Isoflavone consumption and subsequent risk of hepatocellular carcinoma in a population-based prospective cohort of Japanese men and women
Isoflavone consumption and subsequent risk of hepatocellular carcinoma in a population-based prospective cohort of Japanese men and women
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DOI：
10.1002/ijc.24121
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发表时间：
2009-04-01
影响因子：
6.4
通讯作者：
Tsugane, Shoichiro
中科院分区：
文献类型：
--
作者：
Kurahashi, Norie;Inoue, Manami;Tsugane, Shoichiro
男性肝细胞癌（HCC）的发病率远高于女性。一些实验和流行病学研究表明，雌激素可能在肝癌的发展中起抑制作用。由于马诺酮与17 β-雌二醇具有相似的结构，并且似乎在女性中具有抗雌激素作用，在男性中具有雌激素作用，因此我们假设马诺酮对HCC的作用因性别而异。我们在一项基于人群的前瞻性研究中调查了日本19，998名40-69岁的日本人（7，215名男性和12，783名女性）中大豆酮（染料木黄酮和大豆黄酮）与大豆制品和HCC之间的关系。在11.8年的随访中，101例受试者（69例男性和32例女性）新诊断为HCC。病例患者根据食用大豆酮和豆制品进行分组，并根据肝炎病毒感染进行分层。通过考克斯比例风险模型计算HCC的风险比（HR）和95%置信区间（CI）。在女性中，染料木黄酮和大豆黄酮与HCC风险增加呈剂量依赖性相关，最高与最低三分位数的多变量HR分别为3.19（95% CI = 1.13-9.00，P趋势= 0.03）和3.90（95% CI = 1.30-11.69，P趋势= 0.01）。在男性中未观察到马林酮与HCC之间的关联。当分析仅限于丙型肝炎和B病毒之一或两者阳性的受试者时，这些结果持续存在。总而言之，女性的肝细胞癌风险增加可能与食用维生素D有关。患有肝炎病毒感染的妇女可被建议避免食用酒精。需要进一步的研究来证实这些发现。(C)2008 Wiley-Liss，Inc.
The incidence of hepatocellular carcinoma (HCC) is much higher in men than in women. Several experiment and epidemiological studies have suggested that estrogen might play an inhibitory role in the development of HCC. Because isoflavones have a similar structure as 17 beta-estradiol and appear to have an anti-estrogenic effect in women and estrogenic effect in men, we hypothesized that the effect of isoflavones on HCC differs by sex. We investigated the association between isoflavones (genistein and daidzein) and soy products and HCC in Japan in a population-based prospective study in 19,998 Japanese (7,215 men and 12,783 women) aged 40-69 years. During 11.8 years of follow-up, 101 subjects (69 men and 32 women) were newly diagnosed with HCC. Case patients were grouped according to consumption of isoflavones and soy products and stratified by hepatitis virus infection. Hazard ratios (HRs) and 95% confidence intervals (CIs) for HCC were calculated by Cox proportional-hazards modeling. In women, genistein and daidzein were dose-dependently associated with an increased risk of HCC, with multivariable HRs for the highest versus lowest tertile of 3.19 (95% CI = 1.13-9.00, P-trend = 0.03) and 3.90 (95% CI = 1.30-11.69, P-trend = 0.01), respectively. No association between isoflavones and HCC was observed in men. These results persisted when analysis was restricted to subjects positive for either or both hepatitis C and B virus. In conclusion, isoflavone consumption may be associated with an increased risk of HCC in women. Women with hepatitis virus infection may be advised to abstain from isoflavone consumption. Further studies are warranted to confirm these findings. (C) 2008 Wiley-Liss, Inc.