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Jung S, Silva S, Dallal CM, LeBlanc E, Paris K, Shepherd J, Snetselaar LG, Van Horn L, Zhang Y, Dorgan JF. Untargeted serum metabolomic profiles and breast density in young women. Cancer Causes Control 2024; 35:323-334. [PMID: 37737303 DOI: 10.1007/s10552-023-01793-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 09/06/2023] [Indexed: 09/23/2023]
Abstract
PURPOSE OF THE STUDY Breast density is an established risk factor for breast cancer. However, little is known about metabolic influences on breast density phenotypes. We conducted untargeted serum metabolomics analyses to identify metabolic signatures associated with breast density phenotypes among young women. METHODS In a cross-sectional study of 173 young women aged 25-29 who participated in the Dietary Intervention Study in Children 2006 Follow-up Study, 449 metabolites were measured in fasting serum samples using ultra-high-performance liquid chromatography-tandem mass spectrometry. Multivariable-adjusted mixed-effects linear regression identified metabolites associated with magnetic resonance imaging measured breast density phenotypes: percent dense breast volume (%DBV), absolute dense breast volume (ADBV), and absolute non-dense breast volume (ANDBV). Metabolite results were corrected for multiple comparisons using a false discovery rate adjusted p-value (q). RESULTS The amino acids valine and leucine were significantly inversely associated with %DBV. For each 1 SD increase in valine and leucine, %DBV decreased by 20.9% (q = 0.02) and 18.4% (q = 0.04), respectively. ANDBV was significantly positively associated with 16 lipid and one amino acid metabolites, whereas no metabolites were associated with ADBV. Metabolite set enrichment analysis also revealed associations of distinct metabolic signatures with %DBV, ADBV, and ANDBV; branched chain amino acids had the strongest inverse association with %DBV (p = 0.002); whereas, diacylglycerols and phospholipids were positively associated with ANDBV (p ≤ 0.002), no significant associations were observed for ADBV. CONCLUSION Our results suggest an inverse association of branched chain amino acids with %DBV. Larger studies in diverse populations are needed.
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Affiliation(s)
- Seungyoun Jung
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, South Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, South Korea
| | - Sarah Silva
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Cher M Dallal
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA
| | - Erin LeBlanc
- Kaiser Permanente Center for Health Research, Portland, OR, USA
| | - Kenneth Paris
- Department of Pediatrics, Louisiana State University School of Medicine, New Orleans, LA, USA
| | - John Shepherd
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | | | - Linda Van Horn
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Yuji Zhang
- Division of Cancer Epidemiology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, 660 West Redwood St., Howard Hall, Room 102E, Baltimore, MD, 21201, USA
| | - Joanne F Dorgan
- Division of Cancer Epidemiology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, 660 West Redwood St., Howard Hall, Room 102E, Baltimore, MD, 21201, USA.
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Paixão TM, Teixeira LR, de Andrade CAF, Sepulvida D, Martinez-Silveira M, Nunes C, Siqueira CEG. Systematic Review and Meta-Analysis of Metabolic Syndrome and Its Components in Latino Immigrants to the USA. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1307. [PMID: 36674066 PMCID: PMC9858988 DOI: 10.3390/ijerph20021307] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
The Metabolic Syndrome (MetS) is an increasingly prevalent condition globally. Latino populations in the USA have shown an alarming increase in factors associated with MetS in recent years. The objective of the present systematic review was to determine the prevalence of MetS and its risk factors in immigrant Latinos in the USA and perform a meta-analysis of those prevalence. The review included cross-sectional, cohort, or case−control studies involving adult immigrant Latinos in the USA, published during the period 1980−2020 in any language. Studies involving individuals who were pregnant, aged <18 years, immigrant non-Latinos, published outside the 1980−2020 period, or with other design types were excluded. The Pubmed, Web of Science, Embase, Lilacs, Scielo, and Google Scholar databases were searched. The risk of bias was assessed using the checklists of the Joanna Briggs Institute. The review included 60 studies, and the meta-analysis encompassed 52 studies. The pooled prevalence found for hypertension, diabetes, general obesity, and abdominal obesity were 28% (95% Confidence Interval (CI): 23−33%), 17% (95% CI: 14−20%), 37% (95% CI: 33−40%), and 54% (95% CI: 48−59%), respectively. The quality of the evidence of the primary studies was classified as low or very low. Few studies including immigrants from South America were identified. Further studies of those immigrants are needed due to the cultural, dietary, and language disparities among Latin American countries. The research protocol was registered with the Open Science Framework (OSF).
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Affiliation(s)
- Talita Monsores Paixão
- Center of Studies of Worker Health and Human Ecology, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro 21041-210, Brazil
| | - Liliane Reis Teixeira
- Center of Studies of Worker Health and Human Ecology, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro 21041-210, Brazil
| | - Carlos Augusto Ferreira de Andrade
- Department of Epidemiology and Quantitative Methods in Health, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro 21041-210, Brazil
| | | | | | - Camila Nunes
- Fluminense Federal Institute of Education Science and Technology, Campos dos Goytacazes 28030-130, Brazil
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Acheampong T, Lee Argov EJ, Terry MB, Rodriguez CB, Agovino M, Wei Y, Athilat S, Tehranifar P. Current regular aspirin use and mammographic breast density: a cross-sectional analysis considering concurrent statin and metformin use. Cancer Causes Control 2022; 33:363-371. [PMID: 35022893 DOI: 10.1007/s10552-021-01530-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 11/25/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE The nonsteroidal anti-inflammatory drug aspirin is an agent of interest for breast cancer prevention. However, it is unclear if aspirin affects mammographic breast density (MBD), a marker of elevated breast cancer risk, particularly in the context of concurrent use of medications indicated for common cardiometabolic conditions, which may also be associated with MBD. METHODS We used data from the New York Mammographic Density Study for 770 women age 40-60 years old with no history of breast cancer. We evaluated the association between current regular aspirin use and MBD, using linear regression for continuous measures of absolute and percent dense areas and absolute non-dense area, adjusted for body mass index (BMI), sociodemographic and reproductive factors, and use of statins and metformin. We assessed effect modification by BMI and reproductive factors. RESULTS After adjustment for co-medication, current regular aspirin use was only positively associated with non-dense area (β = 18.1, 95% CI: 6.7, 29.5). Effect modification by BMI and parity showed current aspirin use to only be associated with larger non-dense area among women with a BMI ≥ 30 (β = 28.2, 95% CI: 10.8, 45.7), and with lower percent density among parous women (β = -3.3, 95% CI: -6.4, -0.3). CONCLUSIONS Independent of co-medication use, current regular aspirin users had greater non-dense area with stronger estimates for women with higher BMI. We found limited support for an association between current aspirin use and mammographically dense breast tissue among parous women.
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Affiliation(s)
- Teofilia Acheampong
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th street, New York, NY, 10032, USA
| | - Erica J Lee Argov
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th street, New York, NY, 10032, USA
| | - Mary Beth Terry
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th street, New York, NY, 10032, USA.,Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, 1130 St Nicholas Ave, New York, NY, 10032, USA
| | - Carmen B Rodriguez
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th street, New York, NY, 10032, USA
| | - Mariangela Agovino
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th street, New York, NY, 10032, USA
| | - Ying Wei
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th street, New York, NY, 10032, USA.,Department of Biostatistics, Mailman School of Public Health, Columbia University, 722 West 168th street, New York, NY, 10032, USA
| | - Shweta Athilat
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th street, New York, NY, 10032, USA
| | - Parisa Tehranifar
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th street, New York, NY, 10032, USA. .,Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, 1130 St Nicholas Ave, New York, NY, 10032, USA.
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Al-Mohaissen M, Alkhedeiri A, Al-Madani O, Lee T, Hamdoun A, Al-Harbi M. Association of mammographic density and benign breast calcifications individually or combined with hypertension, diabetes, and hypercholesterolemia in women ≥40 years of age: a retrospective study. J Investig Med 2022; 70:1308-1315. [PMID: 35190487 PMCID: PMC9240332 DOI: 10.1136/jim-2021-002296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2022] [Indexed: 11/08/2022]
Abstract
Recent evidence has linked certain mammographic characteristics, including breast calcifications (Bcs) and mammographic density (MD), with atherosclerotic cardiovascular disease risk factors in women, but data are limited and inconsistent. We aimed to evaluate the association of MD and/or Bcs with hypertension, diabetes, and hypercholesterolemia in women ≥40 years of age. Through hospital electronic records, we retrospectively identified mammograms of non-pregnant women aged ≥40 years and without breast cancer and retrieved reports and relevant data. MD and Bcs were recorded; risk factor status was diagnosed based on treatment profile and clinical and laboratory data. In total, 1406 women were included. MD was inversely related to hypertension, diabetes, hypercholesterolemia, triglyceride levels, age, and body mass index (BMI) (p value for trend <0.001). Bcs were positively associated with hypertension, diabetes, hypercholesterolemia, age, BMI, and elevated creatinine (p<0.05). Controlling for age and BMI, MD category A (MD-A) was independently associated with hypercholesterolemia; Bcs were independently associated with diabetes. Combining MD-A with Bcs did not increase the odds significantly. Analysis for additive interactions revealed a significant interaction between MD-A and BMI, increasing the odds of hypertension, and a trend for increased odds of diabetes by adding MD-A and/or Bcs to BMI. Decreased MD and presence of Bcs are associated with hypertension, diabetes, and hypercholesterolemia in women ≥40 years of age. MD-A may represent a new obesity index independently associated with hypercholesterolemia and additive to hypertension risk. Bcs are independently associated with diabetes. Combining MD and Bcs did not improve the odds significantly, which may reflect mechanistic differences.
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Affiliation(s)
- Maha Al-Mohaissen
- Department of Clinical Sciences (Cardiology), College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Arwa Alkhedeiri
- Department of Radiology, King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
| | - Ohoud Al-Madani
- Department of Research Informatics, Saudi Food and Drug Authority, Riyadh, Saudi Arabia
| | - Terry Lee
- Centre for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada
| | - Anas Hamdoun
- Department of Radiology, King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
| | - Mohammad Al-Harbi
- Department of Radiology, King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
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Yu T, Ye DM. The epidemiologic factors associated with breast density: A review. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2022; 27:53. [PMID: 36092490 PMCID: PMC9450246 DOI: 10.4103/jrms.jrms_962_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 01/14/2022] [Accepted: 01/26/2022] [Indexed: 11/04/2022]
Abstract
In recent years, some studies have evaluated the epidemiologic factors associated with breast density. However, the variant and inconsistent results exist. In addition, breast density has been proved to be a significant risk factor associated with breast cancer. Our review summarized the published studies and emphasized the crucial factors including epidemiological factors associated with breast density. In addition, we also discussed the potential reasons for the discrepant results with risk factors. To decrease the incidence and mortality rates for breast cancer, in clinical practice, breast density should be included for clinical risk models in addition to epidemiological factors, and physicians should get more concentrate on those women with risk factors and provide risk-based breast cancer screening regimens.
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Khare S, Irrinki S, Sakaray YR, Bal A, Singh T, Singh G. Metabolic Syndrome in Breast Cancer Patients: An Observational Study. BREAST CANCER-BASIC AND CLINICAL RESEARCH 2021; 15:11782234211026788. [PMID: 34629874 PMCID: PMC8493313 DOI: 10.1177/11782234211026788] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 05/27/2021] [Indexed: 11/24/2022]
Abstract
Background: The reported association between metabolic syndrome (MetS) and breast cancer may have a significant impact on the incidence and mortality related to breast cancer. We undertook this study to find if the disease is different in patients with MetS. Materials and Methods: Patients with biopsy-proven breast cancer were divided into groups based on the presence or absence of MetS (according to the IDF definition of 2006) and also based on menopausal status. The presence of known risk and prognostic factors were also recorded, and the groups were compared. Results: A total of 305 patients were recruited, of which 191 (62.6%) had MetS. Patients with MetS were older than those without (52.1 versus 48.3 years, P = .014) and had a lower incidence of nulliparity (4.1% vs 12.8%, P = .005) and dense breasts (2.9% in MetS vs 10.8% in no MetS, P = .009). On further dividing into premenopausal and postmenopausal, these differences persisted only in premenopausal patients. MetS group had a lower number of HER2-positive tumours (14.3% for MetS, 23.9% for no MetS; P = .036). After dividing into premenopausal and postmenopausal, significant differences were observed in distant metastases (5.4% in MetS vs 16.1% in no MetS, P = .045) and in grade (higher grade in MetS, P = .05) in premenopausal patients. In postmenopausal patients, difference was observed in HER2 positivity (12.3% in MetS vs 28.8% in no MetS, P = .008). Conclusions: Breast cancer in patients with MetS may not be significantly different from breast cancer in patients without MetS.
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Affiliation(s)
- Siddhant Khare
- Department of General Surgery, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Santhosh Irrinki
- Department of General Surgery, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Yashwant Raj Sakaray
- Department of General Surgery, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Amanjit Bal
- Department of Pathology, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Tulika Singh
- Department of Radiodiagnosis, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Gurpreet Singh
- Department of General Surgery, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
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Wang CL, Hsu PS, Lin CY, Yang SF. Clinical Factors Associated with Asymptomatic Women Having Inconclusive Screening Mammography Results: Experiences from a Single Medical Center in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105410. [PMID: 34069375 PMCID: PMC8158679 DOI: 10.3390/ijerph18105410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/11/2021] [Accepted: 05/17/2021] [Indexed: 11/16/2022]
Abstract
Screening mammography is used worldwide for the early detection of breast cancer in women experiencing no symptoms. The Breast Imaging Reporting and Database System (BI-RADS) is used to report mammographic findings. However, little is known about the clinical characteristics of Asian women with BI-RADS category 0, and we aimed to explore such characteristics in the context of Taiwan. This retrospective cross-sectional study was conducted using data from a single tertiary medical center. We examined the association of blood test data and estrogen exposure–related medical histories with BI-RADS reports from screening mammography of 4280 women between 1 January 2010 and 31 July 2019. The data of 4280 participants were evaluated, and they were categorized into BI-RADS category 0 (n = 413; 9.6%) and 1–5 (n = 3867; 90.4%) subgroups. In a multivariate analysis, breast surgery history and premenopausal status had a positive relationship with a category 0 status, with respective risk increases of 64% and 34% (p = 0.010 and 0.013). Hormone contraceptive use for ≥5 years was a negative independent predictor of having a category 0 status. In conclusion, breast surgery history and premenopausal status significantly increased the likelihood of individuals having incomplete mammographic findings, even when they were older than 45 years. Identifying related factors before screening mammography is helpful for clinical physicians to arrange more proper and alternative examination and obtain a definite diagnosis.
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Affiliation(s)
- Chun-Li Wang
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan;
- Department of Family Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
| | - Pi-Shan Hsu
- Department of Family Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
- Graduate Institute of Microbiology and Public Health, College of Veterinary Medicine, National Chung-Hsing University, Taichung 40227, Taiwan
| | - Chia-Yen Lin
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan;
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan
- Correspondence: (C.-Y.L.); (S.-F.Y.)
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan;
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40705, Taiwan
- Correspondence: (C.-Y.L.); (S.-F.Y.)
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Lee Argov EJ, Acheampong T, Terry MB, Rodriguez CB, Agovino M, Wei Y, Athilat S, Tehranifar P. Independent and joint cross-sectional associations of statin and metformin use with mammographic breast density. Breast Cancer Res 2020; 22:99. [PMID: 32933550 PMCID: PMC7493153 DOI: 10.1186/s13058-020-01336-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 09/02/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Well-tolerated and commonly used medications are increasingly assessed for reducing breast cancer risk. These include metformin and statins, both linked to reduced hormone availability and cell proliferation or growth and sometimes prescribed concurrently. We investigated independent and joint associations of these medications with mammographic breast density (MBD), a useful biomarker for the effect of chemopreventive agents on breast cancer risk. METHODS Using data from a cross-sectional study of 770 women (78% Hispanic, aged 40-61 years, in a mammography cohort with high cardiometabolic burden), we examined the association of self-reported "ever" use of statins and metformin with MBD measured via clinical Breast Imaging Reporting and Data System (BI-RADS) density classifications (relative risk regression) and continuous semi-automated percent and size of dense area (Cumulus) (linear regression), adjusted for age, body mass index, education, race, menopausal status, age at first birth, and insulin use. RESULTS We observed high statin (27%), metformin (13%), and combination (9%) use, and most participants were overweight/obese (83%) and parous (87%). Statin use was associated with a lower likelihood of high density BI-RADS (RR = 0.60, 95% CI = 0.45 to 0.80), percent dense area (PD) (β = - 6.56, 95% CI = - 9.05 to - 4.06), and dense area (DA) (β = - 9.05, 95% CI = - 14.89 to - 3.22). Metformin use was associated with lower PD and higher non-dense area (NDA), but associations were attenuated by co-medication with statins. Compared to non-use of either medication, statin use alone or with metformin were associated with lower PD and DA (e.g., β = - 6.86, 95% CI: - 9.67, - 4.05 and β = - 7.07, 95% CI: - 10.97, - 3.17, respectively, for PD) and higher NDA (β = 25.05, 95% CI: 14.06, 36.03; β = 29.76, 95% CI: 14.55, 44.96, respectively). CONCLUSIONS Statin use was consistently associated with lower MBD, measured both through clinical radiologist assessment and continuous relative and absolute measures, including dense area. Metformin use was associated with lower PD and higher NDA, but this may be driven by co-medication with statins. These results support that statins may lower MBD but need confirmation with prospective and clinical data to distinguish the results of medication use from that of disease.
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Affiliation(s)
- Erica J Lee Argov
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, USA
| | - Teofilia Acheampong
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, USA
| | - Mary Beth Terry
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, USA
| | - Carmen B Rodriguez
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, USA
| | - Mariangela Agovino
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, USA
| | - Ying Wei
- Department of Biostatistics, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, USA
| | - Shweta Athilat
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, USA
| | - Parisa Tehranifar
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, USA.
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Rodriguez CB, Wei Y, Terry MB, Wyka K, Athilat S, Albrecht SS, Tehranifar P. Associations of Nativity, Age at Migration, and Percent of Life in the U.S. with Midlife Body Mass Index and Waist Size in New York City Latinas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072436. [PMID: 32260163 PMCID: PMC7178279 DOI: 10.3390/ijerph17072436] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 12/13/2022]
Abstract
Migration to the U.S. has been associated with increased body size and obesity risk in Latinas, but results for Caribbean immigrant women are limited and inconclusive. Emerging evidence also suggests that early-life environment associations with women's midlife body mass index (BMI) may be different for larger and smaller women, but this has not been tested within migration life-course history. We examined the associations of nativity and migration timing with midlife body size in a sample of majority Caribbean Latinas and whether these associations varied across the body size distribution. We used interview data from 787 self-identified Latinas (ages 40-65 years) and assessed overall obesity using BMI (kg/m2) and central obesity based on waist circumference (WC, cm). We used linear and quantile regression to examine the association of migration history with BMI and WC and logistic regression for the probability of obesity. Foreign birthplace, later migration age, and lower percent of life in the U.S. were associated with lower BMI and WC means and lower odds of overall and central obesity. Quantile regression showed only inverse associations in the upper quantiles of BMI and WC. For example, relative to U.S.-born women, women living <50% of their lives in the U.S. had lower BMI in the 75th BMI percentile (β = -4.10, 95% CI: -6.75, -0.81), with minimal differences in the 25th (β = 0.04, 95% CI: -1.01, 0.96) and 50th BMI percentiles (β = -1.54, 95% CI: -2.90, 0.30). Our results support that migration to and increasing time in the U.S. are associated with greater body size in midlife Latina women, with stronger influences at higher body size distribution.
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Affiliation(s)
- Carmen B. Rodriguez
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA; (C.B.R.); (M.B.T.); (S.A.); (S.S.A.)
- Department of Epidemiology and Biostatistics, CUNY Graduate School of Public Health and Health Policy, New York, NY 10027, USA;
| | - Ying Wei
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY 10032, USA;
| | - Mary Beth Terry
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA; (C.B.R.); (M.B.T.); (S.A.); (S.S.A.)
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY 10032, USA
| | - Katarzyna Wyka
- Department of Epidemiology and Biostatistics, CUNY Graduate School of Public Health and Health Policy, New York, NY 10027, USA;
| | - Shweta Athilat
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA; (C.B.R.); (M.B.T.); (S.A.); (S.S.A.)
| | - Sandra S. Albrecht
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA; (C.B.R.); (M.B.T.); (S.A.); (S.S.A.)
| | - Parisa Tehranifar
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA; (C.B.R.); (M.B.T.); (S.A.); (S.S.A.)
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY 10032, USA
- Correspondence:
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Tapia KA, Garvey G, McEntee MF, Rickard M, Lydiard L, Brennan PC. Mammographic densities of Aboriginal and non-Aboriginal women living in Australia's Northern Territory. Int J Public Health 2019; 64:1085-1095. [PMID: 30941443 DOI: 10.1007/s00038-019-01237-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 03/21/2019] [Accepted: 03/23/2019] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES To compare the mammographic densities and other characteristics of Aboriginal and non-Aboriginal women screened in Australia. METHODS Population screening programme data of Aboriginal (n = 857) and non-Aboriginal women (n = 3236) were used. Mann-Whitney U test compared ages at screening and Chi-square tests compared personal and clinical information. Logistic regression analysis was used for density groupings. OR and 95% CI were calculated for multivariate association for density. RESULTS Mammographic density was lower amongst Aboriginal women (P < 0.001). For non-Aboriginal women, higher density was associated with younger age (OR 2.4, 95% CI 2.1-2.8), recall to assessment (OR 2.2, 95% CI 1.6-3.0), family history of breast cancer (OR 1.4, 95% CI 1.2-1.6), English-speaking background (OR 1.4, 95% CI 1.2-1.6), and residence in remote areas (OR 1.2, 95% CI 1.1-1.4). For Aboriginal women, density was associated with younger age (OR 2.7, 95% CI 2.0-3.5; P < 0.001), and recall to assessment (OR 2.3, 95% CI 1.4-3.9; P < 0.05). CONCLUSIONS Significant differences between Aboriginal and non-Aboriginal women were found. There were more significant associations for dense breasts for non-Aboriginal women than for Aboriginal women.
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Affiliation(s)
- Kriscia A Tapia
- Faculty of Health Sciences, The University of Sydney, Room M504, M Block, 75 East Street, Lidcombe, NSW, 2141, Australia.
| | - Gail Garvey
- Faculty of Health Sciences, The University of Sydney, Room M504, M Block, 75 East Street, Lidcombe, NSW, 2141, Australia.,Menzies School of Health Research, Level 1, 147 Wharf Street, Spring Hill, QLD, 4000, Australia
| | - Mark F McEntee
- Department of Medicine, University College Cork, Brookfield Health Sciences Complex, College Road, Cork, T12 AK54, Ireland
| | - Mary Rickard
- Faculty of Health Sciences, The University of Sydney, Room M504, M Block, 75 East Street, Lidcombe, NSW, 2141, Australia.,BreastScreen Australia, Sydney, NSW, Australia
| | - Lorraine Lydiard
- BreastScreen Northern Territory, Level 1, 9 Scaturchio St., Casuarina, NT, 0810, Australia
| | - Patrick C Brennan
- Faculty of Health Sciences, The University of Sydney, Room M221, M Block, 75 East Street, Lidcombe, NSW, 2141, Australia
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Pacsi-Sepulveda AL, Shelton RC, Rodriguez CB, Coq AT, Tehranifar P. "You probably can't feel as safe as normal women": Hispanic women's reactions to breast density notification. Cancer 2019; 125:2049-2056. [PMID: 30768781 DOI: 10.1002/cncr.32002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 12/21/2018] [Accepted: 01/04/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Patient advocacy has led to state-level legislative mandates for the release of personal mammographic breast density information to women undergoing screening mammography. More research is needed to understand the impact of this information on women's perceptions and mammography screening behavior. METHODS Semistructured interviews were conducted in English and Spanish with 24 self-identified Hispanic women who had undergone at least 1 mammogram since breast density notification was enacted in New York State. The women ranged in age from 43 to 63 years. Women were asked about their understanding and perceptions of the communication of New York State-mandated breast density information, and any actions they have taken or would take in response to this information. A content analysis of the qualitative data from the translated and transcribed interviews was conducted. RESULTS The majority of participants had no prior knowledge of breast density and expressed confusion and apprehension regarding the meaning of dense breasts when presented with the notification information. Many participants understood having dense breasts to be a serious and abnormal condition, and reported feelings of worry and vulnerability. Participants mostly expressed a strong interest in learning about breast density and obtaining additional and more frequent breast cancer screening tests. These behavioral intentions were consistent with participants' overall favorable view of breast cancer screening and a belief that their faith, as well as regular screening, can help to protect them from breast cancer morbidity and mortality. CONCLUSIONS Hispanic women conveyed proactive breast cancer screening intentions in response to breast density notification, despite inadequate comprehension of this information and negative emotional responses.
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Affiliation(s)
| | - Rachel C Shelton
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York.,Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York
| | - Carmen B Rodriguez
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | - Arielle T Coq
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | - Parisa Tehranifar
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York.,Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
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12
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Childhood body size and midlife mammographic breast density in foreign-born and U.S.-born women in New York City. Ann Epidemiol 2018; 28:710-716. [PMID: 30172558 DOI: 10.1016/j.annepidem.2018.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 07/26/2018] [Accepted: 08/02/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE We investigated whether childhood body size is associated with midlife mammographic density, a strong risk factor for breast cancer. METHODS We collected interview data, including body size at age 10 years using a pictogram, and measured height and weight from 518 women, recruited at the time of screening mammography in New York City (ages 40-64 years, 71% Hispanic, 68% foreign-born). We used linear regression models to examine childhood body size in relation to percent density and areas of dense and nondense tissue, measured using a computer-assisted method from digital mammograms. RESULTS In models that adjusted for race/ethnicity, and age and body mass index at mammogram, the heaviest relative to leanest childhood body size was associated with 5.94% lower percent density (95% confidence interval [CI]: -9.20, -2.29), 7.69 cm2 smaller dense area (95% CI: -13.94, -0.63), and 26.17 cm2 larger nondense area (95% CI: 9.42, 43.58). In stratified analysis by menopausal status and nativity, the observed associations were stronger for postmenopausal and U.S.-born women although these differences did not reach statistical significance. CONCLUSIONS Heavy childhood body size is associated with lower mammographic density, consistent with its associations with breast cancer risk. Suggestive findings by nativity require confirmation in larger samples.
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Oskar S, Engmann NJ, Azus AR, Tehranifar P. Gestational diabetes, type II diabetes, and mammographic breast density in a U.S. racially diverse population screened for breast cancer. Cancer Causes Control 2018; 29:731-736. [PMID: 29948515 DOI: 10.1007/s10552-018-1048-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 06/02/2018] [Indexed: 01/29/2023]
Abstract
PURPOSE Type II diabetes mellitus (T2DM) has consistently been associated with an increased risk of breast cancer, but the association of gestational diabetes mellitus (GDM) with breast cancer is less clear. T2DM and GDM may influence breast cancer risk through mammographic breast density, a strong risk factor for breast cancer. We examined whether T2DM and GDM are associated with higher mammographic breast density in a largely racial/ethnic minority sample. METHODS We collected digital mammograms, anthropometric measures, and interview data from 511 racially diverse women recruited during screening mammography appointments between 2012 and 2016 (mean age 51 years; 70% Hispanic). We examined the associations of self-reported GDM, T2DM, and medication use (metformin and insulin) with mammographic breast density, measured as percent and area of dense tissue using Cumulus software. RESULTS In multivariable linear regression models, history of T2DM and/or GDM and length of time since diagnosis were not associated with percent density or dense breast area, either before or after adjustment for current BMI. Use of metformin in diabetic women was associated with lower percent density (β = - 5.73, 95% CI - 10.27, - 1.19), only before adjusting for BMI. These associations were not modified by menopausal status. CONCLUSIONS Our results do not support associations between T2DM and/or GDM and higher amount of mammographically dense breast tissue, suggesting that the mechanism linking diabetes with breast cancer risk may not include mammographic breast density in midlife.
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Affiliation(s)
- Sabine Oskar
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St, New York, NY, 10032, USA
| | - Natalie J Engmann
- Department of Epidemiology & Biostatistics, School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Aisia R Azus
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St, New York, NY, 10032, USA
| | - Parisa Tehranifar
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St, New York, NY, 10032, USA.
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA.
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14
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Eldin Ahmed Abdelsalam K, Alobeid M Elamin A. Influence of Grand Multiparity on the Levels of Insulin, Glucose and HOMA-IR in Comparison with Nulliparity and Primiparity. Pak J Biol Sci 2017; 20:42-46. [PMID: 29023014 DOI: 10.3923/pjbs.2017.42.46] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE It is to compare the levels of fasting glucose and insulin as well as insulin resistance in grand multiparas with primiparity and nulliparity. METHODOLOGY Fasting blood samples were collected from 100 non-pregnant ladies as control group, 100 primiparity pregnant women and 100 grand multiparity pregnant women. Glucose (FBS) and insulin (FSI) concentrations were measured by Hitachi 912 full automated Chemistry Analyzer (Roche Diagnostics, Germany) as manufacturer procedure. Insulin resistance was calculated following the formula: FBG (mg dL-1)×FSI (μU mL-1)/405. RESULTS This study found a significant reduction in glucose level in primiparity when compared to control group but it was increased significantly in multiparity comparing to primiparity and control. Insulin level showed significant high concentrations in pregnant women and increased significantly in grand multiparas comparing to primiparas and controls. As a result of that, HOMA-IR was increased significantly by increasing of parity. Also, there was a significant increase in fasting insulin and a decrease in insulin sensitivity with parity with association to age and obesity. CONCLUSION Grand multiparity is associated with an increased risk of subsequent clinical insulin resistance (HOMA-IR).
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April-Sanders A, Oskar S, Shelton RC, Schmitt KM, Desperito E, Protacio A, Tehranifar P. Predictors of Breast Cancer Worry in a Hispanic and Predominantly Immigrant Mammography Screening Population. Womens Health Issues 2016; 27:237-244. [PMID: 27863982 DOI: 10.1016/j.whi.2016.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 09/01/2016] [Accepted: 10/10/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Worry about developing breast cancer (BC) has been associated with participation in screening and genetic testing and with follow-up of abnormal screening results. Little is known about the scope and predictors of BC worry in Hispanic and immigrant populations. METHODS We collected in-person interview data from 250 self-identified Hispanic women recruited from an urban mammography facility (average age 50.4 years; 82% foreign-born). Women reported whether they worried about developing breast cancer rarely/never (low worry), sometimes (moderate worry), or often/all the time (high worry). We examined whether sociocultural and psychological factors (e.g., acculturation, education, perceived risk), and risk factors and objective risk for BC (e.g., family history, Gail model 5-year risk estimates, parity) predicted BC worry using multinomial and logistic regression. RESULTS In multivariable models, women who perceived higher absolute BC risk (odds ratio, 1.66 [95% confidence interval, 1.28-2.14] for a one-unit increase in perceived lifetime risk) and comparative BC risk (e.g., odds ratio, 2.73, 95% confidence interval, 1.23-6.06) were more likely to report high BC worry than moderate or low BC worry. There were no associations between BC worry and indicators of objective risk or acculturation. CONCLUSIONS In Hispanic women undergoing screening mammography, higher perceptions of BC risk, in both absolute and comparative terms, were associated independently with high BC worry, and were stronger predictors of BC worry than indicators of objective BC risk, including family history, mammographic density, and personal BC risk estimates.
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Affiliation(s)
- Ayana April-Sanders
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Sabine Oskar
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Rachel C Shelton
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York
| | - Karen M Schmitt
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York; Division of Academics, School of Nursing, Columbia University, New York, New York; Avon Foundation Breast Imaging Center-New York Presbyterian, New York, New York
| | - Elise Desperito
- Department of Radiology, Columbia University Medical Center-New York Presbyterian, New York, New York
| | - Angeline Protacio
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Parisa Tehranifar
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York; Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York.
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