A cohort study of systemic lupus erythematosus for elucidating the association between intake of isoflavones and prognosis

目的：目的：探讨豆制品、大豆酮等营养素摄入与女性系统性红斑狼疮（SLE）活动性疾病和血管损害的关系。方法：收集1995年基线调查的279例女性SLE患者的临床和问卷资料。使用日本食物组成标准表（第5版）中的值估计膳食营养素，并基于狼疮活动标准计数（LACC）评价疾病活动。对患者进行了10年（1995-2005）的随访，并确定了疾病活动性和主要器官损伤发生率的变化。使用216例非活动性患者的数据，这些患者的饮食数据在基线时是完整的，评估了每种营养素摄入与活动性疾病发生的关联。饮食与3种类型的血管损伤（缺血性心脏病，脑血管意外，血栓性事件）的发展的关系进行了检查，在196例患者谁一直不活跃，没有这些damages.Results的既往病史：在216例不活跃的患者，43例患者在1995-1999年期间发展为活动性疾病。比例风险模型包括每种营养素三分位数的指标变量、总能量和混杂变量，显示豆制品和大豆酮的摄入与活动性疾病的风险无显著相关性，尽管观察到其他一些营养素的摄入与活动性疾病的风险显著负相关：维生素B6（趋势p =0.04）和总膳食纤维（趋势p = 0.01）。另一方面，在196例既往无血管损伤史的非活动患者中，20例患者在1995-2005年期间发生了血管损伤。虽然在大豆制品和染料木素的最高三分位数下观察到血管损伤的适度风险升高，但统计检验显示这些营养素的摄入量与血管损伤风险之间没有线性相关性。

Objective: To investigate the associations of intake of soy products, isoflavones and other nutrients with the occurrences of active disease and vascular damage in female patients with systemic lupus erythematosus (SLE).Methods: Clinical and questionnaire data were collected from 279 female patients with SLE in a 1995 baseline survey. Dietary nutrients were estimated using values from the Standard Table of Food Composition in Japan, 5th edition, and disease activity was evaluated based on the Lupus Activity Criteria Count (LACC). The patients were followed over 10 years (1995-2005), and changes in disease activity and occurrences of major organ damages were determined. Using the data from 216 inactive patients whose dietary data were complete at baseline, the association of each nutrient intake with the occurrence of active disease was evaluated. The relation of diet with the development of 3 types of vascular injury (ischemic heart disease, cerebrovascular accident, thrombotic events) was examined in 196 patients who had been inactive with no prior history of these damages.Results: Among 216 inactive patients, 43 patients developed active disease during 1995-1999. The proportional hazard model including indicator variables for tertiles of each nutrient, total energy, and confounding variables revealed no significant association of intake of soy products and isoflavones with the risk of active disease, although a significant inverse association was observed for intake of some other nutrients: vitamin B6 (p for trend=0.04) and total dietary fiber (p for trend=0.0l). On the other hand, among 196 patients who had been inactive with no prior history of vascular damages, 20 patients developed vascular injury during 1995-2005. Although a modest risk elevation of vascular injury was observed at the highest tertile of soy products and genistein, the statistical test showed no linear association between intake of these nutrients and the risk of vascular injury.