디지털 유방촬영술을 이용한 3차원적 유방밀도와 대사증후군의 관련성
Associations between Metabolic Syndrome and Three-dimensional Breast Density Using Digital Mammography
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연구배경: 유방암의 독립적인 예측인자인 유방밀도와 대사증후군과의 관련성은 잘 알려져 있지 않다. 본 연구에서는 디지털 유방촬영기를 이용한 3차원적 유방밀도와 대사증후군 및 대사증후군의 각 요소와의 관련성에 대해 연구하였다. 방법: 일개 지역병원의 건강검진 센터를 방문한 20세이상의 여성 166명(폐경 전 61명, 폐경 후 105명)을 대상으로 단면분석을 시행하였다. 대사증후군의 정의는 수정된 National Cholesterol Education Program’s Adult Treatment Panel III (NCEP-ATP III)의 기준을 활용하였다. 3차원적 유방밀도는 디지털 유방촬영기를 사용하여치밀조직부피 백분율(Percentage of Dense Volume)로서측정하였다. 대사증후군 및 대사증후군의 각 개별 요소들과 치밀조직부피 백분율과의 연관성을 보기 위해 단계별다중회귀분석(stepwise multiple regression analysis)을 시행하였다. 결과: 대사증후군이 있는 그룹에서는 평균 치밀조직 부피 백분율이 대사증후군이 없는 그룹에 비해 의미있게 낮았다. 치밀조직부피 백분율을 종속변수로 하고 대사 증후군 유무와 그 각각의 항목들을 독립변수로 사용하여 나이, 폐경 유무를 보정한 단계별 다중회귀분석 결과 대사증후군 자체는 유의한 독립변수가 아니었으나 고밀도 지질단백 콜레스테롤(β＝-3.112, SE＝0.927, P＝0.001)과 허리둘레(β＝2.967, SE＝1.109, P＝0.008)는 유의한 독립변수로 나타났다. 체질량지수로 보정한 후에는 고밀도 지질단백 콜레스테롤(β＝-2.953, SE＝0.882, P＝0.001)만이 치밀조직부피 백분율과 관련이 있는 유의한 독립변수였다. 결론: 본 연구에서 3차원적 유방밀도는 나이, 폐경 유무, 체질량지수로 보정한 후 낮은 고밀도 지질단백 콜레스테롤과 의미 있는 관련성을 보였으며, 추후 대규모 전향적후속 연구가 필요할 것으로 생각된다.
Abstract
Background: Metabolic syndrome is associated with increased risk of breast cancer, but little is known about the association between metabolic syndrome and mammographic density as an independent predictor of breast cancer. In this study, we investigated the association between metabolic syndrome or its components and three-dimensional breast density using digital mammography. Methods: We analyzed cross-sectional data of 166 women, aged 20 or over (61 premenopausal and 105 postmenopausal women) in a district hospital. Metabolic syndrome was defined according to the modified National Cholesterol Education Program’s Adult Treatment Panel III (NCEP-ATP III) guideline. We measured volume percentage of dense breast tissue using digital mammography. Stepwise multiple regression analysis was used to estimate the association between mammographic density and metabolic syndrome, as well as its components. Results: The Mean mammographic density was lower in the group with metabolic syndrome compared with the group without it. After adjusting for age and menopausal status, multiple regression analysis showed waist circumference (β＝-3.112, S.E.＝0.927, P＝0.001) and low HDL-cholesterol (β＝-2.967, S.E.＝1.109, P＝0.008) were independent variables for the percentage of mammographic density, although metabolic syndrome itself was not. After additional adjustment for body mass index, only low HDL-cholesterol was associated with percentage of mammographic density (β＝-2.953, S.E.＝0.882, P＝0.001). Conclusions: In this study, only low HDL cholesterol was associated with three-dimensional mammographic density independently after adjusting for age, menopausal status and body mass index. These findings need to be confirmed in further larger prospective studies.
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