followed up for cancer incidence and death. Half the women had used HRT; 9364 incident invasive breast cancers and 637 breast cancer deaths were registered after an average of 2.6 and 4.1 years of follow-up, respectively. Current users of HRT at recruitment were more likely than never users to develop breast cancer (adjusted relative risk 1.66 [95% CI 1.58-1.75], p<0.0001) and die from it (1.22 [1.00-1.48], p=0.05). Past users of HRT were, however, not at an increased risk of incident or fatal disease (1.01 [0.94-1.09] and 1.05 [0.82-1.34], respectively). Incidence was significantly increased for current users of preparations containing oestrogen only (1.30 [1.21-1.40], p<0.0001), oestrogen-progestagen (2.00 [1.88-2.12], p<0.0001), and tibolone (1.45 [1.25-1.68], p<0.0001), but the magnitude of the associated risk was substantially greater for oestrogen-progestagen than for other types of HRT (p<0.0001). Results varied little between specific oestrogens and progestagens or their doses; or between continuous and sequential regimens. The relative risks were significantly increased separately for oral, transdermal, and implanted oestrogen-only formulations (1.32 [1.21-1.45]; 1.24 [1.11-1.39]; and 1.65 [1.26-2.16], respectively; all p<0.0001). In current users of each type of HRT the risk of breast cancer increased with increasing total duration of use. 10 years' use of HRT is estimated to result in five (95% CI 3-7) additional breast cancers per 1000 users of oestrogen-only preparations and 19 (15-23) additional cancers per 1000 users of oestrogen-progestagen combinations. Use of HRT by women aged 50-64 years in the UK over the past decade has resulted in an estimated 20000 extra breast cancers, 15000 associated with oestrogen-progestagen; the extra deaths cannot yet be reliably estimated. Current use of HRT is associated with an increased risk of incident and fatal breast cancer; the effect is substantially greater for oestrogen-progestagen combinations than for other types of HRT.
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            Physical activity and weight gain prevention.

            I-Min Lee (2010)
            The amount of physical activity needed to prevent long-term weight gain is unclear. In 2008, federal guidelines recommended at least 150 minutes per week (7.5 metabolic equivalent [MET] hours per week) of moderate-intensity activity for "substantial health benefits." To examine the association of different amounts of physical activity with long-term weight changes among women consuming a usual diet. A prospective cohort study involving 34,079 healthy US women (mean age, 54.2 years) from 1992-2007. At baseline and months 36, 72, 96, 120, 144, and 156, women reported their physical activity and body weight. Women were classified as expending less than 7.5, 7.5 to less than 21, and 21 or more MET hours per week of activity at each time. Repeated-measures regression prospectively examined physical activity and weight change over intervals averaging 3 years. Change in weight. Women gained a mean of 2.6 kg throughout the study. A multivariate analysis comparing women expending 21 or more MET hours per week with those expending from 7.5 to less than 21 MET hours per week showed that the latter group gained a mean (SD) 0.11 kg (0.04 kg; P = .003) over a mean interval of 3 years, and those expending less than 7.5 MET hours per week gained 0.12 kg (0.04; P = .002). There was a significant interaction with body mass index (BMI), such that there was an inverse dose-response relation between activity levels and weight gain among women with a BMI of less than 25 (P for trend < .001) but no relation among women with a BMI from 25 to 29.9 (P for trend = .56) or with a BMI of 30.0 or higher (P for trend = .50). A total of 4540 women (13.3%) with a BMI lower than 25 at study start successfully maintained their weight by gaining less than 2.3 kg throughout. Their mean activity level over the study was 21.5 MET hours per week (approximately 60 minutes a day of moderate-intensity activity). Among women consuming a usual diet, physical activity was associated with less weight gain only among women whose BMI was lower than 25. Women successful in maintaining normal weight and gaining fewer than 2.3 kg over 13 years averaged approximately 60 minutes a day of moderate-intensity activity throughout the study.
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              Adiposity, adult weight change, and postmenopausal breast cancer risk.

              Demetrius Albanes, A R Hollenbeck, Traci Mouw … (2007)
              Obesity is a risk factor for postmenopausal breast cancer, but the role of the timing and amount of adult weight change in breast cancer risk is unclear. We prospectively examined the relations of adiposity and adult weight change to breast cancer risk among 99 039 postmenopausal women in the National Institutes of Health-AARP Diet and Health Study. Anthropometry was assessed by self-report in 1996. Through 2000, 2111 incident breast cancer cases were ascertained. Current body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared), BMI at ages 50 and 35 years, and waist-hip ratio were associated with increased breast cancer risk, particularly in women not using menopausal hormone therapy (MHT). Weight gained between age 18 years and the current age, between ages 18 and 35 years, between ages 35 and 50 years, and between age 50 years and the current age was consistently associated with increased breast cancer risk in MHT nonusers (relative risk [RR], 2.15; 95% confidence interval [CI], 1.35-3.42 for a >/=50-kg weight gain between age 18 years and the current age vs stable weight) but not in current MHT users. Risk associated with adult weight change was stronger in women with later vs earlier age at menarche (RR, 4.20; 95% CI, 2.05-8.64 for >/=15 years vs RR, 1.51; 95% CI, 1.11-2.06 for 11-12 years; P = .007 for interaction). In MHT nonusers, the associations with current BMI and adult weight change were stronger for advanced disease than for nonadvanced disease (P = .009 [current BMI] and .21 [weight gain] for heterogeneity) and were stronger for hormone receptor-positive than hormone receptor-negative tumors (P < .001 for heterogeneity). Weight gain throughout adulthood is associated with increased postmenopausal breast cancer risk in MHT nonusers.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Int J Gen Med
                Journal ID (iso-abbrev): Int J Gen Med
                Title: International Journal of General Medicine
                Publisher: Dove Medical Press
                ISSN (Electronic): 1178-7074
                Publication date Collection: 2013
                Publication date (Electronic): 05 June 2013
                Volume: 6
                Pages: 439-445
                Affiliations
                [1 ]Faculty of Medicine and Pharmacy/Research Team in Maternal and Child Health and Nutrition, Mohammed V-Souissi University, Rabat, Morocco
                [2 ]National Institute of Oncology, Rabat, Morocco
                [3 ]Pharmacy Unit, National Institute of Oncology, Rabat, Morocco
                Author notes
                Correspondence: Amina Barkat Research Team in Maternal and Child Health and Nutrition, Faculty of Medicine and Pharmacy of Mohammed V-Souissi University, Rabat, Morocco, Email barakatamina@ 123456yahoo.fr
                Article
                Publisher ID: ijgm-6-439
                DOI: 10.2147/IJGM.S40826
                PMC ID: 3682854
                PubMed ID: 23785239
                SO-VID: 6c96503b-90f2-477a-b6f3-dad4db376c39
                Copyright © © 2013 Laamiri et al, publisher and licensee Dove Medical Press Ltd
                License:

                This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

                History
                Categories
                Subject: Original Research

                ScienceOpen disciplines: Medicine
                Keywords: breast cancer,lipid profile,dietary fat intake,overweight,physical activity
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: breast cancer, lipid profile, dietary fat intake, overweight, physical activity

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