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Plasma enterolactone and risk of prostate cancer in middle-aged Swedish men. Eur J Nutr 2017; 57:2595-2606. [PMID: 28884432 PMCID: PMC6182673 DOI: 10.1007/s00394-017-1530-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 08/21/2017] [Indexed: 11/15/2022]
Abstract
Purpose Enterolactone (ENL) is formed in the human gut after consumption of lignans, has estrogenic properties, and has been associated with risk of prostate cancer. We examined the association between plasma ENL levels and prostate cancer in a nested case–control study within the population-based Malmö Diet and Cancer cohort. We also examined the association between plasma ENL and dietary and lifestyle factors. Methods The study population consisted of 1010 cases occurring during a mean follow-up of 14.6 years, and 1817 controls matched on age and study entry date. We used national registers (95%) and hospital records (5%) to ascertain cases. Diet was estimated by a modified diet history method. Plasma ENL concentrations were determined by a time-resolved fluoroimmunoassay. Odds ratios were calculated by unconditional logistic regression. Results There were no significant associations between plasma ENL and incidence of all prostate cancer (odds ratio 0.99 [95% confidence interval 0.77–1.280] for the highest ENL quintile versus lowest, p for trend 0.66). However, in certain subgroups of men, including men with abdominal obesity (p for interaction = 0.012), we observed associations between high ENL levels and lower odds of high-risk prostate cancer. Plasma ENL was positively associated with consumption of high-fibre bread, fruit, tea, and coffee; with age, and with height, while it was negatively associated with smoking and waist circumference; however, although significant, all associations were rather weak (r ≤ |0.14|). Conclusion ENL concentration was not consistently associated with lower prostate cancer risk, although it was weakly associated with a healthy lifestyle. Electronic supplementary material The online version of this article (doi:10.1007/s00394-017-1530-z) contains supplementary material, which is available to authorized users.
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Alves Dias J, Hellstrand S, Ericson U, Gullberg B, Nilsson J, Alm R, Persson M, Engström G, Nordin Fredrikson G, Hedblad B, Wirfält E. Plasma variation and reproducibility of oxidized LDL-cholesterol and low-grade inflammation biomarkers among participants of the Malmö Diet and Cancer cohort. Biomarkers 2016; 21:562-71. [PMID: 27075407 DOI: 10.3109/1354750x.2016.1160431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT Large epidemiological studies often collect non-fasting samples, although the reliability of biomarkers may be uncertain. OBJECTIVE To explore the reliability and reproducibility of a single measurement of selected biomarkers in a sub-sample of the Malmö Diet and Cancer cohort. METHODS We estimated single- and average-measures intraclass correlation coefficients (ICC) for oxidized (ox)-LDL, interleukin (IL)-1β, IL-6, IL-8 and TNF-α. RESULTS Single-measures ICC in non-fasting samples of ox-LDL, IL-1β, IL-6, IL-8 and TNF-α were the following: 0.85, 0.71, 0.61, 0.78 and 0.66 for men, and 0.67, 0.81, 0.87, 0.69 and 0.81 for women. Biomarkers at non-fasting and fasting samples were highly correlated (all r > 0.80). CONCLUSIONS The observed ICC suggest that most of the examined biomarkers (non-fasting blood) would allow meaningful analysis in epidemiological studies.
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Affiliation(s)
- Joana Alves Dias
- a Department of Clinical Sciences in Malmö , Clinical Research Centre (CRC), Lund University , Lund , Sweden
| | - Sophie Hellstrand
- a Department of Clinical Sciences in Malmö , Clinical Research Centre (CRC), Lund University , Lund , Sweden
| | - Ulrika Ericson
- a Department of Clinical Sciences in Malmö , Clinical Research Centre (CRC), Lund University , Lund , Sweden
| | - Bo Gullberg
- a Department of Clinical Sciences in Malmö , Clinical Research Centre (CRC), Lund University , Lund , Sweden
| | - Jan Nilsson
- a Department of Clinical Sciences in Malmö , Clinical Research Centre (CRC), Lund University , Lund , Sweden
| | - Ragnar Alm
- a Department of Clinical Sciences in Malmö , Clinical Research Centre (CRC), Lund University , Lund , Sweden
| | - Margaretha Persson
- a Department of Clinical Sciences in Malmö , Clinical Research Centre (CRC), Lund University , Lund , Sweden
| | - Gunnar Engström
- a Department of Clinical Sciences in Malmö , Clinical Research Centre (CRC), Lund University , Lund , Sweden
| | - Gunilla Nordin Fredrikson
- a Department of Clinical Sciences in Malmö , Clinical Research Centre (CRC), Lund University , Lund , Sweden
| | - Bo Hedblad
- a Department of Clinical Sciences in Malmö , Clinical Research Centre (CRC), Lund University , Lund , Sweden
| | - Elisabet Wirfält
- a Department of Clinical Sciences in Malmö , Clinical Research Centre (CRC), Lund University , Lund , Sweden
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Cardet JC, Johns CB, Savage JH. Bacterial metabolites of diet-derived lignans and isoflavones inversely associate with asthma and wheezing. J Allergy Clin Immunol 2014; 135:267-9. [PMID: 25190319 DOI: 10.1016/j.jaci.2014.07.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 07/14/2014] [Accepted: 07/17/2014] [Indexed: 11/19/2022]
Affiliation(s)
- Juan-Carlos Cardet
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Christina B Johns
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, Mass
| | - Jessica H Savage
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.
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Landberg R, Marklund M, Kamal-Eldin A, Åman P. An update on alkylresorcinols – Occurrence, bioavailability, bioactivity and utility as biomarkers. J Funct Foods 2014. [DOI: 10.1016/j.jff.2013.09.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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5
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Validation of FFQ-based assessment of dietary lignans compared with serum enterolactone in Swedish women. Br J Nutr 2012; 109:1873-80. [DOI: 10.1017/s000711451200387x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The validity of using FFQ to assess dietary lignans is uncertain. We aimed to validate the use of FFQ for the assessment of dietary intake of lignans compared to the serum biomarker enterolactone, the main product of dietary lignans' metabolism in human subjects. A random sample of women, aged 55–75 years, from the Swedish Mammography Cohort was selected. Information from two FFQ, the FFQ-87 (sixty-seven food items) and the FFQ-97 (ninety-three food items), and blood samples were collected. Dietary intake of lignans (secoisolariciresinol, matairesinol, lariciresinol, pinoresinol, medioresinol and syringaresinol) was assessed by the FFQ. Serum concentrations of enterolactone were analysed by time-resolved fluoroimmunoassay. The correlation coefficient between energy-adjusted lignan intake and serum enterolactone was estimated in crude and multivariable-adjusted models, taking into account the factors potentially influencing the serum enterolactone. Among the 135 participants aged 55–75 years, with a mean BMI of 26·7 kg/m2, the average energy-adjusted intake of total lignans was 1616 (sd 424) and 1516 (sd 409) μg/d according to the FFQ-87 (forty-five food items containing lignans) and the FFQ-97 (sixty-five food items containing lignans), respectively. The mean concentration of serum enterolactone was 23·2 (sd 15·4) nmol/l. The adjusted Pearson's correlation between dietary intake of lignans assessed by the FFQ-97 and serum enterolactone was statistically significant (r 0·22, P= 0·01). No significant correlation was observed for the FFQ-87 (r 0·09, P= 0·30). The present study indicates that the FFQ-97 might be better than the FFQ-87 for assessing dietary intake of lignans, although the correlation was low.
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Analysis of prostate cancer association with four single-nucleotide polymorphisms from genome-wide studies and serum phyto-estrogen concentrations. Prostate Cancer Prostatic Dis 2012; 15:365-8. [DOI: 10.1038/pcan.2012.24] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Peñalvo JL, López-Romero P. Urinary enterolignan concentrations are positively associated with serum HDL cholesterol and negatively associated with serum triglycerides in U.S. adults. J Nutr 2012; 142:751-6. [PMID: 22378329 DOI: 10.3945/jn.111.150516] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Fiber-rich diets are associated with favorable lipid profiles, but the specific compounds and the mechanisms behind this effect are yet to be fully understood. Lignans are fiber-related polyphenols that have been associated with lower prevalence of cardiovascular disease. The objective of this study was to investigate the relationship between dietary lignan exposure, measured as the urinary concentration of their metabolites, enterolactone and enterodiol, and serum lipids in a representative sample of U.S. adults. We carried out a cross-sectional analysis of data from 1492 adults who participated in the 1999-2004 NHANES. The mean urinary concentration of enterolignans in U.S. adults was 1.9 μmol/L. The multivariate-adjusted mean differences comparing the highest and lowest enterolignan tertile were 0.06 mmol/L for HDL cholesterol and -0.17 mmol/L for TG (P < 0.05). In spline regression models, we also found an inverse association between serum TG and urinary enterolignan concentrations. Serum HDL cholesterol levels increased linearly with increasing enterolignan concentrations. Modest or no associations were found between enterolignan concentrations and serum LDL cholesterol or total cholesterol. In conclusion, enterolignan concentrations are associated with lower serum TG concentrations and greater HDL cholesterol concentrations in U.S. adults.
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Affiliation(s)
- José L Peñalvo
- Area of Epidemiology and Population Genetics, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain.
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Andersson A, Marklund M, Diana M, Landberg R. Plasma alkylresorcinol concentrations correlate with whole grain wheat and rye intake and show moderate reproducibility over a 2- to 3-month period in free-living Swedish adults. J Nutr 2011; 141:1712-8. [PMID: 21775523 DOI: 10.3945/jn.111.139238] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Plasma alkylresorcinols (AR) are useful as dietary biomarkers of wheat and rye whole grain (WG) during interventions but need to be validated in free-living populations. This study estimated the medium-term reproducibility and relative validity of plasma AR as biomarkers of WG and cereal fiber intake. Seventy-two Swedish adults kept 3-d weighed food records on 2 occasions 2-3 mo apart. Of these men and women, 51 provided a fasting blood sample at the end of each occasion. In addition, 18 participants provided 3 fasting and 3 nonfasting samples for 3 consecutive days on the first and second occasions, respectively. Dietary and blood variables did not differ between the 2 occasions. Nonfasting plasma total AR concentration [210 nmol/L (95% CI: 140, 314)] was higher than fasting [99 nmol/L (95% CI: 72, 137)] (P < 0.0001). Mean WG intake was 70 ± 61 g/d (41% from rye) and the intra-class correlation coefficient was 0.44 (95% CI: 0.26, 0.63) for total WG intake and 0.47 (95% CI: 0.27, 0.67) for the fasting plasma total AR concentration, suggesting moderate reproducibility. Fasting plasma total AR moderately correlated with WG rye + wheat (r(s) = 0.53; P < 0.001) and cereal fiber intake (r(s) = 0.32; P < 0.05) when using mean values from both occasions. This suggests that plasma AR concentration in fasting samples can be used as a biomarker of rye + wheat WG intake in free-living populations with a high and consistent WG intake.
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Affiliation(s)
- Agneta Andersson
- Department of Food, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
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Fabian CJ, Kimler BF, Zalles CM, Klemp JR, Petroff BK, Khan QJ, Sharma P, Setchell KDR, Zhao X, Phillips TA, Metheny T, Hughes JR, Yeh HW, Johnson KA. Reduction in Ki-67 in benign breast tissue of high-risk women with the lignan secoisolariciresinol diglycoside. Cancer Prev Res (Phila) 2010; 3:1342-50. [PMID: 20724470 PMCID: PMC2955777 DOI: 10.1158/1940-6207.capr-10-0022] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Preclinical and correlative studies suggest reduced breast cancer with higher lignan intake or blood levels. We conducted a pilot study of modulation of risk biomarkers for breast cancer in premenopausal women after administration of the plant lignan secoisolariciresinol given as the diglycoside (SDG). Eligibility criteria included regular menstrual cycles, no oral contraceptives, a >3-fold increase in 5-year risk, and baseline Ki-67 of ≥2% in areas of hyperplasia in breast tissue sampled by random periareolar fine-needle aspiration (RPFNA) during the follicular phase of the menstrual cycle. SDG (50 mg/d) was given for 12 months, followed by repeat RPFNA. The primary end point was change in Ki-67. Secondary end points included change in cytomorphology, mammographic breast density, serum bioavailable estradiol and testosterone insulin-like growth factor-I and IGF-binding protein-3, and plasma lignan levels. Forty-five of 49 eligible women completed the study with excellent compliance (median = 96%) and few serious side effects (4% grade 3). Median plasma enterolactone increased ∼9-fold, and total lignans increased 16-fold. Thirty-six (80%) of the 45 evaluable subjects showed a decrease in Ki-67, from a median of 4% (range, 2-16.8%) to 2% (range, 0-15.2%; P < 0.001, Wilcoxon signed rank test). A decrease from baseline in the proportion of women with atypical cytology (P = 0.035) was also observed. Based on favorable risk biomarker modulation and lack of adverse events, we are initiating a randomized trial of SDG versus placebo in premenopausal women.
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Affiliation(s)
- Carol J Fabian
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas 66160-7418, USA.
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Enterolactone and breast cancer: methodological issues may contribute to conflicting results in observational studies. Nutr Res 2010; 30:667-77. [DOI: 10.1016/j.nutres.2010.09.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Revised: 09/14/2010] [Accepted: 09/14/2010] [Indexed: 11/23/2022]
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Kotsopoulos J, Tworoger SS, Campos H, Chung FL, Clevenger CV, Franke AA, Mantzoros CS, Ricchiuti V, Willett WC, Hankinson SE, Eliassen AH. Reproducibility of plasma and urine biomarkers among premenopausal and postmenopausal women from the Nurses' Health Studies. Cancer Epidemiol Biomarkers Prev 2010; 19:938-46. [PMID: 20332276 DOI: 10.1158/1055-9965.epi-09-1318] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Temporal variability of biomarkers should be evaluated before their use in epidemiologic studies. METHODS We evaluated the reproducibility, using intraclass correlation coefficients (ICC), of 77 plasma and 9 urinary biomarkers over 1 to 3 years among premenopausal (n = 40) and postmenopausal (n = 35-70) participants from the Nurses' Health Study and Nurses' Health Study II. RESULTS Plasma and urinary stress hormones and melatonin were measured among premenopausal women, whereas melatonin and the remaining biomarkers were measured in postmenopausal women. ICCs were good to excellent for plasma carotenoids (0.73-0.88), vitamin D analytes (0.56-0.72), bioactive somatolactogens (0.62), soluble leptin receptor (0.82), resistin (0.74), and postmenopausal melatonin (0.63). Reproducibility was lower for some of the plasma fatty acids (0.38-0.72), matrix metalloproteinases (0.07-0.91), and premenopausal melatonin (0.44). The ICCs for plasma and urinary phytoestrogens were poor (< or = 0.09) except for enterolactone (plasma, 0.44; urinary, 0.52). ICCs for the stress hormones among premenopausal women ranged from 0 (plasma cortisol) to 0.45 (urinary dopamine). CONCLUSIONS Our results indicate that for the majority of these markers, a single measurement can reliably estimate average levels over a 1- to 3-year period in epidemiologic studies. For analytes with fair to good ICCs, reproducibility data can be used for measurement error correction. Analytes with poor ICCs should only be used in settings with multiple samples per subject or in populations in which ICCs are higher. IMPACT This article summarizes the feasibility of the use of >80 biomarkers in epidemiologic studies in which only one biospecimen is available to represent longer term exposure.
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Sonestedt E, Ivarsson MIL, Harlid S, Ericson U, Gullberg B, Carlson J, Olsson H, Adlercreutz H, Wirfält E. The protective association of high plasma enterolactone with breast cancer is reasonably robust in women with polymorphisms in the estrogen receptor alpha and beta genes. J Nutr 2009; 139:993-1001. [PMID: 19321582 DOI: 10.3945/jn.108.101691] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
It is plausible that polymorphisms in the estrogen receptor alpha and beta genes (ESR1 and ESR2) may modulate the association between enterolactone and breast cancer. Seven polymorphisms in ESR1 (rs827422, rs1709184, rs2347867, rs3020328, rs72207, rs2982896, and rs2234693) and 5 polymorphisms in ESR2 (rs915057, rs1269056, rs1256033, rs3020450, and rs3020443) were selected. The risk of breast cancer for these polymorphisms was estimated among 542 cases and 1076 matched controls from the population-based Malmö Diet and Cancer cohort. The joint effect of these polymorphisms and enterolactone was estimated among those individuals about whom we had information on enterolactone blood concentration (365 cases and 728 controls). Breast cancer risk was not significantly associated with any of the selected polymorphisms. We found a tendency for an interaction between a polymorphism in intron 3 of ESR1 (rs2347867) and enterolactone concentration (P = 0.07). Breast cancer and enterolactone concentration were not associated among those homozygous for the major allele (A) (P = 0.93), whereas we found an inverse association among carriers of the minor allele (G) (P = 0.007). None of the other polymorphisms seem to modify the association between enterolactone and breast cancer. This study suggests that the protective association of enterolactone is reasonably robust across the investigated genotypes. The suggested interaction between enterolactone concentration and rs2347867 needs to be confirmed in larger samples.
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Affiliation(s)
- Emily Sonestedt
- Department of Clinical Sciences, Nutrition Epidemiology, Lund University, SE-20502 Malmö, Sweden.
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Landberg R, Kamal-Eldin A, Andersson SO, Johansson JE, Zhang JX, Hallmans G, Aman P. Reproducibility of plasma alkylresorcinols during a 6-week rye intervention study in men with prostate cancer. J Nutr 2009; 139:975-80. [PMID: 19321581 DOI: 10.3945/jn.108.099952] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Alkylresorcinols (AR), phenolic lipids exclusively present in the outer parts of wheat and rye grains, have been proposed as concentration biomarkers of whole-grain wheat and rye intake. A key feature of a good biomarker is high reproducibility, which indicates how accurately a single sample reflects the true mean biomarker concentration caused by a certain intake. In this study, the short- to medium-term reproducibility of plasma AR was determined using samples from a crossover intervention study, where men with prostate cancer (n = 17) were fed rye whole-grain/bran or refined wheat products for 6-wk periods. AR homologs C17:0 and C21:0 differed between the treatments (P < 0.001). The reproducibility determined by the intraclass correlation coefficient (ICC) was high (intervention period 1: ICC = 0.90 [95% CI = 0.82-0.98], intervention period 2: ICC = 0.88 [95% CI = 0.78-0.98]). The results show that a single fasting plasma sample could be used to estimate the mean plasma AR concentration during a 6-wk intervention period with constant intake at a precision of +/- 20% (80% CI). This suggests that the plasma AR concentration can be used as a reliable short- to medium-term biomarker for whole-grain wheat and rye under intervention conditions where intake is kept constant.
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Affiliation(s)
- Rikard Landberg
- Department of Food Science, Swedish University of Agriculture Science, SE-75007 Uppsala, Sweden.
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Sonestedt E, Borgquist S, Ericson U, Gullberg B, Olsson H, Adlercreutz H, Landberg G, Wirfält E. Enterolactone Is Differently Associated with Estrogen Receptor β–Negative and –Positive Breast Cancer in a Swedish Nested Case-Control Study. Cancer Epidemiol Biomarkers Prev 2008; 17:3241-51. [DOI: 10.1158/1055-9965.epi-08-0393] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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