Генетический профиль, метаболический синдром и риск развития рака молочной железы среди женщин Казахстана
DOI:
https://doi.org/10.26577/eb-2018-1-1317Аннотация
Работа посвящена исследованию связи рака молочной железы с метаболическим синдромом и генами, участвующими в метаболизме липидов. В рамках данного исследования нами были рекрутированы 136 участников с диагнозом РМЖ и 83 условно здоровых участников контрольной группы. Среди заболеваний, сопутствующих раку молочной железы, преобладают артериальная гипертензия, хронический бронхит, ишемическая болезнь сердца, миома матки, холецистит, варикозное расширение вен нижних конечностей, панкреатит. Встречаемость сахарного диабета 2-го типа составила 13,2%. Биохимический анализ на 18 метаболических показателей показал, что в группе больных по сравнению с контрольной группой уровень гомоцистеина и витамина В12 значительно превышает нормы. Анализ данных показал высокую корреляцию уровня гомоцистеина с риском развития рака молочной железы (ОШ = 15,29; ДИ = 5,67-41,28; р<0,001) в исследуемой группе. При исследовании ассоциации полиморфизмов исследуемых генов с риском развития РМЖ среди женщин Казахстана выявлено протективное воздействие в генах FTO, PRKAA2 и STK11. В случае гена CRTC2 в сверх доминантной модели выявлена ассоциация с риском развития РМЖ (ОШ=1,95; ДИ = 1,1-3,46; р=0,021). При исследовании связи между генетическим профилем и метаболическими показателями было выявлено, что генотип С/С (дикий) гена PRKAA2 может влиять на увеличение уровня холестерина при нормальных показателях витамина В12 (ОШ=3,43; ДИ = 1,25-9,39: р<0.015) и генотип Т/С влиять на увеличение холестерина при повышенных показателях витамина В12 (ОШ=3,23; ДИ = 1,1-9,52: р<0.035). Из данных анализа следует, что уровень гомоцистеина может быть использован как биомаркер, входящий в состав комплекса диагностических мер при раке молочной железы. К тому же, генотипы С/С и Т/С гена PRKAA2 могут быть использованы как маркеры уровней холестерина и витамина В12 в организме. Для исследования ассоциации других генов с биохимическими показателями и риском развития РМЖ необходимо увеличение выборки.
Ключевые слова: рак молочной железы, метаболический синдром, генетический профиль.
Библиографические ссылки
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14 https://www.nur.kz/945272-sovremennoe-sostoyanie-problemy-serd.html.
15 Jarde T., Perrier S., Vasson M.P. (2011) Molecular mechanisms of leptin and adiponectin in breast cancer. European Journal of Cancer, vol. 47, no. 1. pp. 33–43.
16 King M.W. AMPK: Master Metabolic Regulator. Medical Biochemistry. http://themedicalbioche- mistry page.org/ampk.php.
17 Largent J.A., McEligot A.J., Ziogas A. (2006) Hypertension, diuretics and breast cancer risk. Journal of Human Hypertension, vol. 20, no. 10. pp. 727–732.
18 Liao S., Li J., Wei W. (2011) Association between diabetes mellitus and breast cancer risk: a meta-analysis of the literature. Asian Pacific Journal of Cancer Prevention, vol. 12, no. 4. pp. 1061–1065.
19 Michels K.B., Solomon C.G., Hu F.B. et al. (2003) Type 2 diabetes and subsequent incidence of breast cancer in the nurses' health study. Diabetes Care, vol. 26, no. 6. pp. 1752–1758.
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25 Rose D.P., Haffner S.M., Baillargeon J. (2007) Adiposity, the metabolic syndrome, and breast cancer in African-American and white American women. Endocrine Reviews, vol. 28, no. 7. pp. 763–777.
26 Soler M., Chatenoud L., Negri E., Parazzini F., Franceschi S., La Vecchia C. (1999) Hypertension and hormone-related neoplasms in women. Hypertension, vol. 34, no. 2. pp. 320–325.
27 Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation, vol. 106, no. 25, pp. 3143–3421.
28 Tornberg S.A., Holm L-E., Carstensen J.M. (1988) Breast cancer risk in relation to serum cholesterol, serum beta-lipoprotein, height, weight, and blood pressure. Acta Oncologica, vol. 27, no. 1. pp. 31–37.
29 Ursin G., Longnecker M.P., Haile R.W. et al. (1995) A meta-analysis of body mass index and risk of premenopausal breast cancer. Epidemiology, vol. 6, no. 2. pp. 137–141.
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31 World Health Organization. Definition, Diagnosis and Classification of Diabetes Mellitus and Its Complications: Report of a WHO Consultation. Geneva, Switzerland: World Health Organization, 1999.
32 Zhang S.M., Willett W.C., Selhub J., Hunter D.J., Giovannucci E.L., Holmes M.D., Colditz G.A., Hankinson S.E. (2003) Plasma Folate, Vitamin B6, Vitamin B12, Homocysteine, and Risk of Breast Cancer. J. Natl. Cancer Inst., vol. 95, no. 5. pp. 373-380. doi: 10.1093/jnci/95.5.373.