Dietary lignan intake and postmenopausal breast cancer risk by estrogen and progesterone receptor status.
Dietary lignan intake and postmenopausal breast cancer risk by estrogen and progesterone receptor status.
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DOI：
10.1093/jnci/djk096
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发表时间：
2007-03
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影响因子：
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通讯作者：
M. Touillaud;A. Thiébaut;A. Fournier;M. Niravong;M. Boutron‐Ruault;F. Clavel-Chapelon
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文献类型：
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作者：
M. Touillaud;A. Thiébaut;A. Fournier;M. Niravong;M. Boutron‐Ruault;F. Clavel-Chapelon
在亚洲人群中进行的研究表明，大量食用富含植物雌激素的大豆食品与乳腺癌风险降低有关。然而，其他饮食植物雌激素的潜在关联-即，木脂素或其生物活性代谢物肠木脂素与乳腺癌风险的关系尚不清楚。方法：我们前瞻性地研究了绝经后浸润性乳腺癌的风险与四种植物木脂素（松杉醇，落叶松树脂醇，开环异落叶松树脂醇和matairesinol）的饮食摄入量之间的关系，并估计了两种肠木脂素（肠二醇和肠内酯）的暴露量，通过自我管理的饮食史问卷调查，在58，049名未服用大豆油补充剂的绝经后法国妇女中进行测量。使用多变量考克斯比例风险回归模型估计相对风险（RR）和95%置信区间（CI）。分析进一步分层的联合雌激素和孕激素受体（ER/PR）状态的肿瘤。统计检验是双侧的。结果：在383，425人-年的随访中（中位随访时间为7.7年），诊断出1469例乳腺癌。与摄入量最低四分位数的女性相比，总木脂素摄入量最高四分位数的女性（>1395微克/天）有乳腺癌的风险降低（RR = 0.83，95% CI = 0.71 - 0.95，P（趋势）= 0.02，376例vs 411例/100，000人-年），落叶松树脂酚摄入量最高四分位数的患者也是如此（RR = 0.82，95%CI = 0.71 - 0.95，P（趋势）= 0.01）。植物雌激素摄入量与绝经后乳腺癌风险之间的负相关性仅限于ER和PR阳性疾病（例如，总植物木脂素摄入量的最高与最低四分位数的RR = 0.72，95% CI = 0.58至0.88，P（趋势）= 0.01，每100，000人-年174例与214例，总肠木脂素水平的最高与最低四分位数的RR = 0.77，95% CI = 0.62至0.95，P（趋势）= 0.01，每10万人年164例对204例）。结论：在不食用富含大豆的饮食的西方人群中，植物木脂素的高饮食摄入和肠木脂素的高暴露与ER和PR阳性绝经后乳腺癌的风险降低相关。
BACKGROUND Studies conducted in Asian populations have suggested that high consumption of soy-based foods that are rich in isoflavone phytoestrogens is associated with a reduced risk of breast cancer. However, the potential associations of other dietary phytoestrogens--i.e., the lignans or their bioactive metabolites, the enterolignans--with the risk of breast cancer are unclear. METHODS We prospectively examined associations between the risk of postmenopausal invasive breast cancer and dietary intakes of four plant lignans (pinoresinol, lariciresinol, secoisolariciresinol, and matairesinol) and estimated exposure to two enterolignans (enterodiol and enterolactone), as measured with a self-administered diet history questionnaire, among 58,049 postmenopausal French women who were not taking soy isoflavone supplements. Relative risks (RRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox proportional hazards regression models. Analyses were further stratified by the combined estrogen and progesterone receptor (ER/PR) status of the tumors. Statistical tests were two-sided. RESULTS During 383,425 person-years of follow-up (median follow-up, 7.7 years), 1469 cases of breast cancer were diagnosed. Compared with women in the lowest intake quartiles, those in the highest quartile of total lignan intake (>1395 microg/day) had a reduced risk of breast cancer (RR = 0.83, 95% CI = 0.71 to 0.95, P(trend) = .02, 376 versus 411 cases per 100,000 person-years), as did those in the highest quartile of lariciresinol intake (RR = 0.82, 95% CI = 0.71 to 0.95, P(trend) = .01). The inverse associations between phytoestrogen intakes and postmenopausal breast cancer risk were limited to ER- and PR-positive disease (e.g., RR for highest versus lowest quartiles of total plant lignan intake = 0.72, 95% CI = 0.58 to 0.88, P(trend) = .01, 174 versus 214 cases per 100,000 person-years, and RR for highest versus lowest quartiles of total enterolignan level = 0.77, 95% CI = 0.62 to 0.95, P(trend) = .01, 164 versus 204 cases per 100,000 person-years). CONCLUSIONS High dietary intakes of plant lignans and high exposure to enterolignans were associated with reduced risks of ER- and PR-positive postmenopausal breast cancer in a Western population that does not consume a diet rich in soy.