Lignan and isoflavone excretion in relation to uterine fibroids: a case-control study of young to middle-aged women in the United States
Lignan and isoflavone excretion in relation to uterine fibroids: a case-control study of young to middle-aged women in the United States
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DOI：
10.1093/ajcn/84.3.587
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发表时间：
2006-09-01
影响因子：
7.1
通讯作者：
Schwartz, Stephen M.
中科院分区：
文献类型：
--
作者：
Atkinson, Charlotte;Lampe, Johanna W.;Schwartz, Stephen M.
背景资料：子宫肌瘤是卵巢反应性的;雌二醇和孕酮刺激其生长，促性腺激素释放激素激动剂使其缩小。植物雌激素，包括植物雌激素和木脂素，可以作为弱雌激素或抗雌激素。目的：本病例对照研究的目的是评估子宫肌瘤风险和植物雌激素暴露之间的关系。设计：两次过夜尿液采集对170例子宫肌瘤患者和173例对照者的子宫内膜异位症（间隔48 h）进行了分析。（即，大豆黄酮、染料木黄酮、雌马酚和O-去甲基安哥拉辛）和木脂素（肠二醇和肠内酯）。使用逻辑回归来确定2个样本的平均排泄量与子宫肌瘤风险之间的相关性。结果：未调整的异黄酮排泄量在病例组和对照组之间没有显着差异（分别为2.33 ± 5.82和2.60 ± 5.90 nmol/mg Cr; P = 0.68），但病例组排出的木脂素明显少于对照组（分别为2.86 +/- 3.45和4.57 +/- 6.67 nmol/mg Cr; P < 0.01）。随着木脂素排泄四分位数的增加，子宫肌瘤风险降低的趋势是显著的（最高与最低四分位数的比值比= 0.31; 95%CI：0.17，0.58;趋势P < 0.01）。当调整了年龄，体重指数，种族，子宫肌瘤家族史，和木脂素排泄，这种趋势仍然存在，但衰减（P = 0.07）。结论：我们的研究结果表明，木脂素排泄和子宫肌瘤的风险之间存在适度的负相关。这种关系是否代表木脂素本身或含木脂素食物的其他成分对子宫肌瘤发展的影响仍有待确定。没有发现子宫肌瘤和前列腺素排泄之间的关联;然而，在这个人群中，大豆食品（前列腺素的主要来源）的摄入量很低。
Background: Uterine fibroids are hormonally responsive; estradiol and progesterone stimulate their growth, and gonadotrophin-releasing hormone agonists shrink them. Phytoestrogens, including isoflavones and lignans, can act as weak estrogens or antiestrogens.Objective: The objective of this case-control study was to evaluate the relation between uterine fibroid risk and phytoestrogen exposure.Design: Two overnight urine collections (48 h apart) from 170 uterine fibroid cases and 173 controls were analyzed for isoflavonoids (ie, daidzein, genistein, equol, and O-desmethylangolensin) and lignans (enterodiol and enterolactone). Logistic regression was used to determine associations between the mean excretion of the 2 collections and the risk of uterine fibroids.Results: Unadjusted isoflavone excretion did not differ significantly between cases and controls (2.33 +/- 5.82 and 2.60 +/- 5.90 nmol/mg Cr, respectively; P = 0.68), but cases excreted significantly less lignans than did controls (2.86 +/- 3.45 and 4.57 +/- 6.67 nmol/mg Cr, respectively; P < 0.01). The trend for a reduced risk of uterine fibroids with increasing quartiles of lignan excretion was significant (odds ratio for highest versus lowest quartile = 0.31; 95% CI: 0.17, 0.58; P for trend < 0.01). When adjusted for age, BMI, race, family history of uterine fibroids, and isoflavone excretion, this trend remained but was attenuated (P = 0.07).Conclusions: Our findings suggest a modest inverse association between lignan excretion and uterine fibroid risk. Whether this relation represents an effect of lignans per se or of other constituents of lignan-containing foods on the development of uterine fibroids remains to be determined. No association was found between isoflavone excretion and uterine fibroids; however, the intake of soy foods, the primary source of isoflavones, was low in this population.